Do you know the best questions to ask about your healthcare?

expectations, concerns, obstacles-medical communication #askthedoctor

I blog about healthcare communication because you need to understand your doctor better and  we doctors need to understand our patients’ expectations, concerns and obstacles.

Physicians should  use clear understandable plain language with patients. Patients should also be clear and specific when they talk to their doctor.

You may think your doctor knows exactly what you mean, but sometimes we are left trying to read between the lines of what you tell us.

Dr. Aletha talking to a mother and her son
Talking to a patient through an interpreter makes communication extra challenging.

You know it’s important to tell us details of your symptoms, medical history, family history, habits, and other medical facts.   But besides medical information about you , we need to know

Your expectations about your care,

Your concerns about your care,

Your obstacles to getting care,

You may wonder, won’t or shouldn’t my doctor ask me theses questions? Sure, we can ask and probably will, but by volunteering it , you start dialogue that gets you and your doctor communicating effectively much faster. Your doctor knows about disease, but you as the patient know the experience of the illness much better. 

Let me illustrate by giving you some examples. These are all statements patients say  to me in my daily practice. The original statements aren’t bad or wrong, but by rephrasing to add some additional detail they  give your doctor valuable information that will help provide you the best care possible.

The underlined words can be substituted for others listed in parentheses.  The exact words aren’t as important as the  message they convey. 

Hello doctor, I’m here because I want my thyroid checked.

(substitute heart, lungs, cholesterol, blood sugar, kidneys, etc.)

Instead try-

Hello doctor, I’m tired a lot, and wondered if it might be a thyroid problem or something else. What testing would help us find out what’s wrong with me?

It’s better not to limit your doctor to checking just one thing, when there are many possible explanations for your symptoms. You expect a thyroid check, but you’re open to other possibilities.

tubes used to collect blood samples in a lab

 

Doctor, I feel terrible and think I have  pneumonia. The last time I felt like this the doctor said it was pneumonia, so it must be that again.

( sub kidney infection, strep throat, sinus infection)

But if you say this

Doctor, I feel so sick. This illness is similar to when I was diagnosed with pneumonia and I’m afraid I have it again. I am concerned it’s pneumonia again so  I’m here to find out what is wrong, as I realize it may be something else.

You’ve told the doctor your concern about pneumonia but you’re not trying to diagnose yourself.

 

 

I have a family history of cancer so I want to have a mammogram.

(sub any other cancer, heart disease, stroke and other tests)

That’s good, but this is better.

Doctor, I’m concerned about breast cancer as it runs in my family. My grandmother was diagnosed at age 45 and now my sister has been, and she is 40. Do I need a mammogram or any other testing now?

Knowing who in your family had a disease and at what ages helps the doctor make an accurate recommendation. It also tells your doctor this may be an emotional issue  (concern)  for you.

Top 10 cancers in the U.S.

 

 

I need an antibiotic (anti-inflammatory, muscle relaxer, steroid, shot )  for this; I know because my previous doctor always gave me one for this.

Please try this instead:

When I had this before my doctor prescribed an antibiotic; I wonder if that would be appropriate this time?

This tells the doctor your expectation, but also that  you are open to different  advice/recommendation. (and avoid getting a medication you don’t need.) 

6 smart facts about antibiotic use

 

 

 

Will my insurance pay for this? How much will this cost me? Is this an expensive drug?

Patients may expect us to know about insurance and cost, but often we don’t. We can work with you on financial issues if we know more about your obstacle. Try asking-

I need to find out if this is covered by my insurance. Can someone in your office look that up, or help me find out?

I’ve had a lot of medical bills this year that have stretched my budget. I will need to find out what my out of pocket cost will be before scheduling this test. Can your office help me with that?

If there is a generic version of this drug that will work just as well, I would like it, to minimize my out of pocket cost. If not, is there another alternative?

 

 

Is this drug safe? (effective, good, best, dangerous, harmful)  

Few things are 100% safe. But what we can discuss with you is –

What are the risks and side effects of this drug? Is the benefit I get from the drug worth the risks? Are there alternatives that would be effective and less risky?

We always should be concerned about drug use, and safety isn’t the only issue. Don’t hesitate to ask questions.

medication capsules

 

 

 

 

 

How long will I be off work? When can I go back to work?

Here’s what your doctor needs to know –

My job requires me to stand and walk for several hours?

