How to Get What You Want from the Doctor
See Me, Hear Me, Take Me SeriouslyNo matter what your age, gender, or position, you are the weaker sex in the doctor's office. The whole operation reeks of inequity. You're naked under a paper sheet, he's dressed. You call him "doctor," he calls you by your first name. You speak English, he wields a technical vocabulary that's impenetrable to all but those of his own tribe. You have the power to take your business elsewhere, he has power over sickness and health.
We want to trust our doctors and believe they are superb at what they do. The alternative is too unnerving to consider. Yet the thriving medical malpractice industry proves that our doctors don't always deserve our devotion. Sometimes they disappoint us, endanger us, treat us like children, and ignore our input. Or do they? Maybe the problem is with us. Maybe we just don't know how to talk to them. Whoever is to blame for the miscommunication, both sides pay dearly in health and money: 70 percent of all medical malpractice suits are filed not because of technical negligence but because the patient misunderstood the doctor.
Medical schools have been paying more attention to this problem lately, and the new generation of doctors is supposedly trained to listen, be empathetic, and look beyond the most obvious diagnosis to see if a patient's problems might be more complex. But while doctors are trying improve their bedside manner, reality is undermining them. Doctors today have far less time to spend with patients than they did twenty years ago, mostly because of the paperwork demanded by HMOs and insurance companies and the patient load required to make ends meet. In the typical practice, a visit with the doctor lasts 7 to 15 minutes—and is interrupted within the first 27 seconds by a nurse or a telephone call.
Meanwhile, doctors who think they are improving their communication skills are often mistaken. One study asked physicians how much time they spent educating their patients. "Nine to ten minutes" was the most likely response. In reality, it was about one minute. And patients clearly need the education. Another study highlighted the sorry state of patients' "medical literacy": more than 40 percent couldn't understand instructions that indicated they should take a certain medication on an empty stomach.
Even the most well-meaning doctors regularly fail their patients by overestimating their knowledge of medical terminology and rushing through the exam. Patients complain that doctors don't ask their opinion, don't explain the side effects of drugs, don't take an adequate medical history, don't warn them properly about the difficulty of recovery, don't take their pain seriously, and discourage questions—and that's just a short list of grievances.
Complaining is useless. Waiting for your doctor to change is futile. Your only choice when it comes to dealing with doctors is to change your own behavior in order to influence theirs.
Behind the Scenes: We're Not Gods, We're Overworked Humans with Godlike Powers
As a group, doctors don't inspire much sympathy, yet in order to get the best treatment you must be able to see things from their point of view. Like all of us, doctors have feelings and fears that influence their work.
First, consider your doctor's mission: to heal you. If he can do it, he is a success. If he cannot, he thinks he is a failure—and doctors hate to fail. You may feel powerless in his presence, but in fact his self-esteem depends on you. Will you heed his advice or ignore it? Will you refuse his treatment? Lie to him about your symptoms? Snub him for another doctor? Occasionally, even if you follow the doctor's instructions, you won't get well. His skills will fail you. This is a doctor's greatest fear and a source of constant anxiety.
Next, contemplate the typical doctor's training. Doctors are schooled to diagnose illnesses and prescribe treatments as quickly as possible. With most internists logging about 150,000 office visits in their careers, speed and accuracy are highly valued. Being right is important, but being right fast is the mark of a real pro. In surveys, medical literature, and interviews, doctors repeatedly admit to diagnosing the typical patient within just 30 seconds of walking in the examining room. "It is subsequently quite easy to go on autopilot," writes Victoria Maizes, M.D., in American Family Physician. Instant diagnoses, followed by formulaic, half-interested questions, thus become their normal mode of operation. Maybe it's not the way Marcus Welby would have done it, but it effectively propels them through their overpacked days.
