Choosing a doctor is one of the most important and personal decisions you will ever make. It is a decision that is reversible if need be, but to the extent that it is possible, needs to be done with care. The key to choosing the right doctor is feeling comfortable with that doctor. Being comfortable with the doctor is facilitated by several things. First, a physician should be competent. Competence can be judge by board certifications, quality of academic and training institutions attended, amount of training, years in practice, adjudicated bad outcomes, and often times what their patients tell you. If you are confident your doctor is doing the right thing for you, you will feel comfortable. Second, quality of communication between physician and patient is vital to feeling comfortable. Are you comfortable speaking to your doctor, or do you find you lie, distort, or withhold information because you feel you will be judged, discriminated against, scolded, or belittled? Free, open and honest avenues of communication contribute to a comfortable doctor-patient relationship. Yet a free, open and honest avenue of communication does no good if you can’t understand or follow along with the doctor because he doesn’t speak in a language or way that you understand. The ability to explain complex concepts, treatment regimens, and the pathophysiologic basis for these recommendations, in a way that is easily understandable is essential for patient comfort and a skill more uncommonly found in a physician than you might expect. Third, being comfortable with a doctor is knowing and sensing that you are in caring hands and that your needs matter and your doctor is sensitive to them. Finally, in order to be comfortable with your doctor, his philosophy of medical practice should meet with your approval. There are many specific and unexpected situations that arise in the course of treatment. It is impossible to know or predict in advance what any single physician might recommend or do. Understanding the ethical guidelines, their personal value system and the paradigm of thought within which they operate, you can feel comfortable knowing your doctor is conducting your treatment in a manner which meets with your approval.

Few doctors speak about or publish their philosophy. Dr. Arian feels very strongly that is essential for patients to know how he thinks and what he believes. No doctor is right for all patients. No patient is right for all doctors. “Goodness of fit” is the key to a successful doctor-patient relationship. Dr. Arian believes if your philosophy is not compatible with his, you shouldn’t be his patient and he shouldn’t be your doctor. What follows are Dr. Arian’s personal writings on the way he approaches medical practice, patients, people and life.

Dr. Arian on Privacy:

With the advent of the current communications revolution, very few things in our lives remain private. Our personal medical information should and must remain private. Your personal medical information is no one else’s business and should never be disclosed to anyone or any other entity without your expressed specific permission. I believe you should at all times guard the privacy of your medical information to the extent that you are able and pledge I will do the same.

Dr. Arian on Medications:

Medications are very expensive, have a myriad of side effects and adverse reactions, and are very inconvenient. The less used the better. If I have to prescribe I do so because I believe the benefits far out weight the risks and inconveniences. I use inexpensive medicines wherever possible and am not in any way, in the pocket of the drug companies.

Dr. Arian on Testing:

I have been a patient many times and I am very aware that labs, imaging studies, and other testing is expensive, at times painful, and inconvenient. The less the better. Gone are the days that physicians ordered studies just to be able to write a diagnosis on the line of a chart or form. Bottom line, if it doesn’t change my medical management or if the benefits don’t clearly outweigh the risks and costs, I wont order it. I don’t order tests to run up the bill or for intellectual curiosity.

Dr. Arian on Making Medical Decisions:

I view my role in the doctor-patient relationship as that of “health security advisor”. The patient then is “president” with absolute authority to “veto” any of my recommendations. My responsibility is to speak truthfully to the patient and provide accurate and clearly presented data and recommendations so that the patient is able to make a properly informed decision. Should the patient wish to exercise their veto power and go against my advice, I accept this and merely record it in the medical record as so. The patient as decision maker, accepts full responsibility for the consequences of their decisions.

Dr. Arian on Dignity and Autonomy:

I believe the most precious things a patient has are their privacy, dignity and autonomy. I consider one of my most important roles as a physician to preserve a patient’s autonomy as long as possible. So long as they maintain the capacity to make medical decisions. I will protect their autonomy. Should conditions arise whereby myself or others must make medical decisions due to incapacity I will do so in accordance with the patient’s wishes, maintaining their dignity at all times.

Dr. Arian on Pain:

I have had and suffered with pain. I treat pain aggressively using all the latest prescription preparations in a manner consistent with my training and currently accepted pain management methods. I am ever vigilant for narcotic abuse and interact with the Drug Enforcement Agency on a regular basis to monitor compliance. I have a zero tolerance policy for those who don’t adhere to my regimen and requirements.

Dr. Arian on Alternative Therapies:

Although my training is in classic allopathic medicine, I acknowledge that in certain unique medical situations, alternative therapies such as medical marijuana, acupuncture, biofeedback, herbal remedies, and chiropractic may have a role. As a physician, aiding and healing the sick are paramount and I would be ignorant, short-sided and ineffective if I didn’t acknowledge the roles that alternative therapies can sometimes play.