- Doctor-patient communication is difficult because each “party” is coming at the picture from totally different perspectives and probably from different education levels. Doctors are talking to you from objective perspectives. Usually when you’re sitting in his or her office, the last thing you are concerned about is “objectivity.” You’re scared and most likely in pain or discomfort. These two things do not mix at all. Your mind is not able to focus that well when you’re in a “foreign” environment (the doctor’s office) and when you’re in pain. Understanding this will enable you to realize that the doctor may appear to be unsympathetic or “cold,” but he or she’s really just operating in a normal mode. This is actually good because objectivity is needed in order to appropriately evaluate your symptoms and determine the best course of action. This might also help you look at your interactions more objectively, trying to elevate yourself to their wavelengths.
- When doctors are late, try to avoid getting upset and angry. There is often a good reason for this. It’s so easy to get behind when trying to take care of every patient’s needs (not everyone has problems that will fit into a 10 or 15-minute slot). So, think about how you would want the doctor to take care of you if you had a very serious/life-threatening condition. Would you want him or her to rush through so that he or she wouldn’t get behind for the next appointment? The other possibility is that he or she was held up at the hospital that morning making rounds. He or she has no control over who gets admitted to the hospital and what their needs are. Again, would you want him or her to hurry through seeing you at the hospital to make sure he or she gets to appointments on time?
- Not knowing your medications or your medical problems is extremely frustrating to a physician. It’s so hard to know what you mean when you say, “the blue pill,” or, “I think it’s brown, but I’m not sure.” Of course, most of the medications are probably in your record, but that takes extra time to look up and then double check with you that you’re taking them. If you have your list on a 3x5 or 4x6 card, then you’ll be able to easily communicate what those medications are. Not only will that make the time go faster, but it will also impress your doctor.
- You need to make a symptom diary. When you start having problems, you should begin recording them. Write down what your symptoms are, when they started, and what makes them better or worse. Write in your symptom diary so that you know how long things have been bothering you and how they have changed (better, worse, different location, different character, etc). Make sure you add your associated symptoms.
- Write down your questions ahead of time. This is so important. Once you get in the office, you’ll be distracted, and chances are you won’t remember the questions you have. Then you’ll be upset and frustrated when, after you leave the office, you remember that you didn’t ask the questions.
- Take something to write with. Take a notebook and pen. At first you may feel awkward, but after you’ve been doing this for awhile, it will seem totally natural-and essential. You can take notes while the doctor’s talking to you. You can write down instructions and times to call back. You can get the people in the office to help you write down the things they think are important.
- Make sure you ask the doctor for clarification of anything you don’t understand. This may not be that easy initially because being in that situation tends to intimidate people. But it’s important to remember that this is your health and your life, and you must get things clear. It’s a good idea to tell the doctor, right in the beginning, that you will be asking about things you don’t understand. For some people, it’s difficult to question an authority such as a doctor. But unless you understand what’s going on and what the doctor wants you to do, you cannot possibly be a part of the treatment. Remember that it’s your health, and you MUST understand what’s expected of you in order to take charge of your own care. Do not let the doctor push you around
- You must tell the doctor the entire story. Do not leave things out just because you’re embarrassed, or you don’t think that something is important. If you’re taking herbal medicines or products, make sure you tell him or her about that. If you’re having problems at home or you’re depressed, mention that, too. If he or she doesn’t know the entire truth, he or she may miss something in the diagnostic process or may prescribe something that would interfere with what you’re already taking. Do not leave anything out.
- Ask for references, whether they’re handouts, pamphlets, or even Internet references. No one really expects you to understand what’s going on from a 10 or 15-minute appointment. There are many references for you, and if you have a chronic condition, there are probably support groups that the staff can give you information about. These references are important because they will help to answer the questions you’ll think of after you get home. If you tell the doctor and the staff that having some references or places where you could go look things up will keep you from bothering them, then that will endear you to their hearts. In addition, they will increase your knowledge about your condition. This is another essential aspect of you taking part in your care.
- Keep track of your information-keep it all in one place. Use file folders for each doctor. You can keep your symptom diary, your insurance forms, directions to the doctor’s office, the phone number, your question log, your advanced directives, information that he or she has given you, etc. in each file.
About the Author
Dr. Wurzbacher is a retired Navy emergency medicine physician who recognized, early in her career, that she wasn’t good at communication and, more importantly, that she was probably missing much of what her patients were trying to tell her. Although she was excellent at diagnosing conditions, patients generally need more than that. The emergency department is one (of many) places that being good at communication is essential, since you have no records to work with and a short amount of time to glean information and make a diagnosis. So, she worked diligently at learning to really HEAR what her patients were telling her. Teaching young doctors and ancillary staff the personal aspects of medicine has become a passion of hers. Her book, Your Doctor Said What? is intended to help patients not only understand why many doctors seem like aliens, but also how to empower themselves to deal with them. Check her out at http://www.yourdoctorsaidwhatblogs.com.