Another more troubling aspect of doctors' training is the well-known desensitization that takes place in medical school and during a physician's internship. It is a grueling trial by fire as the student is thrust into a world of pain, suffering, and death with very little emotional support. Barbara M. Korsch, M.D., who has devoted much of her career to studying doctor-patient communication, wrote a book on the topic: The Intelligent Patient's Guide to the Doctor-Patient Relationship (Oxford University Press, 1997). In it she explains that in medical school the emphasis is on anatomy, chemistry, and other hard sciences, with little or no attention paid to the human aspect of attending to the ill. "When third-year students have their first intense encounter with real patients, they are faced with sickness and death in very large doses." As the years of training continue, "students' inner conflicts with facing illness and death become more and more acute. Their role models, the attending physicians, often behave toward them (and their patients!) in ways that are not very human....One of the goals in the education of physicians is to 'professionalize' them, to toughen them up."
When the training is finally over, relatively few doctors emerge with their empathetic equipment intact. Korsch says that doctors "turn away from emotion. They are not trained to deal with feelings." This detachment is very hard to unlearn. It doesn't have anything to do with a doctor's talent, but it does affect the way he treats his patients and the success of his practice. On the one hand, doctors with lousy people skills have trouble keeping clients and attract more lawsuits; on the other, doctors who aren't emotionally tough are likely to burn out and become unable to function.
Today's physicians, then, are constantly grappling with opposing forces. They want to solve your problem but must do it quickly, which automatically increases the likelihood that they will make a mistake. They depend on your compliance but you can defy them at will, which undermines their chances of success. Theirs is a people-oriented profession, yet they learn few social skills and have much of their natural empathy squeezed out during medical school. They must operate within ever-shrinking time and money constraints, even as patients are becoming more proactive and demanding more attention. They are expected to take control but are constantly being second-guessed by insurance companies, HMOs, and the patients themselves.
The result is that doctors are under a lot of stress. The power, respect, and money that once compensated for the tensions of the job are eroding. They spend more on insurance and keep less for themselves than they once did. Some doctors are even forced to change specialties because they can't afford the malpractice insurance. These healers, who at one time held themselves above the fray of commerce, are now neck-deep in it—resentful, frustrated, and concerned about the level of care they are able to provide their patients. So when the doctor walks into the examining room and you're laid out on the table like a piece of pastry, remember: underneath the trappings of power, he too may feel anxious and vulnerable.
Good Patient, Bad Patient
Most doctors genuinely want to help you. "There's a difference between treating people and caring for people. I'd like to think I do both, and that I do the latter well," says Los Angeles oncologist Barry Rosenbloom. Many doctors do empathize with their patients, and there is no question that the issue of bedside manner is getting more attention these days. Hospitals sponsor seminars on the topic and medical journals publish papers on how to master, as Sir William Osler put it, "the kindly word, the cheerful greeting, the sympathetic look." Still, according to Rosenbloom, "Some patients' expectations are way beyond anything the doctor can deliver." In truth, both doctors and patients bring plenty of unspoken (sometimes unconscious) expectations into the examining room.
The first time you meet a doctor, it is fair to assume that he is hoping you will turn out to be a "good" patient, one who listens to him, follows his orders, and promptly gets well. Put another way, doctors have a hard time dealing with patients who don't improve. Patients return the favor—they like doctors who can heal them and dislike those who cannot. Naturally, doctors are aware of this.
In 1995, Consumer Reports published a survey of 70,000 readers who were asked about their experience with medical care. Patients with chronic headaches or back pain reported the greatest amount of dissatisfaction with their doctors. Not surprisingly, the doctors who treat these conditions "may not even want to see these patients come in the door," according to psychologist Judith Hall. The patients who were most satisfied with their medical care were those who had glaucoma, cataracts, or were pregnant—conditions that require a single or easily understood course of treatment that is usually successful. Patients were also generally satisfied with their oncologists (cancer doctors) because, although the outlook may be grim, the illness is always taken seriously. Additionally, cancer patients understand that their condition might be impossible for any doctor to cure.
