Monday, December 29, 2014

Don't be a nail just because your doctor is a hammer

A friend writes:
When my daughter was a year old, she was given a diagnosis of "Failure to Thrive." The definition is something like if your length percentile keeps growing but your weight percentile falls. Anyway she wasn't eating enough.

Her PCP sent us to a famous gastroenterologist who said he wanted to do an endoscopy. That would mean putting her under general anesthesia and a period in the hospital. I asked, "What are you looking for?" He said he wanted to see if her esophagus was inflamed.

I then asked, "What would you do about it if it is?" He said he would give her an antacid.

I said, "Is the antacid dangerous?" He said no.

So I refused the endoscopy and told him to prescribe the antacid. It was both a diagnostic and a treatment.

End of the story: It did nothing.

Moral of the story: Don't be a nail just because your doctor is a hammer.

P.S. The daughter is thriving . . . in college.


LG said...

Eloquent and to the point. My hope is that today this story would be a rarity--an exception not the rule. We still have a long way to go, however. Incentives have to align with quality and patients (and families) need to be health literate and confident to advocate for themselves. Maybe the moral is 'nobody should ever act like a tool…'

JBollen said...

20 years ago I doubt anyone other than another doc could have been able to have a conversation like that with a specialist.

Even now we have seen what can happen to parents who question the care given to their children at the largest childrens hospital in Boston (the Justin P case where the parents lost custody)