Dear Alice,

I recently met with my internist about an ongoing medical problem. She sent me to a surgeon she highly recommended. After an examination and further tests, this surgeon advised that I immediately be scheduled for surgery. I was stunned at how quickly this was arranged. I got a follow-up call from the surgeon’s office the next day, telling me that the doctor wanted me to have the procedure next week. I have been very distressed by the surgeon’s urgency, considering that I have had some symptoms for several years.

My family has urged me to get another opinion from a different surgeon, but I fear the effect this will have on my relationship with my internist. I worry that if I challenge my doctor it may have ramifications and she will no longer want me as a patient.

My instinct is to go ahead with the surgery. Please help me with this important decision.

— In a Quandary

Dear In a Quandary,

Your internist needs to be your partner in your health care, not your boss who you fear controls you. She works for you, not the other way around. If this physician is critical of your intention to have further evaluation of your health, there is a serious problem in your relationship with this person. The decision about what you will do about your health needs to include you.

You need to speak up and be clear what the urgency for surgery is. While the surgeon you met with may ultimately be correct in his recommendation, you still have the right to further evaluation in order to become more comfortable with the surgeon’s assessment. Getting a second opinion can help a patient move forward with ease, particularly when the next opinion agrees with the initial recommendation. At times when there are conflicting opinions among doctors, one can explore and assess the situation further to arrive at a decision. In the past, many patients saw themselves as passive, almost childlike in their role with their physician. They often accepted whatever was suggested, seeing their doctor as godlike. This idea generally no longer holds. Happily, many people now recognize that they are consumers who can choose the health care they wish. Also, good physicians like their patients to be partners in the patient’s health care.

Maintaining a good relationship with your internist is important, but not more important than seeing yourself as your own advocate.

Professionals have to exhibit some humility in their recommendations, unless we present them with a true life-threatening emergency. Have faith in your right to choose. Whether your doctor agrees with you is not the issue. The decision is ultimately yours to make.

— Alice