Patients who get better quickly affirm the doctor's skill, whereas "chronic, insoluble problems are very, very frustrating to doctors," says Barbara Korsch. "Doctors are success-oriented; they can't see a failure. They dislike anything they can't diagnose and cure; they hate fibromyalgia, chronic fatigue syndrome. Those poor patients really suffer because doctors tend to think that if they can't find any objective signs it's probably all in the head, and if it's all in the head, instead of feeling sympathetic they become contemptuous and say, 'That's not my problem.'"
This doesn't mean you must give up hope of finding a caring doctor if you have a chronic condition. It means that, by being aware of the doctor's bias, you can take steps to overcome it. You can begin by voicing what the doctor is probably thinking, advises Korsch: "You can say, 'I realize nobody knows what fibromyalgia is and there is no cure, but I'm hoping you'll find something that will help me.' Build up the good side, the Dr. Jekyll side of the doctor. You might also say, 'I don't expect any magic. I know this is a very complex, long-standing, and partly psychological issue we're dealing with, but I'm hoping you can help with some of the most incapacitating symptoms.'"
People who are overweight also aggravate doctors, because the condition sets them up for almost certain failure. Sooner or later, one of the many diseases associated with obesity will probably show up. Like most of society, many doctors are inclined to feel scorn rather than empathy for people with a weight problem. "Curbside Consultation," a page on American Family Physician's Web site, offers advice and a place for doctors to vent anonymously. One physician confessed, "My opinion of some of these [overweight] patients has been that they are lazy, lack willpower and like being sick. At times I felt that they wanted me to give them a magic pill to cure their problem, when they were the ones who actually needed to do the work."
How do you overcome this prejudice? Korsch advises overweight patients to be candid and at the same time practice a little reverse psychology: "If it's there and real, you have to deal with it. If you're heavy, say, 'I know everybody thinks fat people are just sloppy and overeat and are self-indulgent, but I hope you won't consider me that way because I've really tried and I do want your help with it.' You can sometimes detoxify the particular stigma by bringing it out into the open, because that enables the doctor to say, 'I don't really think that.'"
The point is that the experience you have with your doctor has a lot to do with what's ailing you. Both you and the doctor will bring preconceived notions into the examining room. Both of you will be waiting to see if the other is "good" or "bad." Understanding this dynamic improves your chances of success.
Let's say you have an illness that is not life-threatening and is fairly mundane. How do you solidify your standing as a "good" patient? According to one study cited in Consumer Reports, doctors described good patients as those who appear to understand what the doctor is saying, ask few questions, and respect their time. Sadly, these are exactly the traits that keep patients in the dark. Most people have difficulty understanding the doctor's terminology, so they ask questions, which takes time.
Physicians also agree that "good" patients follow doctors' orders. Noncompliers are the bane of the profession, but the reasons patients don't comply can often be traced to bad communication with the doctor. A man might be told to take a prescription medicine he can't afford and be too embarrassed to admit it. It's common for people to be instructed to change their lifestyle—to diet, exercise three times a week, give up caffeine, and so forth—but often they just aren't up to the challenge. They fear being judged by the doctor, so they put off scheduling a visit or they lie about their progress. Are they bad patients, or are the doctors at fault for not knowing their patients well enough to advise a course of action they might actually follow?
As a patient, you have your work cut out for you. You want to be a "good" patient, one whom the doctor will want to spend time with and help. Yet you must speak up and make sure you understand what the doctor is talking about. It's like downhill skiing: the course is fast, skill is essential, and you must be sure of the terrain before you push off. The first stop on the journey is inside your own head.
Patient, Know Thyself
Physicians constantly complain that patients don't share crucial information about their symptoms and lifestyle. This is ironic, since patients' number-one complaint is that doctors don't seek their opinion. It seems as if patients are forever waiting for the doctor to ask just the right questions, while doctors are waiting for their patients to go ahead and spit out the facts already. It is up to you to break the impasse and start speaking up in the doctor's office whether or not he asks you the right questions. In fact, speaking up is the single most powerful thing you can do for your health. About 70 percent of correct diagnoses depend solely on information the patient tells the doctor, according to an analysis done by the American Society of Internal Medicine.