(sit and type; talk on the telephone; drive long distances in my car)

And here’s what you need to ask:

How soon should I expect my stamina to return so I can work part time? Full time?

When can I safely work without interfering with my recovery?

What can I do to hasten my recovery so I can return to work sooner?

Both  you and your employer, need to know when it is safe to return to work.  We have to balance health concerns with your financial concerns and what is expected and allowed by your employer and the law. 

If you are clear  with your concerns and obstacles  and flexible in your expectations it will be easier for your doctor to make the right decision.

 

 

These are just a few examples. I’m sure you can think of others.

Whenever you have a need to consult a physician, think ahead of what your

expectations, concerns and obstacles are before you make the visit so you’ll  be

prepared to share .

Here are  more tips on talking with your doctor-

How to talk to your doctor to improve your medical care

How to tell your doctor what’s wrong with you.

I invite you to follow this blog as we explore the HEART of health together.

 

Dr. Danielle Ofri’s book  What Patients Say, What Doctors Hear,

details the reasons doctors and patients don’t communicate well

and offers ways to improve our interaction.

What Patients Say, What Doctors Hear by Danielle Ofri, MD
written by Danielle Ofri, M.D.

(this is an affiliate link)

How to talk to your doctor to improve your medical care

Talking to your doctor should be comfortable and therapeutic. #communication

For you to receive correct and effective medical treatment , your doctors need the right medical information.

I’ve written about doctor-patient communication before, because  it’s the most important part of the encounter. No amount of lab tests, scans,or  invasive procedures substitutes for the information we get from patients.

You may think doctors make a diagnosis based on lab tests or xrays. But much of the time, those tests only confirm what we already suspect  based on your symptoms. If we misunderstand what you describe, or fail to get complete information we may  start testing for something far removed from what is wrong with you.

 

Wrong information > wrong working diagnosis>wrong testing>wrong final diagnosis  

taking blood pressure

 

 

 

Doctors are learning how to communicate better with patients. One key is using “plain language” rather than medical jargon. However, even plain language can be misunderstood. And with a plethora of medical information online patients know and use medical terms too. Communication between doctors and patients may never be perfect, but we can do better.

 

2 medical people talking to a patient
a patient encounter in a rural clinic in Panama

 

 

 

Here are some tips on talking to your doctor .

There are always exceptions. Doctors have different communication styles, and may interact differently than what I’m suggesting here. These are general guidelines.

 

 

GET TO THE POINT

Be clear and specific about why you are there; don’t expect your doctor to uncover a hidden objective.

Sometimes we can read between the lines and suspect you didn’t come because of a mole that hasn’t changed in 10 years. So if you’re there because you’ve been having chest pain and you’re worried it’s your heart, say so . Then we have time to give your concern the time it deserves .

GIVE DETAIL

All coughs are not created equal. Knowing  your  cough started yesterday  rather than  6 months  ago helps me determine the more likely cause.

 Tell your doctor how long, how often, how severe, what helps, what worsens, your symptoms; that helps to narrow the possible causes. 

This post will explain

How to tell your doctor what’s wrong with you. 

 

STAY ON POINT

Finish talking about your cough before starting to talk about the pain in your back.

A string of symptoms without detail is confusing and doesn’t give me enough information  to evaluate any of them.

BE HONEST ABOUT YOUR MEDICAL HISTORY AND LIFESTYLE

Sometimes patients leave out important information due to forgetting, thinking it’s not important, embarrassment, or fear. But that may be the very piece of data I need to pinpoint what’s wrong.

So tell the doctor

  • If you can’t do something you’re asked  to do,
  • if you can’t afford the medication,
  • if your insurance doesn’t cover something,
  • if you are afraid to go for the test 
  • if you are seeing other doctors for anything,
  • how much you smoke,drink, or other habits

 

TALK BACK

Ask questions if you don’t understand something.

If you don’t, I may assume you do understand. Ask me to review what I  told you. Put it in your own words and ask me if that’s what I meant.

BE SPECIFIC

Patients may use words or terms they assume I understand, but may mean something different to us.

“Heart attack” often means something different to patients than to doctors.

( Patients may use it to refer to any sudden heart problem, while doctors understand it to mean a specific event called a myocardial infarction.)

diagram of the human heart

 

 

In general, avoid using diagnostic terms. Instead of saying, “I have a sinus infection.”, we need to hear “My nose is stuffed up, I’m sneezing, and my throat is scratchy.”

