When a doctor tells you that you are
the patient and let him do the diagnosing, what do you say when he
ignores a symptom that won't go away. You have answered his
questions to the best of your ability, but yet he doesn't act as if
he has heard you. The nurse tells you that she can see you tense up
when the pain gets worse and you hear her tell the doctor, but yet he
does not get concerned and orders more tests.
This generates resentment and mistrust
of the doctor. I don't like these situations and after several
months of reading, I would like to offer some suggestions to the
medical community and to other patients.
Suggestions to the doctor:
#1. Listen to the patient. Many
doctors only half listen and studies have shown that most doctors
interrupt after about 18 seconds. Often this cookbook style of
medicine can work, but when you don't have all the facts or
complaints of the patient, you may miss something important. This
leads to costly mistakes and mostly a misdiagnosis. If you have a
drama queen/king, you may need to remind them that you need concise
facts and not all the extras they are giving you.
#2. Communicate with the patient.
No, I am not talking about patient engagement. Most doctors talk at
the patient and this leads to mistrust. Many doctors wonder why the
patient has tuned them out. This is because the patient wants to be
considered as a human and many desire to have a part in their own
treatment decisions. Doctors that refuse to do this, often have
one-visit patients. Doctors that have honest conversations with
their patients find that they have more patients and better patients.
#3. Ask questions if something is
not clear. Often patients are nervous and are unable coherently
to explain everything. This is when the doctor needs to asks
questions to bring out clarity. This is when a doctor's skills are
tested and communication skills can be a real asset.
#4. Ask if the patient wants to
hear bad news. Good doctors will ask first before giving out bad
news. The answer received will often disclose the mindset of the
patient and the answer may need to be modified to get the bad news
understood. Doctors that just blurt out the bad news also can lose
patient trust when the patient does not understand the news.
#5. Learn about the patient as a
person. This will not only raise patient trust, but will result
normally in a patient that listens more carefully to what you say.
Too many doctors just treat patients as an asset to bring in revenue.
Then the doctor wonders why the patient misses appointments and
tunes you out during the appointment.
#6. Ban other doctors (and nurses)
from sitting in on an emotional conversation. Too many doctors
want witnesses on hand during these times. They are practicing
defensive medicine and don't want the increased risk of a lawsuit.
Often the patient will sense this and end the conversation. This is
when trouble is most likely. Often patients can be emotional when
receiving the bad news diagnosis and do not want witnesses other than
the doctor giving them the news. Believe it or not, often during an
emotional conversation, patients ask the best questions, expecting
honest answers. When they don't receive honest answers, this is when
trust goes in the crapper.
Suggestions for patients:
#1. Don't be a drama queen/king.
Keep to the facts and what you know to be happening. The doctor may
be more inclined to believe the facts as you know them when not mixed
in with the drama. Remember that the doctor has limited time for
each patient and your drama may make you feel good, but will not help
the doctor make a better diagnosis.
#2. Try not to let the doctor cut
you short. This will take a lot of polite maneuvering
or tact to finish giving the facts, but
do take the opportunity to finish. When a doctor interrupts, make
sure that he is asking a question that is relevant and that he needs
an answer. If the question is relevant and he continues asking
questions, you may need to abandon your facts. Do try to complete
the facts once he has his questions answered.
#3. Answer the doctor's questions
to the best of your ability. Do not wander, but stick to the
facts as you know them. Keep your answers as concise as possible.
#4. See the correct doctor for what
ails you. Sometimes is will be necessary to see a primary care
physician (PCP) to get a referral to another specialist. Many PCPs
will refer you to the correct doctor. Be wary of a PCP that thinks
he is the only doctor you need. A couple of times I have had to see
another doctor for a referral when my PCP did not think my symptoms
were bad enough and getting the proper referral did prove the PCP in
error for refusing a referral.
#5. Do not be afraid to ask a
question or question the purpose of a test. At best, this can be
daunting for the patient, but sometimes this is necessary. A doctor
that refuses an answer requires a patient to be overly cautious and
sometimes fearful that the incorrect test may be done.
#6. Do not put up with a doctor
that tries to bully you into something against your ethics. Most
doctors will respect religious ethics; however, some doctors will use
the bullying tactic to get their way. Learn to avoid these doctors
and change doctors when needed.
These are for your information and I
hope some value to you. Use or adapt them to your needs.
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