Why do patients find it so difficult to talk to their doctors? Some common reasons include:
- I don't want to waste the doctor's time. This is a natural reaction to the hurried, no-nonsense atmosphere in most doctors' offices. What you need to do is come prepared with a list of questions and concerns so that you won't ramble and lose focus.
- I don't want to seem weak. Lots of people were taught to bear their pain silently, even in a doctor's office. They don't want to seem like wimps. Yet pain is often the first signal your body sends when things are going wrong. You could seriously jeopardize your health by hiding or downplaying your symptoms.
- I am afraid of what the doctor might find. If this is the case, talk your symptoms over with a friend before you go to the doctor. It will get you more comfortable with saying the words out loud, and your friend will give you moral support and encouragement.
- I am afraid the doctor will tell me to change my lifestyle. Instead of fibbing to the doctor about your lifestyle, try asking him to give you a range of options for making changes. Request that he help you devise a plan that's broken down into small steps so you will be more likely to comply.
- I am intimidated by my doctor. It's not unusual for people to be so fearful of their physician that they simply tell him what they think he wants to hear. This is especially true if they have not been following the doctor's orders concerning medications, diet, and/ or behavior. If you're too afraid of your doctor to be honest, you should consider changing doctors.
- I don't speak the same language as the doctor. Bring along a friend who can translate or ask the doctor's office if they can provide a translator.
- I don't fully understand which information is important. No matter how unrelated it seems, tell the doctor anything you think might have influenced your condition. Pain in the body is often "referred"—that is, an injury or ailment in one part will result in pain somewhere else.
- I don't want the doctor to know everything. Some patients deliberately withhold information to protect a third party (such as an abusive spouse) or for some sort of gain, such as qualifying for disability or an insurance claim. This is a pretty dangerous game to play with your health.
Of all the reasons patients clam up in the doctor's office, the most common is that they're afraid the doctor will think they are stupid. Doctors' intimidating terminology is to blame for this. If you're like most people, you may walk into the office fully prepared to state your case only to have your mind go blank the moment the doctor opens her mouth. Doctors often ask questions that require a simple "yes" or "no" response, so you answer those and forget everything else you were going to say.
To set the record straight, no one except other doctors understands what doctors are talking about. Doctors know this, but they tend to forget. "The situation is like trying to talk in English to a Japanese speaker who has studied one year of English," according Dr. Terry S. Ruhl. "[The patient] will understand many of the simple words but will miss much of the complex meanings....Likewise, many patients lack the basic anatomy and physiology concepts to understand our explanations. They are starting with no frame of reference."
Ruhl suggests that doctors use analogies to explain how the body works, and you might ask your doctor to do the same. Although some of the examples he provides seem a little preschoolish—"The heart is like a pump that pushes blood around the body....The spine is like a pile of blocks"—you have to start somewhere.
No layperson can be expected to grasp medical terminology, and most doctors are not adept at translating it. To resolve this problem:
- Bring a notepad and pencil, or, better yet, a tape recorder.
- When the doctor totally loses you, politely interrupt: "Excuse me, but I don't understand what you're saying. Can you explain it in layperson's terms?"
- Don't expect to understand everything, even if the doctor tries his best to explain. Tape record everything or take notes and plan to research it later. Then, with a little more knowledge, you can call him back for a phone consultation or schedule another visit.
- Ask the doctor where to go for more information. The office may have brochures about your condition, but they are usually very brief or published by drug companies who have their own priorities. Ask the doctor for specific Web sites, books, or magazines that would be helpful.
If you have read anything at all about preparing for a visit to the doctor, you know that you're supposed to bring a list of health concerns with you. What you may not know is that although doctors recognize a need for "the list," most of them cringe inwardly when you pull one out. In Patient Care magazine, Frederic W. Platt, M.D., writes that doctors resent patients who bring long, poorly organized lists that waste their time and (some feel) challenge their authority. French doctors even have a nickname for what's ailing the list-bearers: "la maladie du petite papier" (the sickness of the little paper).
