How to Get What You Want from the Doctor
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.
From Say the Magic Words by Lynette Padwa. Copyright © 2005. Used by arrangement with Penguin Group (USA) Inc.
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