Part 1 of 2 Parts
How doctors blog does say a lot about
them. Some are very caring and understanding, while others are brisk
and matter-of-fact in their approach to patients. This is evident in
their writing as well. Communication is the topic of these two blogs
and express both of the above approaches.
The first blog is by Dr. Leana Wen and
I will take time to list her points and give my thoughts as a
patient. I will encourage you to read each doctors blog and then
read my response.
Tip #1: Answer the doctor’s
pressing questions first. This requires a very concerted effort
on your part to be polite. You must restrain yourself when doctors
behave this way. This is how many doctors are and they are easily
upset when things are not accomplished in their order.
Tip #2: Attach a narrative response
at the end of these close-ended questions.
This will often tax your diplomacy, but
it can work. If the doctor asks more questions to follow-up, you
know that you are getting his/her attention. Don't over dramatize
the point as a simple statement of the facts will generally work the best.
Tip #3: Ask your own questions.
This can serve you well if properly done. Some doctors are
running on autopilot and this can bring them out of it. Be careful
if the doctor just repeats the question and then it may be important.
Then if you fumble because you don't understand, often then the
doctor will know to reword the question. Always respond to the best
of your ability.
Tip #4: Interrupt when interrupted.
This will work for some doctors, but be polite and use
diplomacy. For those doctors that refuse to let you interrupt,
follow their lead even though you may be irritated. If this
technique works, keep the narrative brief and state the facts.
Tip #5: Focus on your concerns.
Yes, if you feel like the doctor is
ignoring your concerns or not listening, use your best diplomacy and
politely interrupt. Express your concerns and Dr. Wen's example is
appropriate, “Excuse me, doctor, I have
tried to answer all your questions, but I am still not certain my
concerns have been addressed. Can you please help me understand why
it is that I have been feeling fatigued and short of breath for the
last two weeks?” (insert your health concerns)
or what the problem is. Do not over state the problem,
just give the facts as you know them. If this does not bring the
doctor into the discussion of your problem, then you may need to
consider more drastic action. Depending on the seriousness of the
problem or medical issue, ask the doctor if you need to see the
emergency department. Don't use this if you really wish to keep your
doctor.
Tip #6: Make sure you are courteous
and respectful to your doctor.
Yes, your doctor is supposed to be a
professional and is probably doing their best to help you, but don't
let them bully you into totally doing things their way and ignoring
your medical problem. If at all possible use diplomacy and be
respectful. This will normally build a solid doctor-patient
relationship.
When I was much younger, as a teenager,
I was kicked in the groin by a cow and the doctor was very careful
and when he was done with his examination, he said that I had a tear
in the bladder and this could likely affect me for the rest of my
life. After leaving the military, I had a rough time and the doctor
I had did many of the same procedures. He said basically the same
thing, and gave me a new antibiotic to help with the healing again as
it had somehow torn slightly.
After moving to another part of the
state, the trouble flared up again, and it was not six months later.
I could tell the new doctor had dollar signs in his eyes, as he would
not call the previous doctor, so I ended the conversation and
appointment and went home. There I called my previous doctor, and he
was kind enough to call in a prescription to my pharmacy. In the
meantime I had my previous doctor locate another doctor and forward
my records to him. He asked me to come in for an appointment and he
also gave me a prescription and said if I had more problems to call
and he could prescribe the antibiotic again. I went another 28 years
before I had any more problems.
The above tips will generally serve you
well in most situations. I have had doctors be on autopilot and I
have been able politely to bring them back to the present. One
doctor had to think a long time about what I had done. At the next
appointment, he did apologize and we even discussed how to bring him
back to the now. He had asked his nurse if she had seen him go on
autopilot and she had to admit this was a problem for him.
Dr. Wen does describe a trend happening
because of the pressure more doctors are facing to see more and more
patients. She says that today doctors spend less and less time
listening. “Cookbook medicine” (I like this term) is prevalent,
with doctors resorting to checklists of yes/no questions rather than
really listening to what’s going on with the patient.
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