Don't let this stop you from bringing your list, however. Just make sure it is brief, specific, and prioritized. Platt recommends bringing a copy for the doctor, too, so she will feel included. For each item, provide the following information:
- What are the symptoms?
- When did you first notice them?
- What times of day or night do they occur?
- How long do they last?
- Are they getting better, worse, or remaining constant?
- How do the symptoms affect your daily activities?
Once you understand the mind-set of doctors, you can choose behaviors that will put them at ease while you draw information out of them. The most important strategy is to keep your voice steady and calm. Doctors are afraid of emotion, so the less you show, the more comfortable they will feel. Barbara Korsch explains: "If you put drama in your voice, it will turn the doctor off. Be quantitative and objective instead of saying how you feel. This is unfortunate; doctors shouldn't be that way, but in my studies we've learned that they are." When you seem desperate or panicky, when your voice is trembling with anxiety, the doctor's first reaction will be to try to tone it down. "Your emotional reactions engage doctors less than describing what it is you're reacting to," says Korsch.
In addition to using a neutral tone of voice, the following words and deeds will keep you in the doctor's good graces.
- Use neutral words to describe feelings. Be concerned instead of scared. Be apprehensive instead of a nervous wreck. In everyday life we tend to exaggerate to get results, but with doctors you have to go to the opposite extreme. Even if you are in agony, try not to use those words. Instead say, "I have a lot of discomfort."
- Use specific words to describe symptoms. "I haven't slept a wink," doesn't tell a doctor much. Instead say, "I've been averaging only four hours of sleep a night, and I usually get seven. I've been waking up every hour or so, and it takes me at least 20 minutes to fall asleep again."
- Talk about the most important things first. Doctors are very time-sensitive and will (understandably) be annoyed if you wait until the end of your visit to bring up a problem that requires some time to address.
- Make your expectations clear. At the beginning of the visit, tell the doctor exactly why you are there and what you hope she can do for you.
- Acknowledge the doctor's situation. If the office is jam-packed and everyone seems stressed out, let the doctor know you're on his side: "It must be hard for you today, so I'll try to be concise."
- Be clean. Personal hygiene does matter. If you smell bad, the doctor will want to get away from you, just as anyone else would.
- Keep an open mind. "Patients have a tremendous amount of misunderstanding about medicine," says Barry Rosenbloom. "It's vague or distorted or based on what they've heard from a friend or read in a magazine." As a result, some people arrive at the doctor's office expecting a certain response, and when they don't get it, they go on the offensive. "They may not like what the doctor says, and that's OK," says Rosenbloom. "But if they're going to challenge the doctor at every turn, the doctor, like any other human being, is going to be put off by it. If people want a valuable experience with a physician, they have to be open-minded."
Certain behaviors are like fingernails on a chalkboard to doctors. Some of these you can control, others you cannot. As mentioned earlier, if you are overweight or have a chronic health problem, you will need to strategize to overcome the doctor's possible bias against you. Beyond that, here are a few behaviors to avoid:
Don't act entitled. No matter how lofty your position in the outside world, when you are on the doctor's turf, resist ordering him around. "[Patients] seemed to think my job was to write them referrals," groused one doctor anonymously in "Curbside Consultation." "At their jobs...[they] were used to aggressive, confrontational relationships and they continuously challenged me into arguments." Control is extremely important to doctors. If you challenge them or overstep the bounds of typical patient behavior, you will raise their hackles. If you need to question their decisions, ask politely; never demand or confront.