 

Some words your doctor may ask you to clarify-

 

  • Dizzy- do you mean off balance or spinning?
  • Tired- do you mean fatigued or sleepy?
  • Difficulty focusing – do you mean vision focus or mental focus?
  • Weak- do you lack  energy or lack strength?
  • “I’ve tried everything.”- Tell me what “everything” is.

 

If you have  received a specific diagnosis from a doctor, it’s helpful for us to know that; we may want to confirm it with appropriate questions, exam, review of your records, and possibly additional testing.

 

Read about Understanding medical terms and asking questions 

 

And I share medical terms and their meanings at  Watercress Words on Facebook

 

 

TELL ME WHAT WENT WRONG

I know this one is tricky; you don’t want to offend me, maybe you’re afraid you won’t get good care if you complain. But I can’t fix problems if I don’t know about them.

If my care or care from my staff is unsatisfactory, please tell me. If you offer constructive criticism about specific problems, we can work together to solve them. And if it’s not something I can or will change, I will explain. 

 

Learn to handle conflict here Why patients sue their doctors 

 

 

doctor holding a patient's hand
Courtesy and kindness should be part of every medical encounter.

 

 

Talking to your doctor should be comfortable and therapeutic. Remember

It’s confidential,

It’s all about you,

It’s not a surprise to your doctor- we’ve heard just about everything before

 

 

Over the Moon Link Party- featured Blogger
This post was featured at Over the Moon Link Party

 

Health blogs you should read- blogs by docs (part 1)

These blogs open a window into the medical community. You may be surprised that physicians have the same concerns about health and medical care as you , and some that you are unaware of. Most importantly, you will find they are on your side; they care about you,their patients, probably a lot more than you care about them.

Why read Health, Fitness, and Medical blogs

Since I started blogging I have reviewed many health, fitness and wellness blogs. I find most of them interesting and/or entertaining. I find a few of them informative, stimulating ,and valuable.

  • health bloggers who write about their personal experience dealing with a particular medical condition, which I think can be powerful and helpful.
  • bloggers who discuss and promote a particular lifestyle or product that they believe has value to health and/or fitness.
  • blogs written by people with training and experience in some aspect of medical care, wellness, fitness and/or nutrition (all of which I define broadly)

I think all of these blogs have a place and all seem to have their audience. One of the first things I check when I read a blog is the “about” section, or its equivalent. I want to know who writes the blog and what their credentials are. Anyone who writes a blog about a particular topic should clearly and accurately state their credentials for that topic, or lack of, if that’s the case. (I state my credentials on the page “Meet Dr. Aletha”)

Health blogs worth reading

In this blog series, I tell you about health blogs that I think are worth reading. Most of them are written by physicians, medical scientists, other health professionals and affiliated professionals. Persons who spend the majority, if not all, of their adult life studying and pursuing a discipline, likely know that subject well.

I recommend these health blogs because they

  • offer valid medical information on a variety of topics.
  • offer sound advice without quick fixes.
  • discuss common everyday health concerns
  • discuss the healthcare system, how it works well and how it doesn’t.
  • offer insights on healthy living, both as individuals, families and a society.
  • show you how physicians think , feel and act , both as persons and professionals
  • will educate and challenge you.

These blogs open a window into the medical community.  You may be surprised that physicians have the same concerns about health and medical care as you , and some that you are unaware of. Most importantly, you will find they are on your side; they care about you,their patients,  probably a lot more than you care about them.

These bloggers’ viewpoints often surprise and challenge me; I don’t always agree with them and you may not either.  By recommending them, I don’t endorse their opinions, nor do I benefit financially.  

“Alert and Oriented”

the progress notes of Michel Accad, M.D.

(Doctors write progress notes  in the charts of hospitalized patients to document medical treatment and response each day)

Dr. Accad is a cardiologist and internist in solo private practice and teaches at the University of California San Francisco.

” ‘Alert and Oriented’ is a medical phrase that describes the mental status of a patient who, despite being in serious shock from trauma or disease, maintains clarity of mind and focus of thought.

EKG tracing of heart activity on a cardiac monitor.
Based on the heart rhythm, this patient is likely alert and oriented.

