7 Signs of a Bad Doctor

                                                

Quick: What's the difference between a PET scan and a CAT scan? Or HDL and LDL cholesterol? If you're like many people, you may not be sure--you leave the medspeak (and screening decisions) to the pros. In fact, 70 percent of Americans put blind faith in their doctors and opt out of researching their advice or getting second opinions. But disquieting studies show you'd be smart to keep a close eye on your own care. General practitioners are now shouldering loads of patients--the average family doctor sees 20 a day--which may lead to rushed visits and inadvertent mistakes. And all types of physicians might engage in, intentionally or not, some bad-for-you behavior. To protect yourself, stay two steps ahead of docs who are .

Seventeen minutes--that's how long the average doctor takes to listen to, diagnose, and prescribe treatment for a patient. So it's no surprise many M.D.s go for an oft-reliable fast fix: prescription meds. In fact, from 1999 through 2009, the number of prescriptions doctors wrote rose 39 percent, perhaps unnecessarily. (The number of sleeping-pill scripts, for example, has grown 21 times more rapidly than reported sleeplessness complaints, according to the American Journal of Public Health.) Unfortunately, reaching for a pen and prescription pad is often easier than searching for intel on whether a healthier alternative exists. 

Take Care: Before starting any medication, you should ask your doctor the following three questions: Are there nondrug options I can try first? Why did you pick this medication over others? And what are the pros and cons of taking this? If he or she brushes off your queries, it's time to find a new M.D. (And don't settle for second-tier treatment: You can check propublica.org to see if a doctor has taken kickbacks from big pharma companies in return for pushing certain drugs.) 

Pilots are required to log at least 10 hours of off-duty time between flights, but there's no such clear-cut rule for doctors, who also take lives in their hands--sometimes while on 24-hour shifts. Their lack of shut-eye can have scary repercussions: Surgeons who got fewer than six hours of sleep the night before a procedure encountered roughly twice as many operation complications as their well-rested peers, according to the Journal of the American Medical Association. General practitioners are at risk too: The paperwork that comes with heavy patient volume can keep them up late, potentially clouding their next-day judgment, says Charles Christopher Landrigan, M.D., director of the Sleep and Patient Safety Program at Brigham and Women's Hospital in Boston. 

Take Care: "It is absolutely within your rights to ask your doctor what his or her sleep is like, especially before a surgery," says Landrigan. When booking a procedure, query your doc about his on-call schedule--and pick an operation date before a long shift starts. Likewise, opt for the earliest morning appointment possible, before he is exhausted from a full day of patient woes. And if you have to make an unexpected trip to the ER and find yourself with a drowsy resident or attending physician, ask to be seen by another doctor. 

Like anyone else, doctors can be judgmental--but their prejudices may affect your health. A study in The Journal of Law, Medicine & Ethics found that women who had the same pain symptoms as men were less likely to receive appropriate treatment presumably because their physicians assumed they were exaggerating. Another example: Research shows that doctors spend less time with their obese patients (more than 50 percent of M.D.s view such patients as unattractive and noncompliant). 

Take Care: All doctors should see you as a patient first and check their preconceptions at the door, says Richard Klein, M.D., author of Surviving Your Doctors: Why the Medical System Is Dangerous to Your Health and How to Get Through It Alive. If your physician answers your questions with generalized rebuffs ("Oh, it's normal for women to feel overemotional"), look for another M.D., says Klein. And if you've had bad luck with male doctors, consider seeing a woman: Female physicians tend to spend more time with patients and are more likely to build trusting partnerships with them. "They may get to know them better, which can diminish their bias," says Debra Roter, D.P.H., of the Johns Hopkins Bloomberg School of Public Health. 

Doctor-patient romances are the ultimate medical no-no. Despite that, some M.D.s will leverage their position of power (it was reported in March, for example, that a Pennsylvania surgeon was fined $5,000 and had his license suspended for sleeping with a patient). To give the best care, physicians need to be objective, not desirous. Plus, "patients have to feel comfortable being honest, especially about unglamorous symptoms," says Pamela F. Gallin, M.D., author of How to Survive Your Doctor's Care. If you've been flirting, you'll be less likely to ask about, say, that weird, embarrassing down-there bump. 

Take Care: No matter how attractive he is, remember this: It's wrong for a doctor to hit on a patient. Even if his is just a mild flirtation, it's best to find a new physician. "There's no combining church Cloleli, and state, so to speak, even if he's a great doctor," says Gallin. (By the way, same goes if you're the one nursing a crush, she adds: "Fire him . . . then ask him out!") 

According to a new study in Health Affairs, more than 50 percent of doctors admit they've sugarcoated a bad prognosis. Worse: Eleven percent say they've lied to a patient in the past year. (Meanwhile, more than one-third don't think it's always necessary to disclose all serious medical errors to patients. Even if he means well, an M.D. who hides the truth robs you of the chance to make totally informed decisions, says Rosalyn Stewart, M.D., an associate professor of medicine at Johns Hopkins University. 

Take Care: You can't always tell if someone is being truthful, but you can check a diagnosis by getting a second opinion, says Stewart. Keep a diary of your meds, symptoms, and doctor's feedback. If his advice flip-flops, he could be trying to cover up an error. Use your BS detector--if your gut tells you something's up, say, "I don't understand. Can we go over the diagnosis again?" 

Some patients assume older doctors have more know-how. But that's not necessarily true, per the Annals of Internal Medicine. Researchers found that often the longer a physician has been practicing, the less he knows about newer diagnostic and screening tests, and the less likely he is to adhere to good standards of care. The study also found that patients of older heart surgeons may have higher mortality rates, possibly because those docs may not have embraced the newest lifesaving procedures. 

Take Care: Green as they may seem, fresh-out-of-school physicians are often more up on the latest medical technology. "If you're getting a procedure involving a laproscope, robot, or other new technique, the doctor who just finished her training could be your best bet," says Janet Pregler, M.D., director of the Iris Cantor-UCLA Women's Health Center. In general, though, midcareer doctors have a good balance of current knowledge and work experience. You can typically find with-it physicians at your local teaching hospital; med-school faculties are regularly vetted by their peers and are generally held to a higher standard, says Gallin. (Don't dump a doctor just for being old, though, if it's clear he keeps up with the times.) 

More and more Internet-savvy M.D.s are crossing a nebulous ethical line...online, according to the Harvard Review of Psychiatry. Patient-targeted googling is becoming more common among psychiatrists (the paper's authors admit that they--and many of their shrink colleagues--have looked up patients on the Web). But while it's standard for doctors to go online to confirm diagnoses and treatments, it's unethical for them to go beyond that. Plus, things could get risky for you when their searches turn personal: If, for example, your therapist reads up on the men you date or your political leanings, it could influence his judgment. 

Take Care: "Remember, there's protection in formality," says Gallin. You want to be treated based on clinical facts--not on your, um, wild Facebook party pics. Restrict access to your social media accounts and make your photos private; then keep your ears open in case your doctors bring up any details you didn't divulge. And, of course, don't follow their virtual lives, either. Ever.