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It's a familiar sight in the U.S.: a commercial where happy people smile while promoting a medication that claims to change the lives of those with psoriasis. As the actors remain upbeat, a narrator rapidly lists side effects. The commercial ends with a direct message: "Speak with your doctor today about [the medication]."
The challenge arises when you try to discuss a medication with your doctor, especially if you walk in with the name of a drug from a TV ad, but no real understanding of how it works. Should you even bring it up? After all, your doctor has years of expertise. Is it acceptable to suggest a medication to them?
It’s perfectly fine to suggest a medication you’ve heard of, but there’s no guarantee you’ll get it. That’s okay, too. Let’s talk about how to approach your doctor when discussing medication options.
Don't hesitate to discuss medication with your doctor
If you're experiencing symptoms and have researched your options, you might fear that a doctor will dismiss your interest in a particular medication since you're not a medical professional. While it's possible—doctors are human and biases in healthcare do exist—there’s no reason not to advocate for your own health. While you may not be a medical expert, you are the expert when it comes to your body.
Dr. Yoni Freedhoff, an associate professor of family medicine at the University of Ottawa, has observed that patients are often "cautious about suggesting to doctors that they have a medication they believe they should take or want to try." This hesitation can stem from previous negative experiences with healthcare providers or feelings of embarrassment when expressing the desire for medication.
Dr. Joseph Thomas, a hospitalist in New York, agrees that patients sometimes hesitate because they don’t want to appear demanding. However, he believes if patients have questions or curiosity, or want to discuss a potential treatment, they should definitely bring it up with their doctor.
Freedhoff’s conclusion is this: "If someone wishes to discuss something with their doctor, no matter the subject, they should be able to have that conversation. A doctor’s job is clear: to inform patients about their treatment options, the risks of actions and inactions, but never to judge their treatment choices."
The doctor’s role is to listen to your concerns and provide answers to your questions, so you have every right to express them.
If a doctor declines medication, make sure to ask follow-up questions
Have you ever heard the saying, "God answers all our prayers, just not always with a 'yes'?" Doctors can be somewhat similar (though, of course, they’re not God). They don’t hold all the power in making decisions about your treatment, and unlike God, they are available to answer any follow-up questions when they say 'no'.
"There will be times when patients suggest medications that aren’t ideal," said Freedhoff. As a non-medical professional, you may not know that a certain medication isn't suitable for your condition or might not be appropriate in your current treatment stage. You might be unaware that you don’t meet the criteria for a specific prescription or your insurance doesn’t cover it. That's completely understandable. The doctor’s responsibility in this case is to explain these factors to you. A good doctor, Freedhoff emphasized, would clarify this in a way that doesn’t make the patient feel uncomfortable.
If your doctor says you don't meet the clinical criteria, inquire about the reasons why and ask what alternatives are available that you do qualify for. Freedhoff suggested asking what criteria are used to determine whether a medication is suitable, while Thomas pointed out that a doctor might offer insights based on your individual tolerances. Ultimately, your health, your body, and your life are what matter most. You should feel confident in asking as many questions as needed until you have a clear understanding of your treatment.
Consider seeking a second opinion
We’re not suggesting you should jump from one doctor to another until you find one who agrees with your self-diagnosis, but consulting with another doctor is completely reasonable, especially if there are doctors available in your area.
Looking for a new doctor could address more issues than just the fact that your current one is refusing to prescribe a certain medication. As Freedhoff pointed out, "If you have a doctor and feel uncomfortable discussing medication or treatment options, that’s a sign you may need to either talk about your relationship with your doctor, try to understand why you feel uncomfortable, and work through it, or find a new doctor."
Thomas shared, "I've heard too many stories where patients feel dismissed by their doctors, with remarks like, 'That’s why you shouldn’t consult Dr. Google.' This happens, and it’s something that I, along with many of my colleagues, believe should be discouraged. When patients bring up these kinds of questions, it's usually because they want to take an active role in their own health and aim to do what they can to improve and feel better."
See? There are doctors who want to listen and engage with you. You should feel empowered to be honest about your symptoms and what you're going through, no matter what treatment path you choose. If a doctor dismisses you, refuses to answer your questions, or shows any bias, you should always feel free to seek a new one.
Approach these discussions with reason
That being said, maintain reasonable expectations. If you're being treated poorly or a doctor is being overtly dismissive, by all means, stand your ground and advocate for yourself. However, use your judgment. If a doctor tells you that you're not suitable for a certain treatment but is open to discussing alternative options, it's worth listening to what they have to say.
Freedhoff acknowledged, “Is there bias in healthcare? No question.” But there are times when a medication simply isn’t effective for you, and that’s not necessarily due to bias. He emphasized, “It’s important to respect the clinical criteria that guide prescriptions.”
Remember, as we've noted, doctors aren’t infallible, but they are highly trained and possess knowledge that most patients don't. Thomas gave the example of monoclonal antibodies, which, while widely promoted during the COVID-19 pandemic, may not be as effective against newer variants. While you should feel confident bringing your research into the conversation, remain open to learning from doctors, who have deeper expertise than journalists or marketers.
Thomas also pointed out, “These discussions are worthwhile because medical care today is a collaborative effort between doctor and patient. It’s no longer the paternalistic relationship it once was.” So, don’t hesitate to ask questions.