Sadly, the medical community enmeshed in today’s health care system is like a patient in acute shock. The only chance to survive is to remain alert and oriented.” (quote from the blog introduction)

Dr. Accad blogs about the healthcare system, the doctor-patient relationship, medical ethics, medical economics, and health care policy.

In this post he explains the

evolution of the food pyramid to the healthy plate nutrition recommendation.

healthy plate of vegetables , pita bread and hummus

In another interesting post, he explains

why mammograms may be over diagnosing breast cancer.

Breast cancer screening and treatment: One size doesn't fit all. bras hanging on a clothes line

The Accad and Koka Report podcast

Dr. Accad has joined Anish Koka, M.D. in a weekly medical podcast, The Accad & Koka Report. In their own words,

We discuss current topics in medical science, policy, economics, and ethics, always with an eye toward safeguarding the doctor-patient relationship .

Their conversations are aimed more at physicians than patients, but if you want to know what some physicians really think about the U.S. healthcare system, you might find out here. Here is an episode anyone might find interesting-what happened when a 90 year old patient of Dr. Koka was told

“You’ll be dead in a year”- A Patient’s Journey though the Healthcare System

exploring the HEART of health

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

                              Dr. Aletha 

.

Why patients sue their doctors

Too often doctors and patients become adversaries rather than partners, and this blog series addresses that.

 

 

“6 reasons to sue your doctor and how not to”

was the original title of a series of posts I wrote soon after starting this blog. Later the posts were called

 “Stopping medical malpractice- how patients can help”

 

The main point of the series ,the relationship between patients and physicians, prompted me to start this blog. Too often doctors and patients become adversaries rather than partners, and this series addresses that.

You will find  links to all four articles in the series here, with a brief excerpt from each one. They have also been slightly revised and updated.

Part 1

In the March 2015 issue of Medical Economics, attorney Richard Baker wrote,  “Being sued for malpractice, especially for the first time, can be an unsettling and frustrating experience for a physician.”    And stressful and unsettling for a patient, or patient’s family .

A medical malpractice lawsuit follows an adverse medical outcome –

  • a missed or inaccurate diagnosis,
  • an ineffective or harmful treatment,
  • a surgery gone bad,
  • an outcome that left permanent harm or at worst, death.

Patients become  upset and often angry, and may assume that malpractice has occurred. They want to hold the doctor responsible , and want compensation for medical expenses, lost income, pain and suffering.

I don’t understand all the legal aspects of medical liability. But an unsatisfactory outcome may not mean poor care ;  illness or injury can be so severe  that any treatment is ineffective.  Or  there were multiple possible treatment options so the physician  made a judgement call that proved less than ideal.

But  it may reflect some behavior on the part of the doctor, another healthcare professional, or even the patient that could have been avoided.

continued here

Dr. Aletha treating a child

 

 

 

Part 2

No matter how careful hiring policies are , incompetent, unscrupulous and dishonest employees get into the healthcare system undetected. This is  bad for any industry, but in healthcare is  dangerous and even deadly.

If you notice something out of line in a medical office or hospital, or if the care is not as expected, don’t hesitate to report it to someone in authority. You can do this anonymously, although the more specific information you provide, the more likely the situation can be corrected .Even if nothing proves to be wrong, it will  give them helpful feedback about their service.

continued here

Dr. Aletha examining an infant

 

 

 

Part 3

You can’t control  your doctor’s training, CME (continuing medical education), and certifications. But you have a right and responsibility to confirm that the doctor is qualified to perform the services offered. Doctors’ offices have diplomas, licenses, awards displayed on the walls for a reason-they want you to look at them.  Hospitals and other health care facilities confirm  that  the  physicians who work there have the appropriate credentials.

continued here

 

Dr. Aletha with a health worker in Central America
Here I am with a health worker at a rural clinic in Central America. We held a medical outreach with a volunteer team.

 

 

 

Conclusion

The best way for physicians and patients to work through their feelings about a bad outcome is to start out with a mutually respectful, cooperative relationship.

