It's not you, it's me. A classic break-up line. However, this is something that can be used when you want to leave one physician's care for another.
Breaking up with a doctor and their care can be one of the hardest break-ups you face. Whether you've been with them for a long time or you only had one visit, you can feel guilty for wanting to leave them for a second opinion or wanting different care. I'm here to tell you that it's okay to break up and move on and how to do it.
Some doctors may take this personally. Doctors are human and like most of us they may not like rejection. It is important for you to remember that this is about you and not about your doctor. Hopefully your doctor will realize that too and understand your need for another opinion or a change to help you find your best path forward.
Here are the signs that you may want to break up with your doctor (in no particular order):
1. The care they have you on is not aggressive enough for your condition or disease
2. You are not seeing the results you want from your current care
3. You doctor is not listening to your wants, goals or concerns
4. You are moving, and want care closer to your new location
5. The doctor's office is not great at keeping up with your medication refills and/or developing medications
I'll explain these below:
1. The care they have you on is not aggressive enough for your condition or disease
You might have a doctor who is more passive in their care (only does routine blood work or medical exams or tests), does not do want to do anything but routine care, and continually says "Let's wait to see what happens next visit. This can be an issue. I had a GI doctor who was the nicest guy, easy to get into appointments, however, he had one way to treat Crohn's and was not open to anything else. When I started to have more and more issues, he did not want to change medications or do surgery for "too much risk". After I had too many issues and waiting around, I decided it was time to leave his care for someone who monitored my care closely and used different medications and methods to treat my specific needs.
2. You are not seeing the results you want from your current care
With each condition comes different results you want to see: some may want to see remission, some may want to see better quality of life, and others may want to see more superficial results. Whatever the case may be, if you are not seeing the results you want from your physician, after voicing your concerns, it may be time to look for new care.
3. Your doctor is not listening to your concerns and goals
Your care should be personal to you, and a physician should not only listen to your concerns about symptoms, but the goals of your care that are specific to you. It does not matter if you are trying to find the cause of your issues and obtain a diagnosis, or if you are trying to meet a goal based on your established medical condition, if a doctor is not listening to you, you may need to break up.
Concerns not being taken seriously can be dangerous, and you can break up with your physician, just for that. When I went to an internal medical doctor about concerns about passing out after walking up a flight of stairs, she dismissed it as nothing. I could have left it there, but after this kept happening I went to another doctor for a second opinion, which eventually led to my diagnosis of Pulmonary Hypertension (PH). If a doctor is not listening to you about your concerns and symptoms, you do not have to settle and can look elsewhere.
Your goals are unique to you, and may not be the same for each patient. While the goal for every patient is to get better, there are sustainable goals to meet in the meantime that you can talk to with your doctor to make sure that you are working towards a common goal. That is why it is important to find and keep a doctor who is on the same page as you.
For example, when diagnosed with PH, my first goal was to get my PH under control to be well enough to travel again. My doctor and I made a plan to start medication to make this possible, and check points and tests to make sure this would be safe and attainable.
4. You are moving, and want care closer to your new location
This may be the easiest reason to break up with your physician. It is not realistic to keep seeing a doctor who is not in your area, and have to travel to see them. It is also not safe to have care so far away, and you should have a physician closer to your new location. Your physician may also help you find a doctor near your new location, which would be very helpful if you do not know one already.
When I moved for school, I knew I needed a GI doctor in my new city in case anything would occur while I was there. While I was still going home for the summer and school breaks, it was best to establish care in my new city. When I informed my then GI doctor of my moving, he was more than happy to help me set up care with a physician there. I may not have ever told my doctor I moved back, but that's another story.
5. The doctor's office is not great at keeping up with your medication authorizations and refills and/or developing medications
This is a two-fold issue with medication.
First, your doctor (or their office) is not good at completing pre-authorizations for medications or refills. It does not matter if you take medication from a specialty pharmacy or from a pharmacy like Walgreens of CVS, getting prescriptions can be a pain if your doctor and his office is not compliant and timely.
For example, I take Humira, which each year needs a new pre-authorization from my doctor's office. I would get calls about not having a pre-authorization put in by my doctor, despite the pharmacy calling them months in advance. I would even call the doctor and ask for them to send it in, and they wouldn't do it. It would get to the point where I would call each day, and nothing got done. Eventually, they would get around to it, but this happened every year for 3 years. For me, this was a sign I needed new care.
Second, if your doctor is not keeping up with the newest medications, therapy and trials, it can be a red flag in your relationship. A doctor may be set in their ways and care, and may not be willing to recognize that other care may be best in your case. While other doctors are on top of their game, knowing the newest things out there that may improve your care.
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If you have any of the above signs, it may be time to consider breaking up with your doctor.
However, before you go down the path of breaking up with the doctor, if you are feeling frustrated with your care first take the time to ask yourself if it is really you that is the issue. Sometimes we can feel like an article in WebMD makes us an expert. We should not lose sight of the fact that doctors spend many years of their life learning how to treat us. While we should always strive to educate ourselves about our disease or diseases and openly discuss what we learn with our doctors, we should be open to listening to our doctors about why they are recommending the care they chose. If you still have questions or feel like there is another path to take, then it may be time for a new course of action.
If after all this, you have made the decision that changing care is in your best interest, then like most break ups, there are different ways of severing your ties to your doctor. My two methods though are the ghosting method or the lay it all out there method.
Much like in your dating life, using the ghosting method you could silently fade away from your doctor's care and never schedule another appointment with them again. Chances are either they will never even notice that you are gone, or after 2 times trying to reschedule you, they get the hint.
The lay it all out there method is just what it sounds like - you tell your doctor why it’s not working out. The problem with this method, like with some relationships, your doctor can say they'll change, be more attentive and meet your needs. You can give them another chance and hope for the best, but it may backfire and be back in the same situation again. The other downside to this method is that the physician may not care, and you are wasting your time with explanations.
It does not matter which method you choose to use, either gets you to the end goal - better care.
Just be aware, unlike most break ups there is one important difference... a back up. Before you leave one doctor's care, you should do your research on other doctors who may fit your needs better, and schedule an appointment with them before you leave your current care. This way you have no gaps in your care and not be under any physician care in case of an emergency.
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