Conflict of interest vs. geniune motives?

IMHO, you and your doctor should be making decisions together. If you aren't informed enough to contribute to the decision, then it's his job to give you that information. My own policy is not to make a decision until I feel equipped to participate in that decision. If that means a second opinion, then I seek that second opinion. I am leery of physicians who try to discourage patients who want to be informed about their own care. My own docs know that I do this, and have always said, "I'm glad you did that. What did the other guy say?" or "What did you learn from your research?" They won't always agree with my answers, but they explain WHY--and not one of them has done so by commenting on the age of another practitioner.

I'm not suggesting your doctor doesn't have your interests at the forefront, or that his plan is not a good one. He may actually be a great guy and a great doctor. What I am suggesting is that YOU aren't comfortable with your level of care at this point. You need to be. If that means another opinion, or questioning this guy further, those would be my first steps. The goal here should be to ensure that you understand the medical necessity, and the benefits vs cost/risk of any treatment plan offered.

I too didn’t take treatment (MTX) until I had looked at the facts (I mean facts from accredited sites not just anywhere on the net) and talking to my collegues who prescribe MTX for other conditions. I did this as I wanted a rounded view of the effects of the medication and what it means to me…I’m an advocate for informed choice with my Renal patients, much to the annoyance of some of my collegues who think patients should just accept the professionals opinion whatever and conform. Communication is the best way forward in my opinion talk it out…generally I’ve found doctors prefer you to take part in the discussion of treatment because it means they can rely on you to understand the treatment plan and then can engage in it.
They cannot know you have a problem unless you tell them, I was given steroid shot in my shoulder on my first appointment, it actually didn’t help me, the problem was enthesitis but I said I was willing to try as I had read this was the most likely first step, I didn’t find it painful but my shoulder ached all afternoon at the injection site

So RB, I did get an appt. made with a young new rheumy in town. I called the old rheumy to get my records faxed to the young guy and when I offered to give the fax number, the clerk stated, no thanks, I have it right here. haha. They are probably using that fax number every day as more and more patients think about their options. Appt. tomorrow at 3 pm.

RB said:

If he gave you grief about getting a second opinion - to me it's a clear sign you need one AND a new doctor! Jerk. Also if he said he'd prescribe the biologic if you demand it - that also means he knows it's safe for you - otherwise he wouldn't accept the liability. Still if it's at all feasible - get a new doc :)

New rheumy started me on Enbrel. Based on history and exam there is no reason the other guy should've waited. (Except for the money he made from office appts with me and his ultrasound machine). Can't wait to begin feeling good. Received an i.m. injection of steroid which I've not heard of but it is supposed to help quickly and get absorbed over 5-6 weeks. Gettin' my walking shoes ready.....