Have you ever felt dismissed or demeaned by a physician? This blog is going to give you five secrets I’ve uncovered from years of working with physicians, personally and professionally.
They, just like us “normal” folk, have varied personalities and preferences. It sounds obvious, but, many times, we expect physicians to be better than “normal.” We expect them to have a heart of gold, a compassionate bedside manner, be an expert on all the latest research and be a savvy diagnostician. Oh, and by the way, we wouldn’t mind having their pager number or email address just in case.
As many of you have experienced, I’ve, too, have met the gamut — from physicians who were sharp and sensitive to those whose egos couldn’t fit inside the exam room.
In fact, two real-world situations come to mind. First, was the surgeon who helped my first husband and I through five years of surgical procedures. From relatively minor procedures to insert a catheter into the main artery of the heart to emergency surgery because of an intestinal abscess, he continued to be our surgeon because he was direct, kind, respectful, as well as pragmatic and serious. Mostly, we loved him and trusted him with my husband’s body and life because he not only had a demeanor that gave us comfort, but he had the reputation to back up his skill.
The second example is a consult that I scheduled with a neurosurgeon for my herniated discs. My back problems had gotten more serious for me and I wanted to learn about my treatment options. When I made the appointment, I expressly stated that I wanted to learn about my options and get the physician’s recommendation. When I arrived, I knew this appointment was going to be a challenge when the physician’s assistant asked me if I was “interested in surgery.” Interested in surgery? Frankly, who is really interested in surgery? My suspicions were confirmed when the first question the physician asked me when he entered the room was “Are you here today because you want to have surgery?”
Hold the phone. Were we all there that day to sell some surgery or to explore the needs of the patient, her perspective, issues and make a shared decision? Needless to say it was a very brief consult.
But, despite our positive or negative experiences with physicians, for those physicians you actually want to continue to work with and feel some initial comfort, I have witnessed five strategies that patients and caregivers can use to gain the physician’s respect. And, not just earn their respect, but as I have seen, you can receive more of their precious time, attention and responsiveness when you reach a level of mutual respect.
1. Prep your “story”
Physicians are taught to approach patient problems using a “scientific method.” You can gain their respect and, ironically, more of their time, by being clear, concise and factual.
Overly anxious patients (I’ve been one myself) who tell their story in a scattershot manner and throw every symptom and detail into their story will lose the physician’s attention and create a reputation with the physician that could hinder communication in the future.
It’s critical to get clear on your problem and be able to share your symptoms and the story around your problem as clearly as you can. Tell your physician the facts — what you felt, how it happened, where it happened, when it happened. You can download my Medical Appointment Prep Worksheet to help you prepare.
2. Bring your data
When I start to notice new symptoms, like pain, I have a notebook where I track symptoms. You can use a calendar or just make note on a handy piece of paper. This information can be invaluable data to back up your experience and symptoms. Physicians, using the scientific method, want facts that help them get a clear picture of what’s happening so that they can make the best diagnosis possible.
Track information like date, time of day and specific symptoms. For example, if tracking pain, you could note the level of pain (annoying or worst ever), location of pain (what specific part of the body), and quality of pain (stabbing, burning).
When you meet with the physician, ask him or her if they would like to review the information that you have tracked over the last (days, weeks, months). They may not want to look at it if it’s extensive so prepare a couple points as to an overview that you see. For example, your pain is always in one location, it usually occurs after dinner and the pain is worse in the morning and gets better through the day.
Tracking is especially helpful for you, the patient, to get clear on your symptoms. Many times, we just notice something here and there and don’t realize it’s a pattern until it’s a lot worse. Or, on the other hand we say “I hurt every day” when we really only experience symptoms a couple of days a week.
3. Speak to your concerns, but try to keep emotions out of it
Ok, so this one can be tough. If you’re like me, you come to the appointment already hurting or nervous and you just want to feel better (or at least learn what’s going on and how to fix it). If it helps to bring a family member or friend to support you in the conversation, that’s a great strategy. They can even take notes for you.
Because physicians should consider many aspects about you beyond just your medical symptoms, they ought to care about your emotions, home or work life, etc. However, it helps immensely if you can be as concise and factual as you can and hold back from clouding the conversation with your emotions. Now, I’m not saying that you should not share your concerns, worries or fears; you should. But, try your best to keep those for later in the conversation rather than starting with how you feel emotionally. Instead, start with how you feel physically.
4. Ask thoughtful questions
The book “How Patients Should Think” suggests that patients should no longer simply ‘follow doctor’s orders’ and should expect to be encouraged to ask questions of their physicians. However, it can be tough to think of questions on the fly and it can feel uncomfortable to ask a physician direct questions. Trust me, if they react as if you are questioning their authority or intelligence, you may want to think again about whether this physician is right for you.
It’s most helpful to prepare questions ahead of time (reminder – download Doctor’s Appointment Worksheet) or come armed with a list of standard questions to refer to so that you are sure to get as much information as you can. Modern physicians appreciate, and value, patients who demonstrate that they are engaged in their health and have put some work into preparing for the appointment. It goes a long way to building mutual respect.
The following questions have helped me in the past. They are helpful to keep the conversation going and to understand the physician’s initial thoughts and recommendations. See if they help you on your next appointment:
- I’d like to understand your diagnosis better. What information leads you to think that my diagnosis is…?
- Out of the possible diagnoses you considered, are there other diagnoses that you think are equally possible?
- Can you share with me the benefits and risks of the treatment you are recommending?
- [If a test is suggested] Are you suggesting this test to confirm the diagnosis or to get more information?
- Are there trusted sources that you would recommend for me to learn more about this diagnosis?
I remember when my first husband and I received the diagnosis of his very rare blood clotting disease. A world renowned specialist was to consult with us in the hospital the next day. I immediately went to the hospital’s library and met with the medical librarian. She loaded me up with basic disease information as well as the latest journal articles and treatment information available. I sat bedside most of that night consuming the material so that I could speak intelligently with the physician and have relevant questions.
Ironically, the nurses who came in and out during my exchange with the physician to care for my husband commented after the visit that they had never seen him take that long with a patient or caregiver before. I believe that the key was twofold. First, I did my homework and had a basic enough knowledge to carry on some level of conversation. Second, I took real interest in the physician’s work and that made him want to educate me more. Physicians will invest their time where they feel it’s a good use of their time and I can’t blame them.
I share this suggestion of “do your homework” with one critical reminder. The informational sources that you use for your education make all the difference. If you cite information from sources that aren’t respected by physicians, it will do more harm to your relationship and communication that it will towards gaining their respect.
A few tips on finding trusted sources of education:
- Speak to a research librarian at your local or regional library for suggestions of sources of information that a physician would respect. They know what kind of journals and online sources will get the physician’s attention.
- Does your hospital or area health system have a library or medical librarian? Typically, these would be found at larger, academic institutions in cities. They can be invaluable to provide you with many sources of information.
- If checking online, trust only those sources that are backed by research. Those could include academic medical and research organizations, like the National Library of Medicine’s Information Rx web site; a physician association, like the American Medical Association; a well-known consumer health organization, like the American Cancer Society; or a governmental department, like healthfinder.gov that is run by the US Department of Health and Human Services.
With these five secrets in mind, you can engage your physician on a deeper level, gain his or her respect and have a more positive experience along with better health results.
What part of gaining your physician’s trust is most frustrating to you? Do you have a tip that has worked for you? Please Join Us and share your comments below.
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