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How and when to break up with your doctor

The doctor-patient relationship is an important one, but it's not always forever. Knowing when to cut the cord is key to your health.
/ Source: TODAY

The doctor-patient relationship is an important one. But it’s not always forever and it's key to know when it's run its course. Many people get attached to their doctors and find it difficult to separate.

Here are three situations when it's time to re-think the relationship and break up with your doctor:

1. You’re too old for a pediatrician

Are you 24 and still seeing your pediatrician? It’s time to cut the cord. Every kid outgrows the pediatrician at some point — exactly when that happens can vary. Most pediatricians treat patients until they are between 18 and 21 years old. If you're a parent, it pays to discuss the transition with your pediatrician as your kids hit puberty.

Among the questions to ask are:

  • At what age does the doctor typically stop treating patients?
  • How many teenagers are in the practice?
  • What’s the policy about private discussions and confidentiality?
  • How does the doctor handle physical exams, OB/GYN care and contraceptive care?

2. You need to rely more on a specialist

You don’t really need to break up with your primary care physician (PCP).

“Think of your PCP as the mayor of your medical town,” Dr. Sally Mravcak, a physician with Vanguard Medical Group, told TODAY. “Your PCP will provide your routine care, preventive care and treatment for common illnesses. They should coordinate your care, but you may need to start relying more on a specialist for most of your health care needs once it gets out of the scope of your physician.”

For many women, their OB/GYN can take care of some of their basic health care needs and screenings.

When it comes to the following, it’s time to see a specialist:

  • A life-changing diagnosis— for example, if you’re told you have rheumatoid arthritis, diabetes, Parkinson’s disease, and/or have suffered a stroke
  • A complex chronic condition — if you have cardiomyopathy (a heart muscle disease), pulmonary hypertension (high blood pressure that affects both heart and lung arteries), and frequent seizures.
  • A rare disease — such as cystic fibrosis, Huntington’s disease, or muscular dystrophy.

3. Your styles don't match

The doctor-patient relationship depends on trust. Doctors also may differ in therapeutic approach. A patient who values conservative modern medical interventions wouldn't be best matched with a doctor who is aggressive in treatment recommendations. In these cases, finding a doctor who is a personality and value match, or at least one who respects your approach to health management, is also important.

These scenarios can be warning signals:

  • You can’t get an appointment when you need to — you run on a tight schedule, but the doctor is very late or cancels at the last minute
  • The doctor fails to explain your condition, treatment, or options for care — you want to know why the doctor is prescribing certain medications or ordering tests, but the doctor gives you short, dismissive answers.
  • You can’t trust or be honest with your doctor— you end up leaving the doctor’s office confused.
  • Your doctor doesn’t collaborate well with other physicians to coordinate care.

When your doctor breaks up with you

It can be difficult to say goodbye to a doctor you have grown to like. So why would your specialist or doctor breakup with you?

  • The treatment plan is over — patients can be referred to specialists for many reasons, but after their treatment is done, the specialist will have the patient return to their PCP for continuation of care.
  • The doctor moves or retires, or there's an insurance change — when your doctor is leaving, it’s best to be prepared. Be sure to:
    • Secure your medical records.
    • Find out if you're covered — consult your insurance provider for a list of healthcare professionals in your area.
    • Ask for a referral— If your doctor is leaving, check to see if there's another doctor within the practice you can see.

"Can my doctor dismiss me?" The answer is yes — it's legal and fair for a doctor to "fire" a patient under many circumstances, said Mravcak. It can happen if:

  • You fail to keep appointments — from the provider's perspective, that means a window of no income, or a patient who isn't getting the help she needs.
  • You fail to follow the treatment recommendations — this is why it is so important that you and your doctor make treatment decisions together.
  • You're rude to the doctor or their staff — just as patients should fire a doctor who behaves this way, it's fair a doctor should fire a patient for such poor behavior, too.

Finding a new doctor isn't always easy, and jumping from physician to physician could create gaps in your treatment. If you do decide to leave your doctor, it's important to make sure your personal medical records, including physician notes, test results, and other relevant medical information, are transferred to your new doctor.