Dealing with difficult doctors IX: the avoider
Here is another post from my recent book How to Talk To Your Child’s Doctor. It’s about how to handle a doctor whom I call an avoider.
Most of us are, to some degree, procrastinators. We avoid or postpone doing unpleasant things. In this sense, physicians who are avoiders are no different from anyone else. For a doctor, however, avoiding things often leads to poor, or at least less than frank, communication with parents.
One kind of avoidance behavior is when the doctor avoids answering your questions. These doctors do not behave this way because they are poor listeners; they just find it uncomfortable to answer your questions. Often this doctor takes the oblique approach of not quite answering the question you asked, and instead rephrasing it into a question he would rather answer. He tends to talk around issues, especially those that are part of serious, unpleasant, or intractable medical problems. He also tends to use euphemisms for unpleasant things, commonly retreating into medical jargon because medical language seems more sanitized and neutral.
I have considerable professional experience with avoiders because my own subspecialty of critical care often presents parents and physicians with difficult choices, situations in which there are sometimes no good options, just less bad ones. Many times I have spoken with parents who, after an interview with a physician who is an avoider, must ask me what the doctor really meant to say. And that is the key to the avoiding-type of physician: he probably thinks he is doing what is best by filtering what he says and not speaking directly, but parents invariably want their questions answered as directly as possible. If you find yourself in an interview with a doctor like this, you really have no option except to press him for an explicit answer to the question you actually asked, not the one he chose to answer.
There is another variety of the avoiding physician encountered by parents whose child has ongoing medical problems. This is the doctor who just plain avoids them and their child. These are doctors who only reluctantly return your telephone calls or, if your child is admitted to the hospital, always seem to miss you when they come around to see your child in her room. This seems like odd behavior for a physician, but it is not rare. The reason for it is that the doctor procrastinates or even avoids conversations that he believes, for any number of reasons, will be difficult or uncomfortable either for you or for him. Of course, that is all the more reason to have the discussion. Nothing interferes more with a conversation than one of the parties not showing up to partake in it.