Don't play doctor with the doctor. "Patients often arrived at the office armed with complex and marginal information from the Internet that was inconsistent with standards of care," the same "Curbside Consultation" physician complained. Oncologist Barry Rosenbloom voiced similar concerns. "I personally feel good when people are educated about the disease. They ask intelligent questions. But the thing I've got over the patient is experience and judgment and the ability to take care of sick people. Breast cancer is a good example. Patients come with literature; they're aware of the various chemotherapy regimens. But they have no idea what they mean, whether one is better than the other."
Don't test the doctor. Doctors are aware that many people seek second opinions, and that is fine with them. What they object to are patients who see several physicians for the same problem but don't reveal what the other doctors have discovered. This type of blind testing undermines all the doctors.
Don't blame the doctor for his staff. Doctors are often as frustrated with the front office staff as you are. Bring your complaints to the office manager, not your doctor. It's not worth wasting 5 minutes of your 15-minute visit. If you get no satisfaction from the office manager (or if she herself is the problem), call, write, or e-mail the doctor explaining the situation. If the staff is so wretched or disrespectful that you are considering dropping the doctor because of them, it's only fair to let him know.
Don't ask the doctor to do something unethical. People commonly ask their doctors to write false reports so they can get out of work, get on disability, get handicapped parking permits, and so forth. Although it might seem like a harmless request, you are in fact asking the doctor to lie and possibly jeopardize his career.
Don't bad-mouth other doctors. If you disliked a former doctor's care and must explain your concerns to your new doctor, keep your tone and language neutral. Talk about the treatment itself rather than the doctor who provided it. If the doctor asks why you changed physicians, simply say that you and he didn't communicate very well.
Stoicism Is for Wimps
Talking about pain makes doctors experience significant discomfort, to use their own dainty jargon. "They don't care to think anything is painful, especially if they've had something to do with it, like perform the surgery," says Barbara Korsch. Pain is nothing if not emotional, yet here again, "If doctors think you're exaggerating and being very emotional, they'll say, 'There, there, it can't be that bad. I've taken care of a lot of patients who have that.'"
Most of us are encouraged to be stoic about pain, which makes two people in the examining room who don't want to talk about it—the patient and the doctor. According to the American Pain Foundation, this approach is not only pointless, it is dangerous. Ignoring pain can make a condition worse, so that when you do finally treat it, the cost and disability are far greater than if you had dealt with it early on. Chronic pain (lasting six months or longer) impairs your mood, sleep, sexual appetite, friendships, energy, and overall lust for life. Both the Joint Commission on Accreditation of Healthcare Organizations and the Department of Veterans Affairs have requested that pain be treated as a fifth vital sign, to be assessed along with pulse, temperature, breathing rate, and blood pressure.
Whether your pain is chronic or not, don't be ashamed to speak up about it. Make an effort to stay calm. The doctor needs precise information about the nature of your pain, and the more specific you are, the more she will be able to help you. If she attempts to brush off your concerns by comparing you to other patients or insisting that it can't be that bad, bring the focus back to you: "I realize other patients may have reacted differently, but I have a very low tolerance for pain and I need you to take this seriously." Approach the conversation with the attitude that of course she wants to help you alleviate the pain (even if she has tried to brush you off). Do not blame the doctor for the pain. Keep it neutral. The American Pain Foundation suggests the following tips for talking about pain with your doctor:
- Tell him where it hurts and when you first noticed the pain.
- Describe what it feels like, using specific words such as stabbing, aching, radiating, throbbing, sharp, dull, burning, tingling, deep, pressing, and so forth.
- Describe how badly it hurts on a scale from 1 to 10, 10 being worst.
- Describe what makes the pain better or worse.
- Explain how the pain affects your daily life. Has it impaired your work, exercise, sleep, sexual activities, mood, ability to concentrate, state of mind?
- Tell the doctor about pain management techniques and medications you have used in the past, and explain what worked and what didn't.
