During the average office visit the physician listens patiently and compassionately for…14 seconds. That is how long it takes the doctor to interrupt. This means patients speak fast, doctors can read minds or that as physicians we are doing a lousy job of listening to our patients. Given the stories I hear from my patients, as well as knowing the rush I often feel in seeing patients, I suspect “lousy job” often comes in first.
Unfortunately, rapid interruptions are not the whole story. Doctors also may not examine their patients thoroughly, may not ask all the questions that are needed, and do not always educate their patients about what is happening. In substitute for these basic elements of bedside manner, we tend to order excess consults and tests. We trade basic quality personal medical care for cold expensive machines and numbers.
Now, let me be clear. This is the doctor’s fault. Because of training, fatigue, a lack of empathy or just being too busy, doctors can lose track of the very patients they are supposed to be helping. Basic elements of the physician – patient relationship are skipped. A relationship that can be so powerful and heal just by two people working together is drowned in a flood of data, paperwork and distractions.
However, while I blame doctors, there are many things patients can do to help (other then doctor shopping until you are so exacerbated with the entire medical profession that you do not get the vital care you need).
First, be prepared. Know what you want to talk about and write it down. Focus on a short critical list. If your list of problems is long either arrange for an extended visit or make a plan to come back soon. Do not get distracted, stick to that script. If the doctor interrupts, make sure you eventually come back to your questions and list. His/her questions are important, but so are yours. Make certain to answer his/her inquiries completely and honestly. A doctor’s office is not a place to be shy.
Items on your list might include any new symptoms (when possible avoid re-discussing old issues), blood tests (needed or results), blood pressure, tests (mammograms, bone density, colonoscopy…), new family medical history, or medication refills. If you need refills, know the exact amount and dose (better yet bring the bottles). Know your pharmacy number.
A typed list of your medical history is very helpful. Any records you can assemble from prior visits help complete the picture.
When possible go to the doctor with a friend or relative. Another voice and ear really helps.
After a physician explains something to you, tell him what you think you heard. Briefly, repeat the advice, explanation or instructions to make sure you had it right. Write it down. Get clarification of medical terms.
If you brought Internet printouts with treatment alternatives, give the doctor time to review them. It may help to drop it off a couple days before your visit, or just ask the doctor to read them and get back to you. Perhaps, have the doctor send you an email, if it seems appropriate.
Be friendly not only with the doctor, but with the staff. Remember that not all the confusion with insurance, co-pays and referrals was invented by the doctor’s office. We are all trying to figure it out. If you have an extended relationship with a physician, occasionally bringing donuts or fruit to the front desk personnel goes a long way. A thank you to doctor and staff is always welcome.
If you become frustrated with a doctor, whether it is about wait time, lack of answers, lack of listening, paperwork or even an inadequate physical exam, tell the doctor. Doctors want to know. They want to help and have dedicated their lives to that cause. They can better serve you if they get proper feedback. Do not hesitate to gently educate them. Do not bother telling the staff about these issues, because usually the staff will “protect” the doctor and not tell him/her.
Yes, I agree, doctors should do this better and when you are sick, taking care of the doctor may not seem fair. Unfortunately, life is not always perfect. When your health and life is at stake, you really want it to be. You are half of the physician – patient relationship and as in any other relationship there is a great deal you can contribute.