Patient-Physician Communication-Health
- By:Robert Baird Baird
Most doctors are not disinterested in you, but they are busy-so busy that many patients complain that their doctor cannot or will not listen to them. This is a problem because according to the American Society of Internal Medicine, 80% of correct diagnoses depend on what you tell your doctor. In a study of 74 visits to seven doctors, researchers found that only 16 patients were allowed to explain the problem fully. In 70% of the visits, doctors interrupted their patients before they completed their first statement. 20 Usually the interruption occurred within 18 seconds. It was not surprising that a recent survey on public attitudes toward physicians indicated 42% of those surveyed were not satisfied with their doctors. What was the major source of dissatisfaction? According to a recent survey the patients complained that doctors don't explain things clearly, speak too technically, aren't good listeners, are hard to reach, and are too rushed. Doctors also complain that patients aren't good at describing problems and don't listen well. Fortunately, medical schools are beginning to emphasize communication skills. Of the 126 US medical schools, 86% now have mandatory classes dealing with the doctor-patient relationship. More physicians seem to realize that good medicine means establishing good rapport with patients. A leading health newsletter recently acknowledged the importance of the doctor-patient relationship.
A partnership is emerging in which the patient participates more actively and the physician acts more like a consultant. The necessary ingredients in a successful physician-patient partnership are a prepared, assertive (not aggressive) patient and a sympathetic, caring physician.
Patients can do much to facilitate the development of a physician-patient partnership. Understanding the meaning of commonly used medical words, abbreviations, suffixes, and prefixes can enhance this communication. The following are some tips to ensure good communication:
When you see your physician about a problem, you should state the most important problem first. Doctors tend to believe that the first thing a patient says is most important.
You should be specific. If you have a headache, where does it hurt? How long does it last? How often does it occur?
You should know your family history. Because many illnesses run in families, you may be at higher risk for certain diseases. Before your first visit, you should contact your parents and close relatives to learn of their health problems, especially heart disease, cancer, stroke, arthritis, diabetes, alcoholism, and tuberculosis.
You need to list medications and treatments you are receiving, including over-the-counter drugs. You will also need to identify any allergies and drug reactions.
You should ask questions. You can bring a written list of questions but try to make them brief and specific. You should ask about anything that is unclear and repeat the answers in your own words.
Before leaving the doctor's office, you need to make certain you know the diagnosis or how to follow the recommended treatment. If drugs are prescribed, you should inquire about the possible contraindications (reason for not using a drug), side effects, and the possible substitution of generics.
When appropriate, ask your physician to write down instructions or recommend reading material for more information on a particular subject. Finally, inquire about the next steps in the treatment, if and when a return visit is required, and danger signs to look for and report back to your physician.
Second Opinions
Conditions involving elective surgery, chronic pain, and recurring illnesses often benefit from a second opinion. In many situations, a second opinion is appropriate and peace of mind is a sufficient reason for seeking it. A recent editorial in the Harvard Medical School Health Letter provides some helpful advice to the question, "When is a second opinion needed?" "As a general rule, patients should seek a second opinion whenever they are uncomfortable with the explanations offered by a physician, are not happy with the progress of recovery, question the proposed course of action, or simply feel the need for verification. In some cases, such as elective surgery, your health insurer may require a second or third opinion before authorizing payment for certain treatments.
If you decide to ask for a second opinion, common courtesy dictates that you discuss it with your physician. Your physician may suggest bringing in a consultant who will assess your situation and discuss it with you and your physician. You can also ask your physician for the name of someone to see separately.
A physician may feel that a second opinion is a waste of time or money. Regardless, your wish for more information should be respected. Reputable physicians do not feel threatened by another opinion; to the contrary, they may welcome another perspective on a difficult case. If your physician expresses displeasure for or resists your wish to have a second opinion, you may want to consider looking for another doctor.