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" The pain in Cynthia Wolcott&amp;#039;s teeth was so bad that even with ibuprofen, she couldn&amp;#039;t sleep at night. She went to her dentist in New Britain, Connecticut, who said it wasn&amp;#039;t her teeth but a sinus infection. She then saw her internist, who prescribed an antibiotic that worked for a while. But within two weeks, the headaches and tooth pain came back.    Wolcott bounced between her dentist and internist for about six months until a different dentist in the same practice recognized that she had an abscess under her tooth. By then, the infection was raging through her entire body, and she had to take an intensive course of very strong antibiotics. Wolcott finally got the help she needed\u2014but she promptly found a dentist in a different practice and a new internist.   Misdiagnosis\u2014or its close counterpart, a missed diagnosis\u2014is, of course, an obvious reason to find a new physician. &amp;quot;If you&amp;#039;ve lost trust and confidence in your doctor, your relationship&amp;#039;s not going to work,&amp;quot; says Sandra Adamson Fryhofer, MD, clinical associate professor at Emory School of Medicine in Atlanta. There are, however, less dramatic doctor issues that can put your health care in jeopardy. Even the best physicians have bad days, but if any of the following situations sound familiar, consider making a change.   Your doctor seems annoyed or responds curtly when you ask questions   Your physician should make sure everything is clear and be available to answer questions during and after the office visit. &amp;quot;I can&amp;#039;t tell you how many patients come to me because they want me to explain their medical records or test results that should have been explained by their original doctor,&amp;quot; says Nieca Goldberg, MD, clinical associate professor of medicine at the New York University School of Medicine.   Try to ask as much as you can during your appointment and take notes; this will help you better digest the information and form questions. &amp;quot;Patients usually only retain about 30% of what they hear in the office,&amp;quot; says Michael Roizen, MD, coauthor of You: The Smart Patient and chairman of the Wellness Institute at the Cleveland Clinic. If your doctor&amp;#039;s response is still too full of medical jargon, ask her to explain it again. Also ask what to do if you have questions post-visit. Many doctors now use e-mail for nonemergency queries.   Your doctor is intimidating or demeaning   Alice Daood, 37, gets embarrassed even now as she recalls a routine physical she had when she lived in Jackson, Mississippi. &amp;quot;He was one of those very efficient doctors who would dictate his notes into a small tape recorder while he was doing the exam,&amp;quot; Daood says. &amp;quot;I knew I needed to lose a few pounds, and wanted to ask him about it, but I was mortified when he began his dictation with &amp;#039;Extremely well-nourished 26-year-old female\u2026&amp;#039; &amp;quot; After that, she says, &amp;quot;I couldn&amp;#039;t get out of there fast enough. I went home, burst into tears and never went back.&amp;quot;   Daood&amp;#039;s new doctor had a better approach. &amp;quot;He asked me if there was anything about my health that I was unhappy about. I told him I wanted to lose weight and he was very encouraging; we discussed what diet and exercise changes I could make that would help.&amp;quot;   She&amp;#039;s one of the best, but impossible to see   We all want to claim the so-called &amp;quot;top&amp;quot; doctors as our own, but if your physician is the head of her specialty at a hospital, supervising 30 doctors or heavily involved in other aspects of medicine, she may not have the time to devote to her private practice, says Dr. Roizen. If you spend hours in the waiting room before every appointment or don&amp;#039;t get called back about test results within a reasonable amount of time, you may be sacrificing good care for an expert reputation. The reality is that there are many excellent doctors who just haven&amp;#039;t built a reputation for themselves yet.   Your doctor dismisses your concerns about a treatment or test   This could be a sign that you aren&amp;#039;t on the same page when it comes to approach. &amp;quot;Strong patient-doctor partners generally have a similar way of dealing with things,&amp;quot; says Vicki Rackner, MD, a surgeon who started a company called Medical Bridges in Seattle, to help patients better partner with their physicians. If your doctor insists on doing a million tests that you&amp;#039;re not comfortable with, speak up. &amp;quot;Ask him, &amp;#039;What are the chances that I have this condition, and what will happen if we just do nothing at this point?