We are not your parents.
Saying no does not mean we're going to force you to do it anyway if we think it's really important.
Saying no does not mean we're going to spend three hours trying to convince you to change your mind because we know how much you need it.
Saying no is not the beginning of a negotiation.
Saying no is not part of a game.
You say no, and we can't do the procedure. So we're going to leave. And if you didn't really mean "no," but you were just trying to be difficult, well, we're not your parents, and we're legally bound to treat you like a functioning adult, whether you act like one or not, so we're actually not allowed to do anything, and you're only hurting yourself.
It's frustrating. Because on the one hand, patients say they want to be able to make decisions about their care-- and there's every reason to have that be the standard, there's every reason to inform patients as best as we can and then allow them to make choices about their own care. But on the other hand, you say no to a treatment you need, even though we're saying you need it, and explaining why-- and then we don't do it, because you've said no? A month later, you're back, worse, and blaming us for listening to you. "I didn't mean no. I figured you'd do it anyway if it was really important. Why would you ask me if it was important? If it's important, you're supposed to just do it."
You reject an MRI because you don't want to be "trapped in a box," it's on you. I'll explain it once, I'll explain it twice, I'll give you options-- but you keep saying no and at some point it's no, and we leave, and it's on you. So don't say no, if you don't mean no. Please.