#869 3 things you should not tell your new doctor - DOC

#869 3 things you should not tell your new doctor

Today on the Doc On The Run Podcast we’re talking about three things you should not tell your new doctor.



Today I’m about to drive to the airport, get on a plane, fly to Wisconsin to give five lectures on running injuries at a medical conference. And this is where I will be teaching physicians about the way I treat things like runners heel pain, about imaging strategies I use with athletes, and because I was finalizing that talk on medical imaging strategies for athletes, I was thinking about a conversation that I had yesterday with an athlete who’s had a very frustrating course and actually called me for a second opinion.

He’s had an injury that’s been going on for a long time. He’s seen several doctors. He’s tried a whole bunch of treatments and he’s had no improvement at all. And one of the things we were talking about is his medical imaging and he was going to send his MRI scans and his Xrays to me, so that during his second opinion call, we could get on webcam and actually go through them and talk about them in detail.

In short, he’s trying to get a second opinion from me specifically because I’ve worked with runners. The problem is that during that call, when he started just giving me a little bit of the background and he said he had these MRIs, he actually started to say, he said, “Well, the MRI says” and I just cut him off. I was like, “Stop, don’t talk, stop” and he said, “What, what’s wrong?”

I know it was kind of abrasive the way I said it, but I said, “Look, I’m going to a conference in a couple of days. And at those conferences, I tell all the physicians in the room that if they have a runner who is not really responding the way that they think the runner should given the treatments they’ve tried and what they think the diagnosis is, they can actually call me anytime they want and I’ll tell them how I would approach it.”

But I tell them, if you call me and you tell me what’s on the MRI report, or you tell me what the diagnosis is, I’m not going to listen to you. I’m going to tell you to call somebody else because you have to make sure that when you’re getting a second opinion, it is unbiased. You do not want the doctor thinking the wrong thing.

If somebody walked up to you at a cocktail party and said, “Hey, I want you to meet my ex-husband, he’s a real jerk.” Well, it would be very difficult to like meet him and have an unbiased first impression, right? You’d be thinking why is this guy a jerk? Let me find out. And when you call your you go to a doctor, a new doctor where you are going to get a second opinion, let’s say even if it was me, if you say. “Well, these are the things that I know” and you start to tell them things that you know like number one, you say that this is what the diagnosis is and when you say I’ve seen 15 doctors and every one of them says that I definitely have plantar fasciitis, it becomes very difficult to argue against 15 opinions from other doctors. The doctor is immediately going to think, well it must be plantar fasciitis, you must be doing something wrong.  Number one, don’t ever give them the diagnosis that you’ve been given by another doctor.

Number two, do not tell them what is on the Xray report because a radiologist is an expert who reviews Xrays, MRIs and CTS. They give an impression not a diagnosis, but they give an impression on the MRI report. And when you tell your new doctor who’s supposed to give you an unbiased opinion, what this expert believes, it becomes difficult for the doctor to really formulate an opinion based only on what has happened with you. It’s biased based on the information you’ve given them.

The third thing is the names of the doctor you’ve seen. This is a bad idea. So, for example, there’s a guy named Doc Dockery and he actually has written a couple of textbooks and he is the founder of the International Foot and Ankle Foundation. He has been respected for decades in our field. He was the valedictorian of his medical school class, right, so he’s definitely smarter than me. He definitely knows a lot more than me. And so if you said, “Hey, I saw this guy named Dockery and he said that I have this but I don’t think he knows what he’s talking about.” I would try to not roll my eyes and I would think, I know him very well. I have dinner with him several times a year. I know that he knows what he’s talking about.

If you think he doesn’t know what he’s talking about, you’re the problem not Dockery. At the same time, if you see a doctor who for example that I think is an idiot, well that also biases me. My bias would mean your favored because I would probably want to agree with you if I think an idiot, who I don’t like, gave you an opinion, but it’s still biased.

Remember, when you’re getting a second opinion, it’s crucial that you get a fresh set of eyes that takes their knowledge and expertise and applies it to your case and not what other people have applied to your case. So, those are the three things that you really should keep from a new doctor when you’re going in to get a second opinion so that you make sure you get an unbiased second opinion. After they’ve given you their opinion, if you want to tell them all the other stuff that you’ve been holding back and trying to keep from sharing just to make the visit shorter, go ahead and do that. But make sure you get an unbiased Second Opinion first.