&amp;#039; &amp;quot; says Dr. Rackner. A good physician should be willing to listen and consider your questions and concerns instead of railroading you with his opinions.   When Donna Van Vlack, 40, noticed that her 3-year-old daughter&amp;#039;s eyes were crossing, she took her to see a pediatric ophthalmologist. &amp;quot;He very quickly diagnosed my daughter with amblyopia and said she&amp;#039;d need to have surgery,&amp;quot; says Van Vlack. &amp;quot;My husband and I wanted to explore other treatment options, but the doctor wasn&amp;#039;t open to that,&amp;quot; she says. &amp;quot;We went to a different doctor and ultimately, my daughter did have the surgery, but only after a year of trying other things first. That was more in keeping with our beliefs about how we wanted to handle her eye issues,&amp;quot; she says.   The office staff is unhelpful or makes many mistakes   Beyond the niceties of fitting you in when the doctor is busy, they handle important tasks that, if done incorrectly, can seriously impact your health\u2014like getting test results to specialists and giving instructions for tests and medications. If they&amp;#039;re making lots of mistakes, mention it to your doctor; she may not be aware of it, says Dr. Fryhofer. &amp;quot;If nothing changes after you tell your doctor about your concerns, you&amp;#039;ll have to decide if you like her enough to risk staff errors.&amp;quot;   Susan Mannion of Washington, DC, had seen hints of office incompetence: referrals not being faxed to specialists and scheduling mixups. Once she&amp;#039;d even overheard the office manager on the phone discussing an X-ray that was supposedly sent to another doctor but was now lost. The final straw came during Mannion&amp;#039;s annual visit when, as the doctor reviewed her file, she exclaimed, &amp;quot;Wow, I never saw your blood test results from last year&amp;#039;s visit!&amp;quot; &amp;quot;All I could think was, &amp;#039;Thank goodness I didn&amp;#039;t have something serious like leukemia, or I could be dead by now!&amp;#039; &amp;quot; Mannion says.   Your doctor thinks he&amp;#039;s God   Be wary of a physician who wants to treat everything\u2014from removing a suspicious mole to treating the pain in your knee\u2014and never refers you to a specialist. &amp;quot;If your doctor isn&amp;#039;t willing to recognize that someone else might have a better perspective or is never able to say &amp;#039;I don&amp;#039;t know,&amp;#039; he may have ego issues. And that could prevent you from getting the best care for a particular problem,&amp;quot; says Dr. Rackner. Similarly, your doctor shouldn&amp;#039;t be offended if you want to get a second opinion.   The &amp;quot;on call&amp;quot; doctor doesn&amp;#039;t give you good care   &amp;quot;When my daughter was 7,&amp;quot; says Diane Piwinski of Yonkers, New York, &amp;quot;she had the flu and an alarmingly high fever. When it hit 104 degrees, I called my pediatrician. Hours later, a doctor from a different practice who was on call for mine called me. When I explained my daughter&amp;#039;s symptoms and asked if I should bring her in, the doctor told me not to bother because there wasn&amp;#039;t anything she could do. She didn&amp;#039;t even have access to my daughter&amp;#039;s medical records. She said, &amp;#039;If she&amp;#039;s that bad, take her to the emergency room.&amp;#039; &amp;quot;   &amp;quot;When you first join a practice, ask what happens if your doctor isn&amp;#039;t available,&amp;quot; says Dr. Roizen. The on-call doctor should be just as qualified as your regular one and have access to your records. Piwinski said she didn&amp;#039;t want to expose her daughter to a city emergency room unless she absolutely had to. &amp;quot;I nursed her through the night and the next day started looking for a new practice.&amp;quot;   Your doctor is prescription-happy   &amp;quot;During a physical, I mentioned that sometimes I have a little trouble falling asleep,&amp;quot; says Joan McCue, 44, of Great Barrington, Massachusetts. &amp;quot;My doctor&amp;#039;s first response was,&amp;#039;Do you want me to write you a prescription?&amp;#039; I was taken aback\u2014all I wanted was some reassurance that this wasn&amp;#039;t a sign of a bigger health problem,&amp;quot; says McCue. &amp;quot;I was interested to know if there were habits I needed to change, such as my caffeine intake or diet.&amp;quot;   &amp;quot;A physician should do more than just treat you, he should educate you about preventive care and how to live a healthy lifestyle,&amp;quot; says Dr. Roizen. &amp;quot;Ironically, part of your doctor&amp;#039;s job is keeping you out of his office.&amp;quot; "^^<http://www.w3.org/2001/XMLSchema#string>
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