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You might be my "boss" but let's keep it real ....

You've chosen me as your doctor ! In addition to expressing my impartiality and commending you on your excellent choice, I wish to underscore that, from a technical standpoint, from now on I work for you. While you do have the authority to continue or discontinue my services at any point, a fundamental principle governs our collaboration: I am committed to acting solely in your best interests.

 

This is sometimes a very challenging commitment, especially if my decisions and recommendations don't align with your demands, beliefs, wishes, or preferences. In life, it is difficult to say NO, and this challenge intensifies when that no is directed towards someone who hired you and holds the power of terminating a colaboration at any time.


Nobody wants to disagree with their "boss," yet the most exemplary organizations out there actively encourage disagreements. They eschew large egos and rigid hierarchies in favor of an environment fostering the exchange of ideas and the identification of optimal solutions. That is why I believe that one of the key attributes of competent physicians is the ability to decline the request that is not I line with the patient's best interests. This is not to deny the fact that the era of the authoritative and intimidating doctor has long passed. Actually goal of practice is exactly that, to work closely with all my patients and tailor the treatment according to their wishes and preferences, while keeping it in line with safety requirements and the algorithms of modern medicine.

 

I will never expect you to do anything based on my authority. It is my responsibility not only to fully understand the nature of your requests and the reasons behind them but also to articulate clearly why  they are not advisable. In practice, this actually rarely happens. Most of the choices anyway are made in a gray zone where we acknowledge many pros and cons in a collaborative decision-making process. Overall, once we build a relationship of knowing and trusting each other, this becomes easier. Nevertheless, in situations demanding protection of your best interests, I am duty-bound to stand firm with my decision even if that means I will never see you again.


This is the moment when I reflect on many wealthy individuals or celebrities who despite all the wealth and all the access to best possible healthcare ended up with a poor outcome or even dead because simply said sooner or later, they did find usually ethically questionable doctor that would ( usually at a very high price tag ) say yes to their risky and sometimes irrational demands.

 

All tis is not the reason to be afraid of me. On a contrary I am the type of doctor who acknowledges the limitations of my knowledge, I promote inquisitive thinking and I do not take absolutely anything personally. I encourage your autonomy no matter if you are seeking alternative treatments, differing from my recommendations, or obtaining second opinions. I am happy to comment that throughout the years I embraced back many patients who left attempting to find a better solutions and subsequently realized that my recommendations were actually the best way to go and respect and embrace even more the few that proved me wrong and thought me the exceptional and unique characteristics of their condition.

 

The doctor is not always right.

The patient is not always right.

 

Our differences are our strength. You are more than welcome to do your own research, google that symptom, bring up and discuss that experimental treatment, confine in me that you really don't like medication A, and trust me enough to admit that you're not really taking it. We have to be on the same side, and with so many options out there, we can always find something that is safe and that makes medical sense while agreeing with your personal needs and preferences.

 

 

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