I was raised to believe that all doctors were very smart. That they all knew everything that was necessary to keep us well and to heal us if and when we became ill. This belief began with our family doctor (who actually made house calls) and was extrapolated to include anyone practicing medicine – any doctor. This was and is, of course, preposterous as a supposition. There are good plumbers and not-so-good ones, better and worse carpenters, auto mechanics and hairdressers. A person’s education, profession, training and credentials do not eliminate the variable that each individual person brings to whatever it is they do – that key variable is themselves. So, truth be known, all doctors are not created equal! There are better ones, others who are not as good and still others whose practice boarders on the edges of bad medicine. This is the case in each and every specialty of modern medical practice. How are we to know the one from the other and what do we do when doctors who we believe to be both competent and reputably disagree about care that we need?
For the sake of this discussion, let us presume that the patient has done his/her homework. You have researched your medical providers, their training and track records with the procedure(s) they propose performing on your body. They all check out OK. Although, as I mentioned above, this confirmable information guarantees absolutely nothing about the outcome you will experience yourself, you feel that you have done your best to select the best possible medical people. (I am limiting the scope of this discussion to those licensed in the US to practice as “Physicians and Surgeons”, most commonly Medical Doctors (MDs) or Doctors of Osteopathy (ODs.) You seek out two opinions from those you feel are the two very best people you can find and – lo and behold – They disagree! One says that procedure “A” is the way to go, the other insists that procedure “B” is what you really need. What is a patient who needs help to do? A third opinion may well bring a third, still different, recommendation. How does one choose?
Most often, we choose using a function we all have that is generally referred to as ‘intuition.’ That is, our feeling about the person. This feeling and intuitive perception is influenced by many things – each one entirely subjective. How does s/he look? How do they present themselves? Their tone of voice, the lay out of their office, the way we experience their interpersonal manner – I have even talked with a woman who rejected one doctor because she felt that the woman wore too much jewelry. One man told me that he decided against one medical recommendation because the doctor who made it wore open-toed shoes; Something that patient felt was tellingly inappropriate. What does any/all of this have to do with how well they handle a scalpel? Maybe everything and maybe nothing at all.
When doctors disagree you can do a lot of things. Talk with their former and current patients who will allow for it, speak with others who have had some of the proposed procedures performed, research credentials, etc, and lots more. Talk with your friends, family and people you have come to trust and whose judgment you respect. However, in the final analysis, you will decide based on what ‘feels’ like the right thing to you. Many people, facing medical disagreement, will opt for the recommendation which is the most consistent with and thus validates their own idea about their situation. Others may well opt for the opinion which offers the greatest degree of hope for full recovery. Still others will elect the doctor who sounds most realistically cautious and ego-free. To complicate matters even one step further – even the best doctor can have a really bad day. The selection is, again, entirely subjective.
To ask a second doctor for an opinion is to almost assure that you will have to choose. If not which procedure, then at least which doctor! The only way this dilemma can be fully avoided is to trust your own doctor – the one you consult with about the problem first, and to not ask another one! When it comes to medical treatment, there is rarely a guarantee of outcome – In fact, patients are required to sign an Informed Consent that acknowledges that they have been advised of all the risks, including death, of any medical procedure involving surgery. Then there is no dilemma – the situation is solved by the insertion of trust. All these caveats are not intended to discourage anyone from seeking appropriate medical treatment or from making every possible effort to secure the best care possible for themselves. It’s just a reminder. Life inevitably involves risk, and, however unfortunately, so does healing.