Just like any other relationship, there may be times of disagreement; but these can and should be resolved with each satisfied that their viewpoint has been listened to , understood, and respected

continued here  

 

Dr. Aletha talking to a mother and her son

 

(Photos are from volunteer medical trips to Mexico, Panama, Ecuador and VietNam )

 

 

Dr. Danielle Ofri , author of several books about practicing medicine and patient relationships, considers effective doctor-patient communication crucial to successful medical outcomes. I reviewed her book here

What Patients Say, What Doctors Hear- a book review

What Patients Say, What Doctors Hear by Danielle Ofri, MD- a book

 

 

3 keys to effective communication with your doctor, part 2

In part 1, we considered the importance of establishing a connection between doctors and patients before trying to communicate. The goal is to establish effective patient engagement. (if you haven’t read part 1, I suggest reading it now, this post will make more sense if you do)

Now we’re going to look at some practical aspects of exchanging information with doctors- remember, exchange means give something and receive something  in return. 

Doctors want to give patients the information they need and most of the time believe they have done so. We are surprised when patients come back and say we didn’t explain their problem and its treatment, or they didn’t understand what we told them about it. I think this happens for 2 reasons.

  • We doctors tell patients what we think is important, but it may not be what you the patient or family considers most important.
  • After patients hear part of what we say, they get saturated and don’t hear the rest, especially when it is emotionally charged.

 

That’s why it is so important for patients and families to ask questions; don’t just rely on what the doctors volunteer. What is important to them may not be what is most important to you. And the more specific questions you ask, the more detailed the information you receive will be.

The one question you should always ask a doctor at each visit is

“What is the most important problem today, and what is the next step in treating it?”

The most important problem that the doctor finds may not be the one you were admitted for or came to the office for. Or if you came with multiple problems, the most important may not be the one that seemed most urgent to you.

For example, you may go to an emergency facility for an injury that caused a large gash on your leg, one that needs stitches. This is an urgent problem that needs to be treated. But the doctor finds that you have high blood pressure that you are unaware of. High blood pressure can lead to heart failure and stroke  if left untreated. So the doctor is going to instruct you to see your primary care doctor to have this problem addressed. In terms of your long term health, the high blood pressure is your most important problem today.

 

It is important to control blood pressure
High blood pressure can cause a heart attack.

 

You will get more helpful information from your doctor if your questions are as specific as you can ask; always inquire as to how tests and procedures this will affect your treatment and recovery. Here are some examples-

  • What did the xray show and what does mean for my problem?
  • What was blood test result and will it change my treatment?
  • How will this procedure change my condition?
  • What needs to happen before he can move out of ICU?

 

Write important things down. Questions that you want to ask. Information that the doctors need. Answers to the questions. Refer to it each time you speak with the doctors.

 

When you or a loved one is in the hospital, your main concern is going home. When the time comes to be discharged, it is just as important to ask questions and understand the plan as during the illness. Too many times I have had patients return to my office after a hospital stay  unable to give me any information about their illness and care . Important information to know include

  • What problems were treated during this admission and how did they change?
  • What will we need to do at home to continue the recovery?
  • When do we need to see a doctor and which doctor do we see?
  • What medications will I need to be on when I go home?

 

Understanding your doctor– medical jargon may not be the problem

Doctors are being encouraged and taught to use “plain language” when talking to patients, meaning limiting the use of medical jargon. I agree that a string of highly technical terms of any kind makes communication harder. But I’m not sure that simply using plain words solves the problem either. Whatever terms you use to exchange information must be understood by both persons. And that is not always the case.

Here’s an example.

If a doctor says that you or a relative has had a Myocardial infarction , do you know that that means a Heart attack? 

But, do you know exactly what heart attack means? Probably not.

 

What causes heart disease?
A heart attack means the heart muscle is injured from too little oxygen reaching it, usually due to blockage in the arteries.

 

 

So,  if the doctor says “heart attack” without adding any additional information, you should ask

  • “I understand a heart attack to mean ________. Is this correct?”
  • “I do not understand what a heart attack is. Please explain.”

 

You can master medical  terminology . How many new things have you learned in the past 5 years? Each of those had a vocabulary and instructions that you learned and now use regularly. Think of your first smartphone, tablet, digital camera or even a coffee maker . You make the effort to learn what is important to you . 

Make an attempt to learn about your and your family’s medical issues; even if you don’t understand it completely your doctor will appreciate that you are trying.

In addition to  doctors you have nurses, pharmacists, dieticians, physical therapists, social workers who can answer questions. Ask for referrals to community resources.

There are helpful resources on the Internet so anyone with a laptop, tablet, or smartphone has access to medical information anywhere anytime.

