I recently attended a conference dedicated to health and wellness practices in the age of social media. Panelists and attendees convened in a beautiful venue for two days to discuss ways to influence the masses regarding their health and health of their loved ones and community. Several attendees brought up the frustration they had at times when they had a physical ailment and went to see the doctor, only to feel as if they did not have a good office visit. There were stories of times where they felt as if they were rushed by office staff, were not listened to, or could not get their thoughts across to the doctor.
Honestly speaking, I was saddened by these comments. I can not speak for every physician in the world but I can say that I put my heart and energy into the work that I do and make an effort to listen to patients. As someone who has sat on the examining table themselves, I know how it feels to want to be heard during a time of illness. So when I am in the role of the clinician, I try my best to listen intently to the patient’s story, signs and symptoms, and concerns. There are moments where patients may deviate from the initial complaint into something not relevant to the issue at hand, however it is my job as the physician to steer the conversation in the direction that will most benefit the patient. There are other instances where a physician may become so overwhelmed by the case or even the information provided (old records, extensive medical history) that a disconnect occurs between doctor and patient.
Patients may often times feel they are not being heard due to cognitive bias within the medical community. These include but are not limited to:
Confirmation bias — interpreting information as evidence to confirm your own beliefs or theories on the patient’s diagnosis, often dismissing other vital information
Anchoring bias- holding on to an assumed diagnosis based on information gathered, and not considering other diagnoses or more information which may change the diagnosis
Availability bias- the likelihood to form a diagnosis based on recent memories or experiences (ex: assuming a patients symptoms of fatigue, muscle aches, and fever are from the flu given the fact that you have seen several cases of the flu in the past few weeks)
It takes a conscious effort on the side of the doctor to recognize and avoid these biases as they can lead to the wrong diagnosis and frustration for both patient and provider.
Patients can also play a part in making themselves heard during medical appointments. By taking just a few key steps before and during the consultation, patients can aid doctors in managing their care.
Here are some tips to make the most out of your doctor’s visit:
- Write down your thoughts and questions prior to your appointment
- Nothing is worse than realizing you forgot to ask a question after you’ve left the doctors office. By having everything written down either on your phone or on paper prior to arrival, you can clearly discuss the concerns you have.
2. Bring a list of all your previous and current medical conditions and medications
- The “medication” list should include teas, supplements, herbs, shakes, oils and “rubs”, that may be used at home
3. Bring an advocate with you
- There may be times you are unable to fully describe what has been going on with you, but someone on the outside looking in can. Having a family member or friend who can appropriately characterize recent changes (ex: memory loss, snoring at night) can help provide a clearer picture of what is going on. I can personally attest to times where I was grateful to have a patient’s spouse or child in attendance as they gave me a good history of the patient’s issues
- Make sure the individual who accompanies you is someone you feel comfortable discussing your health in front of
4. Share your concerns
- If you do not understand what is being said ask for things be reexplained in a clearer way. As clinicians we can sometimes bombard patients with medical jargon they are unfamiliar with, leaving them confused. It is better to speak up and say you do not understand then to walk away from an appointment without an idea of what is going on with your health
- If you are worried about side effects/adverse reactions to medication or therapy be sure to voice this concern. There may be other treatment options available
5. Be honest
- We can not help you unless we have all of the information necessary to make a conclusion. This includes previous medical conditions, sexual history (including gender of partners), and prior surgeries.
- Do not feel embarrassed about your health or preferences- the more information we have the more likely we will be able to help you.
- Names of previous physicians you have seen in the area may also be helpful as we can request medical records from the past.
- Added bonus: If you have any previous imaging (Xrays, CT scan, MRI’s) on CD or reports that may are related to your issue bring them with you to the appointment.
6. Request an interpreter
If the primary language of your provider is not the same as your primary language there may be some difficulty in conveying your thoughts. If you feel more comfortable explaining things in another language, request an interpreter. Some facilities can provide physical interpreters who will attend the visit with you. If that is unavailable, many examining rooms have language phone lines at bedside and many physicians use language services directly from their cell phones.
7. Ask for a summary
- At the end of the appointment ask for a quick summation of everything that was discussed; diagnosis, plan of treatment and follow up. If there is a new medication regimen be sure to receive a copy which includes how often to take the medication and its dosage
8. Consider a second opinion
- You are the best advocate for yourself so if you truly don’t feel like you are being heard by your physician or disagree with the plan of management, seek a second set of eyes to assess your case.
Managing health is not solely on the side of the patient or physician. As physicians we must work to provide each patient with the time, patience, and respect necessary to provide sufficient care. The patient herself should also make an effort to be prepared prior to the appointment. Optimal health and wellness truly is a joint effort.
How do you think patients and clinicians can improve time spent at a doctor’s appointment?
Originally published at medium.com
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