At one time or another, most of us have complained about feeling dissatisfied with a visit to the doctor’s office. When I hear people voicing their concerns to anyone who will listen-except their doctor-I’m convinced that part of the problem lies in our difficulty speaking honestly with authority figures.
The health-care system has changed over the past five or 10 years. Hospital stays are shorter, and walk-in clinics are more frequently used, in part due to the lower number of GPs accepting new patients. In today’s system, you play an important role in your own care. Here are tips for conveying your needs, so your time with the doctor is as helpful as possible.
Humanizing your doctor
We expect a lot of health practitioners: to spend a reasonable amount of time with us, to communicate effectively, to be in a good mood and to have answers to all our medical questions.
If you ask patients whether these expectations are met, some will say yes, but the majority feel let down. Why? It may be that our expectations are unrealistic, or it may be the result of a breakdown in communication.
Patients often think of their doctors as infallible, but open conversation can change that. If we see our physicians as ordinary people, our expectations will become more realistic.
For example, when a patient visited her doctor for a cold, the doctor was annoyed with her for taking up valuable time. The patient was surprised that he would speak to her so irritably. When he saw her reaction, the doctor apologized. He explained that he had a heavy patient load that week and was also worried about his young daughter, who was sick. The patient realized that perhaps her doctor had a point about a needless visit and that he, too, had personal stresses.
Tell your doctor if you feel uncomfortable with any aspect of your care. You may be uneasy with groin, rectal or breast examinations, for example. A doctor will usually understand and try to decrease your nervousness. But you might want to think about whether the problem could be your own aversion to invasive procedures, which is not uncommon.
If this is the case, you could try thinking or chatting about other things during such exams. Joking can help both the patient and doctor relax. If, however, you still don’t feel at ease, it might be time to consider finding another doctor.
Feeling ignored or dissatisfied
Expressing how you feel to your doctor is important. However, not everyone is open to hearing your criticism, especially if that person is the target. Choosing the right time is important, as is figuring out how to make your point without causing offence. The old adage that you can catch more flies with honey than vinegar rings true, as long as sincerity is a critical ingredient.
Suppose you feel your doctor doesn’t grasp your symptoms accurately. You decide he or she is being obstinate and unwilling to hear what you have to say, and perhaps you’re right. However, you might be able to get your message across by saying, for instance, “Doctor, for some reason, I don’t seem to be describing my symptoms clearly. I wonder if there is some other way I could describe them to help you understand.” This would give your doctor an opportunity to recognize that he or she isn’t on the same page as you.
Exploring your family medical history
We often forget to inform the doctor about crucial family information that might affect diagnosis, prognosis, intervention and even medical treatment. There are many conditions with hereditary factors, such as heart disease, stroke, mental illness and certain types of cancer. If your doctor knows about these patterns, you can discuss which symptoms to watch for and which preventive steps to take.
Imagine a patient becomes concerned about her risk of a stroke, so she books an appointment with her doctor to discuss it.
“I had no idea about the history of strokes in my family until my grandfather’s last year,” she says. “My mother told me that her own grandfather had died of a stroke, too.”
“I see,” says the doctor, taking notes. “I’m glad you’re telling me now. Better late than never.”
“Then a friend told me that chronic stress can add to the risk,” says the patient. “I have a high-stress job, so I began to worry.”
“I think it’s premature to start worrying,” says the doctor. “A family history of stroke is no guarantee that you’ll have one, too, and there are lots of things you can do to reduce your risk.” She explains some of the lifestyle factors the patient could control, before finishing up by saying, “You were right to tell me about this possibility. It gives me a good frame of reference and means we can work together to keep you as healthy as possible.”
The patient leaves the doctor’s office feeling relieved-and with a lot of accurate information about strokes.
You should take note of any changes in your body-such as unusual lumps, rashes or persistent pain-and be sure to communicate them to your health practitioner. It allows for early detection of potentially serious conditions and will give your doctor the opportunity to hear about any worries you might have.
Often, we don’t let the doctor know of the upsets and stresses in our personal lives, even though they might contribute to changes in our health. Emotional problems can, for example, aggravate depression, migraines, backaches, fatigue and stomach pain.
“Doctor,” says a patient, “my headaches have become a lot worse since my wife and I separated last month. They’re interfering with my work, and I’m finding it difficult to concentrate. I’ve tried taking over-the-counter painkillers, like you suggested last time, but they don’t seem very effective. I don’t know what to do.”
“Oh,” says the doctor, “I didn’t know last time about all these changes in your life. They could certainly be increasing your tension levels, which could be a reason for your headaches. How about if I check a few other things?”
As she measures his blood pressure, she asks the patient to tell her more. The patient describes how he feels about the breakup of his marriage and the stresses of his job. By the end of the visit, he feels more relaxed about his situation.
A smart analogy can be an effective way to communicate degrees of physical or emotional pain. Look at the following examples:
• “It feels like my shoulder has been pierced by an arrow.”
• “My stomach feels bruised.”
• “My muscles feel as if they are on fire.”
• “My heart feels overwhelmed with grief.”
• “I feel a crushing sense of responsibility, as though I’m carrying a heavy knapsack.”
There are many words or images you can choose; the point is to find a way to describe exactly how you feel.
For example, after a hockey accident, a patient felt as if his knee would explode. “I can see that you’re in a lot of pain,” said his doctor. “Where does it hurt most?”
“Here,” said the patient, pointing to the side of his knee.
The doctor gently touched the knee. “It’s quite swollen,” she said.
“It’s burning, throbbing,” said the patient. “Please give me something to ease the pain.”
“First, tell me how deep the pain is,” said the doctor. “Can you describe it?”
“It feels as if a knife is piercing a nerve.”
“I see,” said the doctor. “Has it been gradual?”
“Yes, it started slowly,” said the patient. “But then it suddenly got worse.”
In this way, the patient gave his doctor a picture of his pain that allowed for appropriate treatment and speedier recovery.
Putting what you hear into your own words is an element of good listening. It’s also a great way to check that you understand what your doctor is telling you.
A patient had an active life before she became plagued with chronic pain and low energy levels. She was no longer able to participate in sports and other exercises with the same enthusiasm as before.
Eventually, she found a GP who diagnosed her condition as fibromyalgia, which involves chronic sore muscles, tiredness and mental fogginess, along with other symptoms.
“Make sure you stretch before you exercise,” said her doctor. “You might also want to reduce the intensity of your exercise regime for now, to see how your body responds.”
He handed her some brochures. “Here’s some more information you can read when you get home, and we can talk about it some more at your next appointment.”
“Okay, let me get this straight,” said the patient. “I should take some time away from my regular sports, which are fairly intense. Then I should report back to you on how I’m doing. Right?”
“Right. Your next appointment should be in two weeks.”
“Will that be my last visit?”
“No, I think I should follow up with you for the first while,” said the doctor. “There are all kinds of options to explore, such as attending support groups and changing your diet. For now, start with those brochures I’ve given you.”
If we are mindful listeners in patient-doctor exchanges, we will avoid frustration and misunderstanding, and experience better results.
© 2015 By Mary F. Hawkins. Talk to Your Doc: The Patient’s Guide is Published by Self-Counsel Press. selfcounsel.com