1. Health

Why Doesn't My Doctor Tell Me About All My Treatment Options?

By

Updated July 17, 2012

Question: Why Doesn't My Doctor Tell Me About All My Treatment Options?
Once you are confident that you have a solid diagnosis, you may begin intensive research into treatment possibilities to be sure you are making the best choice for your treatment goals.

It's possible you'll uncover a treatment your doctor hasn't mentioned, especially if you engage in online support groups with patients who have a similar diagnosis to yours. You may wonder why your doctor didn't tell you about a treatment that seems so promising, and you may want to know how to broach the subject with your doctor.

Answer:

There may be several reasons why your doctor may not tell you about every treatment option that could help you. Some are fair and reflect good medical practice. Others pertain to the scope of your doctor's awareness or service. In those cases, the best thing we patients can do is discuss them with our doctors.

Examples:

  • Time: Your appointment time is very limited. Your doctor may only tell you about the one or two options that he or she thinks are most likely to help you.

  • Your body: Sometimes treatment options are eliminated because something about you prohibits that option. For example, you may not be able to take a certain drug if you are already taking a drug that conflicts with it. Or you may not be a candidate for certain forms of physical therapy if you already use a walker.

  • Off Label or Too New: Your doctor may not know about an emerging treatment, off-label use, or an alternative or complementary therapy. More likely, though, is that he may not bring up such options because he doesn't want to subject you to their potential risks without yet having good, solid evidence to back up their use. You may find other patients discussing a treatment possibility online that your doctor hasn't told you about. If you're curious about them, ask your doctor.

  • Cost: Sometimes a prescription is written for the "right" drug (chemically), but it is wrong for you because it's too expensive. Branded drugs, those that have not yet become generic, are pushed by pharmaceutical reps -- you've probably seen them in your doctors' offices. The reps arrive at the doctor's office bearing gifts of anything from meals for the doctor's staff, to free samples of their drugs for you. If the doctor is not tuned in to the cost of these more expensive branded drugs, he or she may simply write the prescription without regard to the cost.

    If you have heard about a generic drug, or a similar drug made by a different manufacturer that will be less expensive for you and that is listed in the same class of drugs, ask your doctor about it. It's even possible there is a non-drug approach to your treatment that should be discussed.

  • Offerings: In some cases, better treatments are available, but since a doctor can't or doesn't offer them, they aren't mentioned to patients. Doctors will offer what they know well, or what they have trained for.

    For example, a drug called Bexxar (similarly Zevalin) treats certain forms of non-Hodgkin's lymphoma. But it is a radioactive drug, and can only be administered by a facility (usually an academic medical center) that has government permission to do so. Since most oncologists do not have that capability, and since some patients may not have easy access to a center that provides the service, it may not be mentioned as a treatment.

    Another example is the surgeon who has performed a certain type of surgery for many years, is comfortable with it and knows it works. New technologies may have become available which require tools and training he or she doesn't have access to, or that the surgeon doesn't feel has been tested well enough yet. In that case, the possibility may not be raised for the patient.

    What You Can Do

    If you find or hear about a treatment option your doctor hasn't mentioned, then there are three things you can do:

    1. Say nothing, and go along with the treatment your doctor has recommended. An empowered patient will rarely default to this choice. If you don't ask questions, you'll never have the confidence that the right recommendation for you was made. As empowered patients we ask questions, we discuss options, then we make choices. When we are finished, we have as much confidence as possible in the choices we have made in partnership with our doctors.

    2. Learn as much as you can, and talk to your doctor about the not-yet-mentioned treatment option. This should not be confrontational. Simply ask, "Doctor, what do you know about _____?" Or, "I found information about ____ and would like to talk about whether it's a possibility for my treatment."

      Your doctor will then explain why it would or would not be a good option for you. From there, you'll have to determine whether those reasons make sense to you.

    3. Seek out a Shared Decision-Making professional or advocate. Sometimes this person will be a physician who practices in the specialty that relates to your diagnosis, and sometimes it will not. The shared decision-making process will weigh your values against your options and help you figure out what's right for you.

    4. See another doctor for a second or third opinion if you don't feel satisfied with your doctor's response. See if the treatment is mentioned, and if not, raise the question. From there, based on that conversation, decide which doctor you have the most confidence in.

    Learn why "following the money" is the answer to more doctors' appointments mysteries:

  • ©2014 About.com. All rights reserved.

    We comply with the HONcode standard
    for trustworthy health
    information: verify here.