The Power of No

In the last year there are whole populations of people that are beginning to say no, many for the first time in their lives. But one area of our lives where people seem to be hesitant to say no is when it comes to sitting in front of their doctor. I was just visiting with two of my favorite people, Clare and Alan. I love how Clare rolls her eyes and says the most insightful things while a visit is never complete until Alan tells a great joke, which usually prompts the eye rolling from Clare.

Clare was expressing her concern that someone she knows is terrified because she has a chronic heart condition (she is 88) and her doctor’s office called to say they wanted her to have a chemical stress test which involves injecting chemicals into a vein to force the heart to act as though it is under stress. Her friend was not only terrified, but had not been told by her cardiologist that it was necessary, nor explained it to her, nor said why she needed it at this point. She lives alone and doesn’t drive, so she has to make extensive arrangements to go to each appointment and the idea of being injected with chemicals practically brought her to tears. If the doctor’s office was trying to create stress, they certainly succeeded.

Recently medical offices are creating a “norm” of people having to return again and again for appointments removing the patient’s input about what is best for them. Driven by insurance companies, doctor’s offices are seeing patients so often that wait times can be hours and most doctors are having to reduce the number of patients they have. Now insurance companies are even sending people into a patient’s home to do a health risk assessment, verify their medications and question their compliance with testing recommendations. Now medical record keeping is shared among thousands of practitioners and nothing is just between you and your doctor. So privacy is really just an illusion when it comes to the medical system.

One patient said to me that she didn’t want to have a mammogram and her insurance company was calling her constantly trying to push her into changing her mind. She was worried they would deny her coverage simply because she wouldn’t comply with their demands about a flu shot, a mammogram and wanting to know what pharmacy she used.

This is a clear example of when we need to remember that we always retain the right to say no. Just because the medical system says that the computer has notified them that a test should be done doesn’t mean you have to have that test. You don’t have to justify why you choose to live your life and conduct your health in a specific way, particularly if you have no applicable health history. It is very important that we remember that we are the decision makers when it comes to our health.

A good example of this are the numerous patients who tell me how much of a difference the natural remedies and therapies I have recommended have made. But they don’t want to tell their doctor because the doctor has made it clear they think natural medicine is useless at best and dangerous at its worst. Your doctor works for you - you pay them for their professional opinion so that you can make an informed decision about your health and your care. This means that you should ask questions and never feel pressured to do something you don’t feel is right for you.

Asking questions is very important because you need to understand the why. If you are being told that you “need” to have a test, ask why? How will the outcome benefit you and what would the next steps be after the outcome. Many times my mother has been told by a doctor to have a test, but when we asked why, it would often be just to see if something was worsening. But my mother already knew if something was worsening. What treatment would be provided if the outcome was that things were worsening? There was no treatment or the treatment option was one my mother did not want to do. So then what is the point of the test?

Another consideration is that every test you have is recorded in your medical record and insurance companies are constantly combing through medical records looking for red flags of potential future illness expenditure. Even though it is illegal for an insurance company to deny coverage for a pre-existing condition, they can often find ways to do that based on your current health or your failure to follow doctor recommendations, such as prescriptions or diagnostic procedures.

So many of my patients do not want to be taking their prescription medication because once you are put on a medication, doctors are very, very, very reluctant to take you off (unless it is a specific dose time such as an antibiotic). The burden of proof is on you to convince the doctor that you don’t need it. So many patients become so frustrated that they just stop taking the medication altogether, particularly if there are difficult side effects.

Another issue is that no one seems to really take the time to explain to you exactly what to expect with a procedure or test. My sister complained quite correctly that she was given one group of preparatory guidelines by the doctor’s office, but when she arrived for her test she was told that what she had been told was completely wrong. She was also told it wouldn’t hurt and it was one of the most painful things she had ever experienced, leaving her shaking and crying. She had been told she could drive herself with no problem, but after the procedure she couldn’t even feel her feet and couldn’t drive at all.

So what to do?
Say no.
Say I want time to think about this.
Ask why?
Ask questions.
Record your appointment session so you don’t have to remember what the doctor has said.
Research the recommendation you are being given.
If it’s a test or a procedure, look it up and watch a YouTube video of it.

You are the one who is in control. You are the one who decides what makes sense to you which means do not agree to something you don’t understand or don’t want. During the winter we don’t want to take my mother out to doctor’s appointments because her risk of falling is much greater. So we just say no when they say they want to see her in 3 months.

We used to only go to the doctor when we had a problem. The increase in diagnostic detection is a great asset, but it doesn’t mean we all have to have every test or every vaccine or every procedure. Medications can be life-saving, but a patient should be provided the opportunity to try and go off a medication periodically, not just to see if their body can regulate itself without it, but also to give the body a break from the controlling effects of a medication. Once we see a specialist, we shouldn’t have to return to them over and over every few months unless we have a chronic, unstable condition that warrants it.

But most importantly we should be able to tell our doctors very private things and be confident that it is not being recorded for thousands of people to see for years to come. We need to take back our responsibility for our own decision-making. We don’t need permission to say no.