The
simple act of talking to your doctor nowadays seems
to be a lot different — and harder — than
it once was, say about 60 years ago. Let’s face
it, we were all a lot healthier then and we rarely
had to talk to doctors. But that was then, and this
is now.
How to communicate with your medical provider is a subject that’s currently
making the rounds among patients and their physicians. The discourse is taking
place both on the Internet and on the local lecture circuit. AARP’s web
site discusses this subject in great detail; you can easily access it via www.aarp.org,
where there’s information galore to help you bone up your communication
skills with your doctor.
At least one local physician, Dr. George Xakellis, an associate professor at
the UC Davis Medical Center’s Ellison Ambulatory Care Center, has been
meeting with senior groups as part of his work in geriatrics. He evokes considerable
interest among seniors whenever he lectures on “How to Talk to Your Doctor.”
No doubt, it’s a subject that bears discussion. Most of us currently seem
too have more than ever to tell our doctors, with less time in which to do it.
An appointment now can sometimes end abruptly after 10 or 15 minutes with your
doctor striding out of his office while you’re still in the midst of a
sentence reiterating what’s ailing you.. ”I have this funny pain...” you
are saying. And poof! The doctor is gone!
In an interview at the Med Center, Dr. Xakellis, said the patient needs to feel
comfortable with with his or her primary care physician.
“Different doctors have different styles,” he said. “When you’re
comfortable with a specific doctor, there will be easier and more effective give
and take.”
It’s long since seemed clear to me that the days of the Dr. Welby-style
family doctor are over. The thrust of leading HMOs emphasize efficiency and speed
and seniors should try to adapt to this new way of doing things at our medical
centers.
Good communication is a part of this, and Xakellis presented some ideas about
patient-doctor communication in a recent talk to the Sacramento chapter of the
Older Women’s League.
“How do you talk to your doctor?” he asked his audience. “Does
the doctor do all the talking while you do all the listening? Are you afraid
to ask questions? Do you leave the office feeling like you just sat through a
foreign language class?”
Good, easy communication, on the other hand, he added, will result in better
health care and make the patient more confident the medical problems are being
properly addressed.
Xakellis emphasized that patients must prepare ahead of time for their office
visits.
“Doctors are busy people and their offices are often abuzz with activity,
like ringing telephones and crowded waiting rooms,” he said. When the nurse
finally brings you into the examination room, the visit may not last more than
l5 minutes. To make full use of this limited time, Xakellis added, patients need
to prepare ahead for what they will actually tell the doctor. He listed these
suggestions:
1. Write down all questions for the doctor in advance and bring a pen and paper
with you to jot down notes on what you’re told.
2. If you’re not feeling well, bring a written description of your health
or medical problem. You may want to research your symptoms at the library or
on the Internet ahead of time. Try to learn some of the medical terms that may
relate to your condition. This may make it easier to follow what the doctor is
telling you.
3. Bring along a list of the medications that you’re taking, including
the doses and how often you take them. Include vitamins and other supplements.
4. Don’t be late for your appointment. Arrive early enough to allow for
traffic delays and get to the clinic in time to fill out forms.
5. And don’t forget your insurance card. Have it ready, along with your
co-pay, if that is required for the office visit.
The patient should make certain to discuss potential medical issues that include
tests that may be needed, possible treatment choices, side effects from certain
treatments or medications – and the possibility of a second opinion if
you’re not satisfied with your doctor’s initial diagnosis.
Xakellis advised not being put off by scientific lingo or a doctor’s manner,
which may seem impatient at times, especially when the waiting room begins to
back up. Despite the pressure, Xakellis recommended, in cases when the doctor’s
words aren’t understood, to have him or her explain it again. “Using
different words, or even drawing a picture can help,” he said.
He also advised patients to be totally candid about what they tell their doctors. ”The
more information you share,” he said, “the better off he or she will
be to figure out what’s wrong with you and how to treat you. Don’t
make the doctor guess.”
If you think of something after you return home from the office visit, Xakellis
advised the patient to call the doctor right away. Be patient but firm if you
want to speak directly with the doctor if he or she is not immediately available.
“Building a successful partnership with your doctor takes time and effort,” he
said. But if problems persist, he added, “you may need to entrust your
care to someone else.”
Xakellis noted that doctors have different styles and approaches. ”From
your (a patient’s) standpoint,” he said, “you should feel empowered
so that you feel, when necessary, that you can contact another doctor who is
more compatible.”
Selecting a primary-care physician is not necessarily a long-term commitment,
Xakellis indicated. ”People are living longer,” he said. “Doctors
eventually retire like everyone else,”
Xakellis recalled the words of Hippocrates, the ancient Greek physician whose
Hippocratic Oath is a time-honored watchword for new medical students. “Life
is short, the art long, opportunity fleeting, experimentation treacherous, judgment
difficult” Hippocrates once wrote.
“It takes years and years to be a good physician,” Xakellis said. “But
the time is not forever.”