The Biggest, Baddest Communication Gaps
Medical malpractice insurance is often blamed for the mess in our current health-care system. There are undoubtedly some rotten doctors out there who deserve to be sued for their bad work, but in nearly three-quarters of malpractice lawsuits, the core reason for patients' unhappiness is their doctors' bad communication skills, not their technical ability. In most cases the patients did not understand the procedure, or what the tests meant, or how long the recovery would take. The lack of understanding, coupled with the doctor's poor bedside manner, left them feeling betrayed and cast aside, and those basic human emotions are what fuel most lawsuits. This is good news, because it means that despite all the scary stories about malpractice lawsuits and incompetent doctors, you actually have a lot of control over your health care. You just need to be aware of the points at which communication most often breaks down.
Barry D. Lang, M.D., of Boston, has particular insight in this area. Lang practiced orthopedic surgery from 1975 until 1996 and then did an about-face: he went to law school and became an attorney specializing in medical malpractice. "I think doctors are their own worst enemies," he says. "I believe that many of my clients, or at least some, would not come to see me even if the doctor did something wrong, if there had been better communication. This is one reason chiropractors are rarely sued. Chiropractors listen to their patients and doctors don't, and I can say that because I'm a doctor."
Many of Lang's lawsuits involve surgery, and the problems are concentrated in a few key areas. First, there is the "complete and unfettered trust" some patients place in their doctor. "They assume the doctor has more education, knows what he's doing, and will do the best for the patient—and most times this is true. Sometimes, unfortunately, it's not. If somebody goes in for a complicated hip procedure, for instance, he may be reluctant to ask the doctor, 'Have you done this before?' And the doctor is not going to tell him unless he asks."
Dr. Lang also warns patients to ask about the specific complications of their surgery, and to get it in writing. A great many of his cases involve arguments about informed consent. "The patient says, 'Gee, the doctor never told me that my foot could drop off in this operation'; the doctor says, 'Of course I did.' Many times the doctor has not even approached the subject. They give the patient a general, generic release that that says, 'My doctor has informed me of every complication,' and the patient signs it. The release is made up by the hospital. The hospital isn't privy to what the doctor and patient discussed."
Patients should also ask how long it will take them to recover from surgery—meaning a complete return to normal functioning—and how traumatic or painful the recovery period will be. Says Lang, "Doctors have a well-meaning tendency to tell a patient, 'I've done this a thousand times and everything's going to be super.' When everything isn't super, guess who the patient is angry at? The doctor." Another malpractice lawyer, Evelyn W. Bradford, attempted to educate physicians about this problem in an article for Medical Economics: "Don't gloss over surgery's effects. I hear this lament again and again in my office: 'If that doctor had told me what to expect, I wouldn't have gone through with the surgery.'...Orthopedists, I've found, are the most guilty of poor communication."
The message to the patient is clear. "Ask questions," says Barry Lang. "There is no such thing as a stupid question. Your doctor wants to help you, but he is not able to look into your mind."
If you are considering any type of surgery or treatment, be sure to ask the doctor:
- Have you done this procedure before? How many times?
- Exactly what are you going to do?
- How necessary is this procedure?
- What are my chances of being completely cured?
- What are the possible complications?
- What is the least and most amount of time it will take for me to fully recover?
- What will the recovery period be like? Is the recovery painful?
- What is your pain-management plan for this procedure and the recovery period?
- What will happen if I do not have this procedure?
Speak Up and Stay Well
Health care is truly in a state of flux, not just because of stingy HMOs and flip-flopping insurance practices but also because so many extraordinary medical breakthroughs are being made every year. Gone are the days when you could find one good, trustworthy doctor and rest easy. You will probably deal with many doctors over the course of your life, so the person you need to trust is you. You have to trust yourself to ask the right questions, speak up, and stand up for yourself. You have to trust yourself to judge the doctor instead of worrying about the doctor judging you. Luckily, this is a skill guaranteed to pay off in a big way as you get older. If you teach yourself to speak up when you're thirty, by age eighty you'll be a master—just when the whole machine is starting to sputter and you really need that expertise.
From Say the Magic Words by Lynette Padwa. Copyright © 2005. Used by arrangement with Penguin Group (USA) Inc.
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