Sometimes it is helpful to find accurate definitions of medical terms. Consider using the

Plain Language Dictionary from the University of Michigan

The dictionary is also offered as a free app on iTunes for iPhone and iPad .

Another source from the CDC is Plain Language Thesaurus for Health Communications-available to download as a  Word document or PDF versions

 

 

Understanding Medical Words: A Tutorial from the National Library of Medicine will help you understand where medical terms come from and how to interpret terms that are new to you. There’s even a test at the end to see how much you learned. Comment and let me know how you do.

 

rhinoceros
It’s easy to remember that “rhino” refers to the nose, as in rhinosinusitis.

Also on this topic, my previous  post How to tell your doctor what’s wrong with you 

3 keys to effective communication with your doctor

Expressing feelings honestly and respectfully, and listening with empathy and respect can build the trust that is vital to creating a connection for effective information exchange – communication.

Surveys suggest doctors and patients often fail to communicate effectively, so public and private medical organizations have implemented programs to improve “patient engagement”. But what exactly does that mean?

The communication problem

Patients may feel that doctors don’t listen to them, ignore their questions , dismiss their concerns, don’t spend enough time with them, and don’t use language they can understand.

Physicians wonder why patients withhold important health information, fail to follow up with recommendations, and don’t ask questions or express their concerns.

The main problem with health care communication is that it involves people- and people frequently communicate poorly, and sometimes not at all. It never will be perfect. But we can do better.

So what is true patient engagement anyway?

Dr. Rob Lamberts writes

“Engagement is about interaction, listening, and learning in relationship to another person.”

Barbara Ficarra, R.N. , puts it this way:

Patient engagement is a connection between patient, caregiver and health care provider.

Patients and their families are empowered and they are active in health care decisions.

Those patients and consumers who choose to be actively involved and in charge of their health work together with their health care providers to successfully rech their health goals and needs. “

To make healthcare interactions more effective, efficient, and empowering, both doctors and patients need to develop skills that may be different from what they have done in the past.

What is communication?

to convey or exchange information, thoughts and feelings.

to join or connect.

Communication is a connection allowing access between persons

doctor holds patient's hand
on a mission trip to Mexico; photo by Brian Edgerton

Establishing a connection, or relationship.

If we try to start exchanging information, or even thoughts and feelings before we have established a connection, it is like to be unsatisfactory.

For example- think about a recent retail service experience – one that worked and one that didn’t. Perhaps it was a call to customer service to get a phone service problem resolved. Or maybe you went to a car dealership and interacted with a sales person. Whatever the situation, and whatever the outcome, you probably rated it more favorably if you felt connected with the person helping you.

Recently I called my medical insurance carrier to resolve some unpaid claims- and my insurance is through a government agency. I dreaded the call, expecting a difficult unpleasant conversation. But the rep was professional, efficient and confident. She started immediately by telling me her name and position, then asked me my name. She then accessed and reviewed my account, giving me feedback about what she found. Then we started working on my problem, and continued until it was resolved. I was surprised to have the situation taken care of not only efficiently but pleasantly.

In dealing with others be willing to be frank , flexible, and forgiving.

the who of connection

Customer service depends on connecting, and that usually starts with knowing who you are dealing with. The first item we exchange in any human interaction is usually our name.

Dr. Oglesby nametag

You should learn your doctor’s name and credentials-M.D., D.O., and specialty- internal medicine, cardiology, psychiatry, etc. in other words, what kind of doctor are they?

What is this doctor’s role in your care? Is this doctor primary or a consultant, and what issues are each managing? (especially in a hospital situation)

Tell your doctor what name you prefer to be called if it’s different than the name on file. Your doctor should know who is your legal next of kin or who has POA (power of attorney if applicable)

Introduce other family and friends and identify the primary contact person; this first level of receiving and giving information, is especially important in the hospital setting. This will create continuity as the doctor speaks to the same person every day.

If you take a friend or relative to your doctor’s office with you, make sure they understand what their role is. Your family’s insights and observations provide helpful information to supplement what your doctor learns from you. They can help you remember and understand answers and instructions. But this isn’t a time for them to discuss their own medical issues with the doctor.

the where of connection

Where you interact with your doctor, is important as interaction may be quite different in a private office setting vs an urgent care clinic vs an emergency room vs inpatient. But general principles apply to all settings.

Approaching others with generosity, grace, and gratitude makes it easier to connect.

