Hitting a Nerve

An unwelcome second opinion


“Why did the other doctor say that?”

I get that question here and there, and it’s always irritating. How should I know?

Generally it’s referring to something they say their family doctor told them: A scan that showed normal pressure hydrocephalus or multiple sclerosis, but when I actually get the neuroradiologist’s report it was normal. Sometimes it’s an alleged side effect from a drug for which I can find nothing in the literature or something that requires urgent surgery in spite of all objective evidence to the contrary.

Dr. Allan M. Block, a neurologist is Scottsdale, Ariz.

Dr. Allan M. Block

These appointments are always frustrating. The patient is upset that what they’ve been told (or at least think they’ve been told) is incorrect. They’ve spent a few weeks doing medical research on Google for a condition they don’t have. They’re angry at me for shooting them down. They’re angry at the person who referred them for not being right. They’re angry that they wasted their time coming to me.

And then they ask me why the other doctor said that. I wasn’t there. I don’t know. Medicine is a less-than-perfect science. Maybe they were looking at the wrong report. Maybe they’d gotten an incorrect “wet read” by phone. (How many doctors today even know where the term came from?) Maybe they were having a bad day, were overwhelmed, and misread something.

There’s also the possibility that the other doctor didn’t say it at all. Many people will only hear what they want to hear. Or they’ve already decided what they have and are claiming “the other doctor” told them just to give credence to it, even if it’s not true.

Such visits often end on an ugly note. The patient doesn’t want to be billed because I didn’t say what they wanted me to say. Or pay a copay. Or just get up and leave.

I try, very hard, to be polite when this happens. I don’t know what really went on at the other office – if what’s claimed even happened at all. Even if the patient is telling the truth, all doctors, like all people, make mistakes. It’s not like they were trying to be wrong or deceptive. I don’t fault my colleagues if they make an error, and hope they feel the same way about me.

But it’s still frustrating when it occurs. In many cases I’m left dictating a polite note back to the referring physician, explaining what happened. I chalk it up to a communication error, or experience, or even just a difficult patient. I never really know for sure.

I don’t think any of us are here to willfully deceive patients. We want to do our best for them. It’s frustrating when something happens to lead them to believe otherwise.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

Recommended Reading

As pandemic regs expire, states get tougher on telehealth: report
MDedge Neurology
Note to self: Relax!
MDedge Neurology
Physicians react: Should docs lose their licenses for spreading false COVID information?
MDedge Neurology
Survey: Medical cannabis use for skin conditions lags behind interest, acceptance
MDedge Neurology
Learning to coexist
MDedge Neurology
When the patient wants to speak to a manager
MDedge Neurology
Pandemic weighing on physicians’ happiness outside of work: survey
MDedge Neurology
Physician burnout, depression compounded by COVID: Survey
MDedge Neurology
Seven ways doctors could get better payment from insurers
MDedge Neurology
This doc still supports NP/PA-led care ... with caveats
MDedge Neurology