How to "break up" with a doctor?

Ya just gotta fire them sometimes. To make light of it.

Just tell them the truth.  It may help your gi with future patients.  I'm sure she... he has had other patients go to other Dr's.

I told my surgeon one time I was going to get other options and see other Dr's.  She expected me to and in no way took it wrong.  When I think about it.  I know I was doing it for me.  Not her(my surgeon) she understood and also thought it to be a reasonable thing to do.

I know it's different firing and hiring. But that's what it is.

If the other one is better That's where you have to go.

Just be honest. It's hard. But best.

Richard. 

My GI referred me to a specialist after the treatment for my cuffitis wasn't working. He explained it as he is a generalist and I needed someone specialized. That might be a good way to break up with her. In my case he referred me to the Mayo Clinic.  

When I needed an endoscope I went back to the generalist.

I actually had to "break up" with a New York City J Pouch specialist who had managed my care for 18 years, very competently and expertly - for insurance coverage reasons.  He was out of network, and had become unaffordable, particularly because my annual pouchoscopies were no longer being covered (this due to a suitable J Pouch expert being located within my network, at Yale in Connecticut).

This ended up being a bad news/good news situation.  I had a long and painful telephone conversation with the NYC specialist, announcing the breakup.  He was extremely hurt.  It was like breaking up with a girlfriend, no other way to describe it.  Painful, because I knew he was a highly qualified and competent man.  I told him my decision was being driven by the health insurance company.  He ended the conversation by vilifying health insurance care in our country and somewhat subtly accused me of disloyalty.   What I did not tell him was the other, secondary reason for the breakup, which was that he was in his mid 60s and, I suspected, a few years away from retirement, which would have forced a change in my care anyway.

The good news is that the supposed expert in network at Yale ended up being younger, and just as qualified.  He was my J Pouch specialist for 6 years before, ironically, he left Yale for greener pastures at Mount Sinai in NYC.

My advice is just be honest, have the painful conversation, treat it like breaking up with a girlfriend/boyfriend, and then move on.  Good luck.

Thank you all for the advice. Just like in romantic relationships, I was feeling unsupported after my surgery and it wasn't until I saw the second opinion GI that I fully realized what I am missing out on. 

@Mysticobra And @CTBarrister I think you're both right that honesty is the best in this situation. I think you're both right that if I tell her why I'm leaving maybe she can use it as a learning opportunity. Maybe it will help her realize the limitations of that hospital.  @TE Marie that is very admirable that your doctor knew when he reached his limits and referred you to someone with more knowledge. I respect that a lot. I think ultimately it comes down to our health and that is great that he recognized that. 

For me I'm going to have to wait a few months until I can change my insurance, but for now I am so glad there is hope. when the time comes I'm going to be as honest as possible with her and my surgeon. Maybe I'll even write thank you notes for all the help I've gotten over the years. 

Best, stephanie 

Usually when I change doctors, it is because the doc is retiring, moving, or leaving my covered group. I’ve had the same HMO for 50 years, so it just comes with the territory. A few times I’ve changed docs simply because I just did not care for the lack of rapport. When asked about it, I just say it was not working for me. I don’t get into particulars and I’d never call a doctor and have a big conversation about it. I just stop seeing him. If they are offended, oh well. Doctors don’t own us.

Jan

Hi @Jan Dollar I have been in the same boat as you in the past. In this case I think I will say it isn't working for me, but we have had such a special doctor-patient relationship over the years that I am sad about it. She's seen me through so much and I've enjoyed getting to know her over the years! (I started seeing her before she had kids and now she has 2!) I think she will understand and respect my decision, it's just making me nervous to "rip off the bandaid" and tell her. You're right though, ultimately, we are free beings and we will care more about our own health than anyone else, so it's important to do what's right!!!

My G.I. doctor didn't like that I got a second opinion from my surgeon, even though we had discussed the possibility of surgery.  I had told him that we had done our own research and received recommendations from others in case I needed surgery.  I wanted to choose who I felt comfortable with.  When I made the decision for surgery I called his office to cancel my Remicade appointment and let them know.  He was not very understanding because he had his "plan" for me and wrote in his notes that, "he would no longer be following" me.  No great loss.  This is not the first time I left a doctor.  The other time was when a obstetrician I had misdiagnosed preterm labor for incompetent cervix and I subsequently lost a baby at 21 weeks.  I again went for a second opinion and had two excellent doctors after that.  Glad I left that practice and had two subsequent high risk pregnancies (no incompetent cervix with either) with two healthy baby girls.  Right now all of the doctors I see, I have been very happy with.  My PCP tends to be a little OCD, but that works for me.  I agree with Jan.  Doctors don't own us.  

@CTB23 Oh my goodness, I'm so sorry about the misdiagnosis that cost you your baby's life. That sounds like malpractice to me and I can't imagine the heartbreak you must have been through. I'm glad that you were able to find better doctors after that and have healthy kids! It's too bad the GI doctor gave you some attitude when you were making such a difficult decision. It sounds like you made the right choice for you.

I'm 33 and I got this disease at 25. I was such a naive young person, I really believed doctors knew everything and I should listen to everything they say. So much has changed over the course of this disease. I've learned that doctors are just people and they are not all knowing. Western medicine has limits and different doctors are willing to go the extra mile to help their patients. Some are even willing to admit when they don't know the answers. Now I'm learning that it's important to exercise my rights as a patient and make sure I'm getting the best care possible. It's my health and well-being at stake and what is more important than that?! 

Jan,

I called my doctor and told him I was going elsewhere because we had an 18 year relationship in which he went more than the extra mile for me and I was leaving him for reasons other than I had lost confidence in him or a lack of rapport. He always called me, often after hours, to discuss results of my tests and pouchoscopies. When the pathologist at Mount Sinai couldn't interpret the results of my Prometheus blood test, this man had my results sent out to a west coast pathologist that was a friend of his and asked for a second opinion. These kinds of things were beyond the call of duty. Therefore, I believed a conversation with this professional who had served me well for 18 years was the appropriate thing to do. I think he would have eventually called me had I not initiated that call myself- in fact I am certain of it because I had to ask his office to transfer my 18 years of records up to New Haven in writing. And we then would have had to have the same painful conversation. And it would have been cowardly not to have called him first, or I would have felt that way if he had to call me to find out about the reasons for the breakup. I should also mention I thanked him for his years of service and told him I didn't want to leave him and the decision had been made by third parties and forced my hand.

That being said, in the case of JourneyToWellness, I believe your reasoning is correct and she does not need to "break up" with her doctor and can simply leave. Of course, if the doctor calls and asks why she isn't coming any more or why the records were transferred, then JTW shouldn't be bashful about being honest. But I agree that it's not necessary for her to initiate the breakup conversation here, as I felt it was in my case.

Good points @CTBarrister. It's helpful to hear everyone's different stories and the nuances of different doctor/patient relations. It's a good reminder that we all have agency over our situations!

I was not happy with my surgeon/doctor so I told him that with his full schedule that I did not think he could provide me with the level of support that I needed.  I asked him if he could provide a referral or recommendation for a doctor who could better "baby sit " me with my issues.  He actually hooked me up with a terrific gastro doc that is into exploring different options to treat my pouchitis problems.  He is cutting edge but is adamant that any treatment must be researched and tested before he will support it.  He has been a godsend for me.

For breaking up with your doctor?

I'd recommend text/e-mail/or facebook message. It'll be too difficult in person. 

@ezpete I really like that way of putting it. It acknowledges that they have a busy case load, but also you're looking for someone to better match your needs. Im going to steal that!!

glad you are working with a better GI. He sounds awesome!