How to Introduce the FNA Option to My Family Care Physician

It can feel intimidating to talk to a doctor about what you want. It might feel even more scary if you’re talking about a high-stakes issue like breast cancer. Good communication, however, is even more vital in these days when doctors are rushed, care is complex and visits are shorter. Here’s how to talk to your family care physician about a fine needle aspiration (FNA).
Understanding the Problem
Research indicates many doctors are better at interrupting than listening. That’s due to a combination of factors. Visits are short because demand is high; many visits last less than 15 minutes. Family medicine faces growing practitioner shortages. The doctor is pushed to see more patients. The payment system is based on procedures, not listening. Doctors also tend to want to focus on a single issue, when you might want to address several. And sadly, some physicians are biased or have preconceptions about patients that make them shut down the conversation.
Prepare Carefully
Do your research and go prepared to explain why you want an FNA biopsy done by a fine needle aspiration specialist. Your talking points should include:
• An FNA is faster and less traumatic to tissue than an open biopsy.
• FNA results are often available within 24 hours.
• An FNA is typically less expensive than an open biopsy.
• No downtime is necessary for an FNA.
Plan the Appointment
If possible, try to get either the first or the last appointment of the day. If you are the first patient, the doctor will not already be behind from late patients, emergencies or interruptions. Doctors who are already behind are more likely to try and rush through the appointment. While you might not get in on time if you have the last appointment of the day, you may also have a better opportunity for a discussion than if the doctor knows there are several more patients waiting.

Stay Focused

Your goal is to obtain an FNA biopsy by a fine needle aspiration specialist. If the doctor seems to want to discuss other issues, bring him or her back to the main point. Ask a question that pulls the doctor back into the discussion: “What kind of results have you seen with other patients who had an FNA?” “I’d like you to look at this material I got from the specialist so we can discuss it while I’m here.” “I’m very concerned about the possibility this lump might be cancer and I really want your support in making this decision.”
Most doctors truly care about working with their patients. If you are respectful but firm and well prepared, your chances of an open, cordial discussion improve. You might also ask the fine needle aspiration specialist to call your family doctor – sometimes doctor to doctor communication is a good idea. No matter what happens, stick to your guns. Remember, it’s your body and your decision.

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Celina Nadelman, M.D.

1125 S. Beverly Drive #602
Los Angeles, CA 90035
Call us: 310.702.6701