It’s Your Body. Ask the Right Questions When Hit With a Medical Diagnosis

You have a CT scan for a broken pelvis. The radiologist sees a suspicious spot on an ovary. More tests are ordered. The results are not what you hoped to hear. But nothing is conclusive “until we go in and look or biopsy,” the doctor says. More anxiety while you wait. Afterward, he suggests immediate surgery to have all your parts removed. What! You’re in shock. 

Do you listen blindly? Nod yes and say, “Whatever you suggest doctor; you’re the boss.” Some of us had parents who never questioned a doctor’s opinion. Our generation is a bit more educated and suspicious, though some of us accept the diagnosis without doing due diligence. Is surgery necessary or as extensive as the doctor recommends? We wonder.

What is the right protocol to follow to make sure you’ve covered all the bases? Is your doctor the best and what’s that based on—where he or she trained, how many procedures they do daily, which conferences they attend to be up on treatments? We have learned that there is not one way to do most procedures or surgeries. There are options. It’s up to us to be our own advocate. 

We have a friend who switched to a new internist. Before her first meeting with the new doctor, Barbara asked her, “Do you have your list of questions ready?” she was blindsided. “What list of questions?” We quickly came up with a very thorough one for her. She couldn’t believe how much it helped.  

Of course, when we receive any diagnosis, we have multiple resources to turn to such as our friends, some of whom might be doctors and can suggest specialists to treat a problem, or the Internet. But we have learned not to trust most websites except perhaps WebMD or the Mayo Clinic. Information on these sites is general. Each person’s health situation is unique. Factor in: Age. Overall health. Family health history. Your health history—how many surgeries, pregnancies or not, previous health issues we’ve experienced. Other current medical conditions should be factored in. Medications we’re taking. Health insurance too and budget since many have to watch out-of-pocket costs. And so on. 

Since it’s your body they’re talking about, it’s important to be as thorough as possible when facing a medical challenge whether a basal cell carcinoma on your face to a Stage 3 cancer in a breast. 

Don’t feel you are bothering the doctors. You are the consumer and have the right to ask what’s necessary to make your final medical choices. Many of us are quick to ask a financial advisor multiple questions if making a large investment or CPA if trying to curtail a large tax bill. Sadly, these days some doctors are starting to charge for email exchanges, so ask about that too if cost is a factor. 

When it’s a medical issue especially, it can be a life and death situation. We feel it’s prudent to take someone with you or at the very least, tape record what the doctor says so you can play it back to make sure you heard everything correctly. We know. We’ve been there. This type of news can cause crippling anxiety, making the information difficult to process. But don’t wait because you’re frightened; some problems can wait and others can’t. Moving forward you’re on your path to better health. 

We’re here to help. 

In our most recent book, Not Dead Yet, we created our own playbook of whom to call and where to go. It’s a list of good questions to ask and issues to address before any procedure or surgery. 

List of Questions to Pose 

Here’s a slightly edited list that was in our book. Feel free to print it out and take it with you the next time you meet with a doctor.

1. Start with your primary physician or internist or the doctor (specialist) who uncovered the problem, possibly a gyn, endocrinologist, or cardiologist. With a friend or family member in tow, visit the office or participate in a video conferencing call, which many did at the height of the pandemic. Ask what the possible solutions are (e.g., medications versus surgery), and whether additional tests, such as an ultrasound, MRI, or bloodwork are needed to reveal more about the problem. Ask about risks. Take notes or tape record the session. Do not hesitate to ask questions on the spot or jot down questions you might think of later. Also, you can ask questions on the doctor’s digital portal if they use one. Check too how much of the procedure is covered by your insurance and whether your insurance requires pre-approvals for additional medical visits or tests.
2. Ask for the names of physicians you might consult for a second or third opinion. (You might also ask any friends who are physicians for names of those they know and would recommend.) If your internist says surgery might be needed, you’ll next want to consult a surgeon, oncologist, or heart specialist. It can be a doctor who’s in proximity to where you live or someone in another city maybe at a teaching hospital who comes highly recommended. Know that your first surgery should be your best, according to two doctor friends of ours.
3. Check credentials and training—where they operate or treat patients, where they received their training, how many years they’ve been in practice, how many times they’ve performed the type of procedure or surgery you need, and what’s their track record of success. You want someone who’s performing your possible surgery regularly. You can also read reviews of many physicians online (with a grain of salt since some disgruntled patients post bad reviews, too). You may also want to know if the surgeon who might perform jaw cancer surgery and may have to do reconstructive work has a subspecialty in plastic surgery? Do you need a gyn surgeon who has had training in oncology if cancer is a potential problem? Also, if you have a complicated problem, consider if the doctor is affiliated with a major medical center or teaching hospital where cutting edge research is conducted. These centers can be 10 years ahead of other small hospitals on best procedures and new treatments.
4. Ask your referring physician how soon you should get the second opinion—i.e., within a matter of a few weeks or a couple months. Also ask how soon you need to be treated—if an emergency, or if you can take more time to research further? Pick one of the names recommended, make an appointment, and have your records sent to that doctor before you meet.
5. Find out test results and communicate with your initial doctor and other physicians you’ve consulted. The portals are good for this, as well as making or breaking appointments, asking for prescription renewals, or simple questions that can be emailed. It’s difficult at times to avoid the risk of information overload—and bad news--on these portals, as well as some information you may not understand. If you don’t understand what’s posted on the portal about a test result, try to stay off the Internet. Instead gather your facts from the doctors when you consult with them in person, during a phone conversation, or via a video conference session. The reason is that not all sites are legitimate or offer up-to-date valid answers, and you may cause yourself unnecessary worry.
6. The day of any appointment with any subsequent physicians, have the same friend or family member go with you again to hear what’s being said. Again, draft your list of questions in advance. Write down what’s relayed or tape it. Ask what they think the right procedure for your condition is, again any risks, and possible side effects. Also ask about the perils of taking a wait-and-see approach or not having the surgery or treatment done at all.
7. Go back and consult with your primary physician or specialist about the results of the second opinion or expert. Some people might get a third opinion if the first two don’t agree on the course of action. (Check with your insurance to make sure a third opinion is covered.) However, at some point, you need to stop since all doctors might agree on the problem but arrive at different solutions. Barbara found two surgeons who wanted to treat a problem two years ago differently; one preferred a much more extensive protocol for preventive reasons. She preferred the medical center and credentials of the other, as well as a strong recommendation and made her decision that way.
8. If one of the physicians with whom you consult suggests the wait-and-see approach and you favor that, ask how often you should get more ultrasounds, MRIs, CAT-scans, blood work, or whatever’s recommended. You want your condition to remain stable.
9. If you have health insurance, ask about out-of-pocket costs. You might have to call the insurance agent, Medicaid or Medicare to get the answers. Make sure your doctor codes your problem in a way that is most cost-effective for you. When a friend needed a bone density a year after she had the last one, she was told it wasn’t covered. Bone densities, the insurance company wrote back, are covered every other year. Her doctor hadn’t coded the request as osteoporosis. Once she made the adjustment, the cost was covered fully.
10. Weigh all options by making a list of pros and cons, best on a list on the computer or on paper so you see it and can refer back. In the end, you are the best person to decide what’s right for you. You might confer with one trusted friend but don’t get an entire roomful of opinions. Then, always trust your gut; it will help to guide you wisely.