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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 55499
Experience:  Cardiology Expert
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I need advice on how to decline a medical procedure

Customer Question

I need advice on how to decline a medical procedure (echocardiagram-like a sonogram for the heart) for my child without being accused of medical neglect.
Background: I am a single father who adopted this child (ten year old) after many legal complications including medical neglect issues which are not pertinent to this present issue but make me afraid to anger any medical professional. My experience with doctors has been that most doctors either want to do surgery or to refer the patient to further specialists and procedures.
Present situation: I have no medical insurance in the state I now live in so I went to a free clinic for an exam on my child's rash. In the course of the exam the nurse practitioner found a low pulserate on the child. Therefore I took the child to another clinic for a pediatric doctor to evaluate the pulserate. This doctor agreed the pulserate was low and conducted an EKG on the child and also emailed the findings to a pediatric cardiologist who evaluated it (by phone). I was told the condition was probably of no concern since the child had the low pulserate throughout her life and had no other medical issues related to it. Still, the doctor wanted my child to go to a hospital and have further tests (probably an echocardiogram). I agreed at the time because I was relieved that my child was pronounced ok and because I just wanted to get out of the clinic at the time. The doctor said she sent the EKG result to the hospital and would have someone call the hospital tomorrow to get an appointment immediately (which otherwise might take 2 months, she said)
I do not want my child to have the echocardiagram for three main reasons (but I know the doctor or clinic nurse will not accept my opinion).
Reasons: 1 The echocardiagram is intended for patients who have “a change in clinical status” whereas my child has had her low pulserate all along without any health problems.
2 The echocardiagram requires the child to lie still for 90+ minutes which my child will not be able to do without general anesthesia (which I do not want her to have).
3 As I noted I am sure the specialist will find “something” wrong with my child in order to do further procedures which she doesn't need being in perfect health.
My question to you is should I call the clinic tomorrow and tell whatever representative who answers not to make an appointment for us at the hospital (this will probably make a nurse or someone call me back to ask why)
Should I wait until the clinic makes the appointment with the hospital and then tell the hospital I don't want the appointment.? (This may make them call the clinic back).
In the event I am asked why I don't want the echocardiagram procedure what should I say.? Should I just repeat that I don't want it and risk having the clinic contact some authority to report me as neglectful?
Submitted: 1 year ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 1 year ago.

I would do this

1)call and tell them you don't want to have the echo done because the child will not hold still for 90 minutes

2)ask about monitoring as an alternative