To The Patient Going AMA

AMA…Against.Medical.Advice. I haven’t seen it often, but I’ve seen it. This one is to the patient going AMA.

I commend you for doing your research. I really do. I like an educated patient. I wish more patients would take the time to educate themselves about the care they’ll be receiving. We’re constantly told to involve patients in their care, to help them feel empowered. I wish more patients would be active participants in their medical care.  Not enough patients have taken the time to educate themselves. A large portion of our jobs involves educating our patients so they can make informed decisions regarding their care. We do our best, but sometimes there isn’t enough time and the patient isn’t in a frame of mind to take in everything we’re putting out. If patients would educate themselves before stepping through our door they could truly be an active participant in their care.

Again, I like an educated patient! A lot (not all) of nurses don’t like a patient with a care plan…I love them. I’m not going to have a care plan myself (they really do signal doom), but I don’t mind when a patient does have one because it usually means they’ve taken the time to educate themselves and really think about what they want and their plan of care. They know what they want and they know what they need to do to achieve it. I don’t mind when a patient asks me questions or when a patient is skeptical about something we’re suggesting.

It drives me crazy when a patient who is planning on breastfeeding doesn’t know a thing about it. They’ve probably spent more time researching their next car or cell phone than they’ve spent learning how to feed their baby! I digress…

While I love an educated patient there also comes a point in time when a patient refuses to accept the plan of care or treatment recommend by the health care team and make a decision against medical advice. I know you have your family’s best interest in mind. You want what’s best for you and you want what’s best for your baby. To the patient going AMA-and this may be hard for you to believe- we (your healthcare providers) also have YOUR best interest and YOUR baby’s best interest in mind! We want the absolute best outcome for you and your family! Crazy, I know! (I sure hope you read that sarcastically).

So…to the patient going AMA!

I know you have your family’s best interest in mind, but so do we—your healthcare team. We also have a lot of education and experience. Especially when considering the combined experience and education of your entire team! I love a patient who knows they’d prefer treatment A to treatment B or medication A over medication B. Many times options A and B are both fine options and it’s great when a patient is involved in their care and makes an educated decision regarding their care. However, sometimes option A and B are the only reasonable options but the patient is insisting upon option C or refusing options A and B.

I know you’ve gone online and done some research, but you can’t possibly have learned as much from Dr. Google as your actual medical Dr.  learned in medical school and throughout their years of experience, however many that is. There is a wealth of information on the internet, but a lot of the information isn’t coming from reliable sources. Do you know if it’s a reliable source? A lot of people take whatever they find on a Google search to be the truth. A lot of people truly don’t understand that a lot of the information found through the internet is not from a reliable source.

So…you found a scientific study did you? Was it a randomized controlled trial? Was it peer reviewed? Was the sample size adequate? Were there limitations to the study? You see…we’ve taken classes dedicated to determining the quality of scientific studies. While you may have “researched” A, B, & C your healthcare team is considering A-Z & beyond. You can’t possibly have researched and understand everything your healthcare team is considering. We’re considering and weighing the risks and benefits of so many options. We appreciate an educated patient, but we don’t expect you to understand everything we’re taking into consideration. If doing some Google searches was all we needed there wouldn’t be doctors and nurses. We wouldn’t go through years of school if it were that simple.

So please….do you research and come to the hospital having educated yourself, but if it comes to a point where your medical team says you’re going to have to sign some papers indicating you’re going against medical device for whatever decision you’re making PLEASE take a step back and try to understand where your medical team is coming from. Try to remember that we really do have your family’s best interest in mind and try to remember the years of school and training we’ve gone through to be your doctors, nurses, etc.


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