Survivors of Domestic Violence Should Question What Their Doctors Tell Them  

By Pamela Armstrong, MPH, MBA

Many patients would be horrified to even think of challenging their doctors’ diagnoses or prescribed treatments. These patients believe that they should not question what their doctor tells them. They assume that whatever their doctor says must be true. The doctor seems god-like and all-knowing. Asking too many questions or challenging the doctor in any way is perceived as useless at best and runs the risk of provoking the wrath of someone who has a great deal of power.

The myth that doctors should not be questioned is common and often keeps patients from getting the best health outcomes. Survivors of domestic violence who believe this myth have extra challenges because many doctors do not understand the connection between past violence and current seemingly unrelated medical problems.

Some doctors may support the doctor-is-always-right myth unknowingly by making it difficult for patients to ask more than a few questions. Office visits are often necessarily short and allow very little “extra” time. In addition, many physicians provide no other avenues for open communication, and often have very little training, for answering patients’ questions. These doctors thereby discourage patients from getting answers to the many questions they often have but do not ask.

Patients should ask questions to answer their concerns. New cutting-edge medical research has proven that patients recover best when:

1. The patient fully understands his/her medical problem, including the real cause of the problem and how the diagnosis was determined.
2. The patient understands all the options for treatment, especially which treatments may have been proven through scientific research to be more effective than others.
3. The patient participates in the decision-making process about his or her treatment.

This approach to getting the best health outcomes depends on the patient and doctor working together. A true partnership is the foundation to good medical health.

For survivors of domestic violence, the partnership between patient and doctor is especially crucial because identifying the real causes of and the best treatments for their current medical problems is not always easy. Many doctors are unaware of the connection between past abuse and/or involvement in violence and ongoing multiple medical problems.

As pointed out by Ellen Taliaferro, MD, FACEP, Director of the Health After Trauma Project, “The survivor usually has not one but many problems, all of which are often intertwined. So they need a multi-system and agency approach to healing, not just one pill or a treatment plan focused on only one problem.” (See http://www.healthaftertrauma.com)

Survivors of trauma and abuse must therefore be ready and willing to question what their doctors tell them. They must not only question what the doctor initially says but be ready to suggest a partnership arrangement that can help the doctor and the patient get to the bottom of medical problems that may seem intractable. It may only be through this collaborative work that the survivor can finally get to recovery and wellness.

Pamela Armstrong, MPH, MBA, is founder of Allied Healthcare Advisors. This group speaks and consults on behalf of consumers, employers, and providers to improve health and health care. Ms. Armstrong is also the author of the new book, Surviving Healthcare, which she wrote to give consumers the information they need to take care of themselves in our broken health care system. The book is available at www.survivinghealthcare.com, on Amazon, and through all book stores.

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