April 10, 2014
Thoughts for Doctors and Patients
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.