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Mary Braun Bates, MD's avatar

I'm a primary care doc and when my patients disagree w my advice, I say, "Guess whose breasts they are? The guidelines say XYZ and I'm supposed to tell you, but you must do what you feel is right for you." At my workplace, one gets the "quality" points if one hits the metric at around 80% (it's different for each metric). There are some metrics I know I will never get bc I think they are a waste of my precious time w the patient. I happen to disagree w some of the official recommendations and I tell my patients that and why. I also tell them, "If you wish to follow the recommendation, by all means, do," but I think it's wiser to do PQR and here's why.

I do not need to wring every last penny possible out of my med school diploma. I love making a good living, of course, but I also love doing work I feel proud of.

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Maggie Rubino's avatar

I really enjoyed reading this. I am a gen X female doctor (pediatrician) myself, and I feel your frustration from both sides of the computer. The way we are pushed to “meet metrics” is dreadful. When I see the parent is reluctant, I will often say, this is your child, it is always your decision. Because it is. We doctors are highly trained and well educated, and it makes many of us bossy. We should be educating our patients about why we do things, and listening to their concerns. That takes time, which we often don’t have. Keep fighting for that autonomy. It’s worth the effort. And if your doctor won’t listen to you even after you’ve tried to get explain yourself, find a new one.

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