Don’t Just Show Up
“My doctor doesn’t listen” is one of the most common complaints Americans have about their medical care, according to research from Boston’s Picker Institute.
Small wonder. Given that a typical appointment lasts about 15 minutes and doctors interrupt patients, on average, 23 seconds after they begin to explain what’s wrong, a medical visit is not exactly a relaxed chat over a cup of tea. But you can get more out of this key relationship if you plan ahead. Here are seven tips on talking to your doctor, based on current research and on the advice of doctors concerned with this aspect of medical care.
1. Prepare for your visit. Doctors rarely have time these days to behave as if they’ve stepped out of a Norman Rockwell painting. But many people walk into the examining room with nothing more concrete to offer than a vague complaint that they’re not feeling well. To make the best use of the appointment, write down all of your concerns beforehand in order, from most urgent to least, and take the list along with you.
In addition, jot down anything related to your health that has happened since your last visit. If this is the first time you’re seeing a new doctor, come prepared with notes on any disease that runs in your family or past treatments you’e had. Also plan to bring with you medical records and X rays from your former doctor. If the office won’t release them to you, have the records sent directly to your new doctor before your first visit.
When you’re clearly prepared it will send a signal that your doctor interprets as, “This is a serious person who respects my time.” And you’re more likely to get what you want from your visit.
2. Let your doctor know how much information you want. Some people like to know everything about their conditions, while others prefer a short, simple explanation. Some expect to share fully in every decision made about their problems, while others want their doctors to take the responsibility.
Doctors appreciate it when you tell them from the start how much and what kind of information you want. They can then tailor the visit to fit your needs.
Although the trend today is for people to be more involved in their health care than in the past, not all doctors will respect that preference. If you ask for a detailed explanation of your options, your doctor should offer just that–and not simply say, “I’ll sign you up for treatment next week.”
“You’re not going to make things work well with the wrong doctor,” says Mack Lipkin, M.D., Professor of Clinical Medicine and Director of Primary Care at New York University School of Medicine in New York City. If you feel your doctor isn’t listening, Lipkin advises that you say something along the lines of, “Doctor, this is important to me, and I’d like you to take that into account.” If your doctor still doesn’t hear you, it’s probably time to find someone else.
3. Be honest, even if some topics embarrass you. Some people find it difficult to talk to their doctors about what causes them the most distress, such as impotence or incontinence, or even problems that put them in danger, such as physical abuse. But your doctor has probably heard similar confidences many times before. Physicians are trained to help with issues you wouldn’t want to discuss with anyone else. For people who nonetheless find themselves unable to bring up a topic, one option is to write down the problem beforehand and hand it to the doctor, saying that you’re uncomfortable talking about it.
Also, be honest if your doctor gives you any medication that causes you problems. You may be taking a drug that successfully lowers your high blood pressure, but its side effects of more frequent urination or dizziness make it seem like more trouble than it’s worth. In such an instance, “You should certainly say to your doctor, ‘My life has been much worse since I started taking that drug’,” advises Steven Woolf, M.D., of Virginia Commonwealth University in Fairfax. “Otherwise, your doctor has no way of knowing the drug has a negative impact on your life. If you’re straightforward, your doctor may be able to substitute another drug or reduce the dosage.”
4. Ask about any new medications your doctor prescribes. When your doctor hands you the prescription, make sure you know the following: What’s the name of this medicine, and why is the doctor prescribing it? How, when, and for how long should you take this drug? Is there anything to avoid while you’re on it, such as certain foods, drinks, or other medications? Should you avoid driving while you’re taking these pills? What are the possible side effects, and which ones should you be concerned about? What should you do if they occur?
If you don’t like the idea of taking a particular medication your doctor prescribes, say so before you leave the office. Maybe your neighbor had poor results with that drug, or you won’t be where you can take the pills four times a day with a full glass of water, or you’re troubled by the possible side effects. Whatever your concerns, tell your doctor about them. By discussing the matter, you should be able to come up with an alternative that satisfies you both. As it is now, research reveals that about half the prescriptions written by doctors are either never filled or are taken incorrectly. So don’t waste both your time and your doctor’s by nodding agreeably and then tossing the prescription into the nearest wastebasket after you leave the office.
If you’ve started taking a new herbal supplement or vitamin since your last visit, bring the bottle with you. “I’d rather see the actual bottles and then note in the chart everything a person takes, including over-the-counter herbal supplements,” says Michael Fleming, M.D., Professor of Family Medicine at the University of Wisconsin-Madison School of Medicine. Sometimes the most innocent over-the-counter preparations can interact adversely with a prescription medication. Along the same lines, if you’re seeing a doctor for the first time, bring in all the medicines, herbal supplements, and vitamins that you use.
5. Bring along a pencil and paper so you can take notes. Better yet, ask if you can tape record your doctor’s explanations. Even if it’s a routine visit, a medical appointment can be stressful and not conducive to careful listening. If the visit turns out to yield an unexpected diagnosis, a tape recording of what your doctor said can help immensely.
Stephanie Bobrowsky, a health news reporter who lives in Columbia, MD, wished she’d taped a visit during which her doctor told her he detected a suspicious shadow on her mammogram and said he wanted her to have a biopsy to rule out breast cancer. Stunned, Bobrowsky asked if there wasn’t some other test she could have instead. She knows he explained his reasons for recommending a biopsy, but she can’t remember a word of it.
“I forgot what he said as soon as I walked out of the office,” Bobrowsky recalls. “All I could think of was breast cancer. Although I’m trained to gather facts, I was too emotionally upset to take it in.” Bobrowsky had the biopsy, which showed she did not have cancer. But she remembers wishing she could have turned on her tape recorder at home, when she was calmer, and played back the conversation.
6. If you have your own opinions about tests or treatments, tell your doctor. If you see your doctor about back pain, you may think that an X ray will be done of your back. If your doctor doesn’t order one, you’re likely to leave the office feeling frustrated and dissatisfied. But if you ask, “Why don’t you want to do an X ray? I thought that was standard with back pain,” your doctor and you can discuss the reasons. What your doctor cannot do is guess what’s on your mind if you don’t say anything.
Expressing your own ideas helps both you and your doctor avoid the outdated, authoritarian scenario in which a person is expected to passively “comply with” or “adhere to” doctor’s orders. These times make it imperative to look at the doctor-patient relationship as a collaboration rather than a reporting relationship between a subordinate and superior.
7. Sum up the visit in your own words. Before leaving the office, say, “So today you recommended that I…” and recap your understanding of what your doctor told you. Then, if there’s any confusion about your condition, treatment, or medication, your doctor can clear it up on the spot.