Coping
Patient Rights & Second Medical Opinions
Even if you are in excruciating pain, you cannot force your doctor to prescribe a pain medication for you or refer you to a pain specialist. Timothy McCall, M.D., an internist and patient advocate, suggests relaying the seriousness of your pain to your doctor by creating an image. "Give specific examples from your life about how your pain affects you," says McCall. If you claim, "I am in such terrible pain, it hurts so bad that you can’t imagine how awful I feel," McCall says this is 'telling' and it is useless for conveying how seriously your symptoms are impacting your function. If you are concerned about the pain in your hands, you could say, "I have so much pain that I cannot button my blouse (or shirt)." This provides your doctor with a clear picture (e.g., showing) rather than merely stating you have hand pain (e.g., telling).
Jennifer Schneider, M.D., Ph.D., a pain and addiction specialist, says "most doctors prefer black-and-white situations." This is why they are comfortable prescribing opioids to cancer patients, but they may say 'no' when it comes to patients with fibromyalgia." If your doctor is unwilling to consider opioids when 'everything else' has failed," says Schneider, "your best bet is to ask the physician to refer you to a pain specialist."
What do you do if your physician gives up on you, tells you that there is nothing else that can be done, or refuses to follow through with the treatment plan suggested by the pain specialist you were referred to? Asserting your rights may require you to fire your doctor if he or she is completely uncooperative ... but it all depends on the situation.
If you harbor doubts about a diagnosis or you feel a different treatment avenue should be tried, you would be wise to seek a second medical opinion. Yet, asking for it may not be easy. Don Uslan, M.A., L.M.H.C., says that the words "second opinion" can imply a "no-vote" of confidence in your doctor and may irritate even the most compassionate provider. Uslan says one way to approach this sensitive situation might be to bring in an article from a reputable source about a therapy or test you wish to try. This allows your physician time to digest the new material and shows that you are still appreciative of his or her care.
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