EMERGENCY-sign
Photo by Pixabay

Ideally it should be as comfortable as possible, private, and quiet, so you can hear and see each other well.

Friendly greetings are fine anytime you encounter your doctor, but discussions of personal medical information don’t belong in the hallway, elevator, or cafeteria. Likewise, if you run into your doctor at church or the grocery, just say hello.

the how of connection

Come to an office visit prepared. If you have test results, previous medical records, xrays, etc. bring them with you. Not all doctors will request it, but most will appreciate an up-to-date list of all medications you take, or even bringing the meds with you. Turn off your phone.

Expectations about time can create conflict, whether the visit lasts longer or shorter than you expect. If you weren’t told, ask the office how long the appointment is for, realizing that it will only be an estimate; it will depend on what you and the doctor end up discussing and what you need done.

Showing up on time helps the office keep to their schedule and shows the doctor you are serious about your care and respectful of other patients’ time. If the office is consistently poor at time management, address it respectfully; sometimes it is best to move on if this continues to be an issue that bothers you.

Most hospitals and clinics have abandoned paper charts for computers, using electronic health or medical records- EHRs or EMRs. I’m not going to dwell on it now, but computer use in the exam room or bedside has changed the dynamic between doctors and patients in ways that were unexpected and challenging. Here is the link to a post I did addressing the issue of

Electronic Health Records- Challenges and Changes

Stethoscope on the keyboard of a laptop

the value of connection

Connecting with your physician depends on acknowledging feelings- worry, fear, despair, hope, relief, anger, resentment, frustration. Give feedback respectfully; if anything about your care is not as expected, or doesn’t seem appropriate, or you just don’t understand something, speak up.

Expressing feelings honestly and respectfully, and listening with empathy and respect can build the trust that is vital to creating a connection for effective information exchange – communication.

a male doctor talking to a middle aged woman
Dr. Weinkle with a patient

Dr. Jonathan Weinkle discusses connection and relationships in his book

HEALING PEOPLE NOT PATIENTS: Creating Authentic Relationships in Modern Healthcare

which I reviewed at this link.

exploring the HEART of communication

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                              Dr. Aletha 

Stopping medical malpractice- how patients can help -conclusion

(previously posted under the title 6 reasons to sue your doctor-and how not to-conclusion) 

The final  reason to sue your doctor involves feelings ,which is more  difficult to quantify and illustrate than the behaviors I have discussed before. Attorney Richard Baker tells physicians, “Don’t be afraid to face them (family of a patient with a bad outcome.) It’s important to let them know you understand how they feel. Compassionate gestures count.”

The best way for physicians and patients to work through their feelings about a bad outcome is to start out with a mutually respectful, cooperative relationship. Just like any other relationship, there may be times of disagreement; but these can and should be resolved with each satisfied that their viewpoint has been listened to and considered and  are comfortable with the final decision.

mission trip in Mexico; photo by Brian Edgerton
mission trip in Mexico; photo by Brian Edgerton

More important than liking your doctor is feeling comfortable with their personality and communication style, respecting their knowledge and skill, and trusting that they will behave ethically and do what is in the patient’s best interest. Patients contribute to the relationship by respecting the doctor’s time, observing boundaries on the doctor’s personal life, and being financially responsible.

When you are unhappy with some aspect of your care, doctors prefer that you address the issue directly and respectfully; no one likes feeling attacked personally. A complaint should be as specific as possible and include what you think is the solution. If you find yourself feeling disappointed, frustrated, or angry at your doctor more times than not, don’t let the situation drag on or escalate. It’s time to admit that the relationship is not compatible and move on.

Here are some ideas on how to find a new doctor.

Here is a summary of the 6 ways patients can help stop medical malpractice suits: 

  1. Cultivate communication

    Doctors need to do it better, and patients need to feel that their input is welcome and valued.

  2. Understand what’s happening

    Doctors need to explain information and patients should ask questions when they don’t fully understand

  3. Credentials

    Doctors need to stay current in their specialty certifications and licensure and patients need access to that information.

  4. Follow up-

    Doctors need to report all diagnostic results and patients need to receive them

  5. Report problems-

    Doctors need to know if anything irregular is happening and patient should report their observations without fear of retaliation

  6. Establish rapport

    Doctors and patients don’t need to be BFFs but should respect each other and show kindness and compassion. We all need it.