Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Doctors are hammers. Don’t automatically be their nails.

Michael Kirsch, MD
Physician
September 20, 2014
Share
Tweet
Share

Is your doctor a hammer and you’re a nail? Here’s some insider advice coaxing patients to be more wary and skeptical of medical advice. Should you trust your doctor? Absolutely. But you need to serve as a spirited advocate for your own health or bring one with you. Ask your physician for the evidence. Sometimes, his medical advice may result more from judgement and experience as there may not be available medical evidence to guide him. Make sure you have realistic expectations of the medical out me. And most importantly, try as best you can to verify that the proposed solution is targeted to your problem.

Consider a few hypothetical scenarios.

A 66-year-old patient has chronic right lower back pain. Physical therapy has not been helpful. Radiological studies show a moderate amount of hip arthritis. A hip replacement is flawlessly performed. The orthopedist discharges the patient from his practice. The pain is unchanged.

A 60-year-old patient has chest pains that are not typical for angina. Her internist arranges a stress test and the results are equivocal. A cardiologist performs a cardiac catheterization and a moderate narrowing is found in an artery. A stent is successfully placed in the proper location. The patient is reassured that her cardiac pipes are all wide open. She returns to see him a month later wondering why the pains have continued.

A 50-year-old patient sees his gastroenterologist for stomach pain. An ultrasound confirms the presence of gallstones. The patient accepts the specialists advice to have his gallbladder removed. The operation proceeds smoothly. You can guess the rest.

This is not meant to serve as an indictment of the medical profession. The examples above have been highly simplified to make a point.

First, making accurate diagnoses are complex undertakings that can frustrate even seasoned diagnosticians. Patients’ medical histories are often vague and evolving. Many diseases and conditions have clever mimics that can lead doctors astray. Every doctor can regale you with anecdotes detailing episodes when they have been fooled. There isn’t a medical doctor alive who hasn’t fumbled over a case of chest pain.

Just because medical advice doesn’t lead to the desired outcome, doesn’t mean that the advice was wrong. I concede, of course, that bad medical advice can cause adverse outcomes, a self-evident statement.

Despite the vagaries and uncertainties in the medical arena, physicians try as best we can to propose a remedy that is directed to your symptom, rather than serve as a fix for something that is not ailing you. My advice to patients is that when your doctor is raising the healing hammer, is to try not to get nailed.

Make sure this inquiry is in your toolbox: “Doctor, can you please explain why the treatment will cure the symptom that brought me to you in the first place?”

Maybe a hammer is the right tool for you. Without doubt, the time to have this conversation is in advance of pulling the treatment trigger. Having realistic expectations can prevent future frustration when a treatment doesn’t bring you to the end zone.

So, next time your physician proposes a plan of action, hammer away.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower. 

ADVERTISEMENT

Prev

Ebola: Don't forget the patients who are left behind

September 20, 2014 Kevin 1
…
Next

Not knowing what we don't know: How can we help doctors?

September 20, 2014 Kevin 4
…

Tagged as: Gastroenterology, Primary Care

Post navigation

< Previous Post
Ebola: Don't forget the patients who are left behind
Next Post >
Not knowing what we don't know: How can we help doctors?

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Michael Kirsch, MD

  • Are Ozempic patients on a slow-moving runaway train?

    Michael Kirsch, MD
  • AI-driven diagnostics and beyond

    Michael Kirsch, MD
  • The surprising truth behind virtual visits

    Michael Kirsch, MD

More in Physician

  • Why adults need to rediscover the power of play

    Anthony Fleg, MD
  • Physician patriots: the forgotten founders who lit the torch of liberty

    Muhamad Aly Rifai, MD
  • The child within: a grown woman’s quiet grief

    Dr. Damane Zehra
  • Why the physician shortage may be our last line of defense

    Yuri Aronov, MD
  • 5 years later: Doctors reveal the untold truths of COVID-19

    Arthur Lazarus, MD, MBA
  • The hidden cost of health care: burnout, disillusionment, and systemic betrayal

    Nivedita U. Jerath, MD
  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • Why adults need to rediscover the power of play

      Anthony Fleg, MD | Physician
    • Bird flu’s deadly return: Are we flying blind into the next pandemic?

      Tista S. Ghosh, MD, MPH | Conditions
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Why adults need to rediscover the power of play

      Anthony Fleg, MD | Physician
    • How collaboration across medical disciplines and patient advocacy cured a rare disease [PODCAST]

      The Podcast by KevinMD | Podcast
    • 5 cancer myths that could delay your diagnosis or treatment

      Joseph Alvarnas, MD | Conditions
    • When bleeding disorders meet IVF: Navigating von Willebrand disease in fertility treatment

      Oluyemisi Famuyiwa, MD | Conditions
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician
    • Why adults need to rediscover the power of play

      Anthony Fleg, MD | Physician
    • Bird flu’s deadly return: Are we flying blind into the next pandemic?

      Tista S. Ghosh, MD, MPH | Conditions
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Why adults need to rediscover the power of play

      Anthony Fleg, MD | Physician
    • How collaboration across medical disciplines and patient advocacy cured a rare disease [PODCAST]

      The Podcast by KevinMD | Podcast
    • 5 cancer myths that could delay your diagnosis or treatment

      Joseph Alvarnas, MD | Conditions
    • When bleeding disorders meet IVF: Navigating von Willebrand disease in fertility treatment

      Oluyemisi Famuyiwa, MD | Conditions
    • The hidden cost of becoming a doctor: a South Asian perspective

      Momeina Aslam | Education
    • Physician patriots: the forgotten founders who lit the torch of liberty

      Muhamad Aly Rifai, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Doctors are hammers. Don’t automatically be their nails.
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...