doctor-patient communication

Patients often lack a framework for thinking about health care

In the summer after I finished first grade, my family moved to a house located about an hour's drive from our last one. I had learned to read that year, and over the summer I polished off the entire Bobbsey Twins series, the entire Hardy Boys series, and so forth. The first day of school, I was excited to find out what they would teach us now.

Actions you can take when doctors act disrespectfully

Are you kept waiting for a long time to see the doctor? Do you get "patronizing and dismissive answers" to questions you ask? Have you gotten the sense that you didn't get the whole story - "full and honest disclosure" - when something went wrong in the course of treatment? Did you ever feel later that you weren't given the information that would have allowed you to make a better choice about getting certain tests or treatments?

Rude, dismissive doctors put patients at risk

In my books about healthcare (including one to be published this summer, "When Health Care Hurts"), I always conclude by talking about the future of healthcare. What will be different? What will lead to change? One theme remains constant: For serious change to occur, patients must be treated with more respect than they are today.

Make a list of your medications before a doctor's visit

You arrive at the office of a doctor you're seeing for the first time, and after handing over your insurance card and driver's license, you're given a clipboard with pages and pages of forms to fill out.

After sighing to yourself - how many times in your life are you going to have to write down that you had your tonsils out when you were 6 and broke your right wrist when you were 13, and that your father died of a heart attack? - You settle in to the task of completing the forms.

Bring list of questions, concerns to doctor appointment

How can you ensure that you tell the doctor everything you meant to? Prepare a focused one-page note covering your key points, and give it to the nurse or aide who takes you to an exam room and checks your temperature and blood pressure. Ask her to give it to the doctor.

What happens if your doctor doesn't listen to what's important to you?

Guadalupe, age 64, was 5'2" tall and weighed 145 pounds. She fussed over her weight as she drove to the doctor's office. She sighed, knowing that he would tell her to lose weight. "I can do this," she said to herself. "Maybe WeightWatchers - it worked for me once before."

She had struggled with her weight for decades. But now, it was really interfering with her life. If she got down on the floor with her grandchildren, she had trouble getting up because of the pain in her knees - which she didn't have when she weighed 10-15 pounds less.

Does your doctor take your priorities seriously?

When Heather was 35, she married a man she'd been dating for four years who already had three children. From very early on in their relationship, they had discussed whether they wanted more children, and consistently agreed that the three he already had were enough. Unless Heather accidentally got pregnant, they would not be having any more.

Two years after they married, the results of a routine Pap smear revealed that Heather had abnormal cells in her cervix that could become cancerous.

Make sure your doctor shares your goals

Kimberly was shocked when she was told that she had breast cancer that had spread to her lymph nodes. It quickly became clear that she would need a mastectomy - surgery to remove her breast.

As soon as she got the diagnosis, she went on the internet to find out what other women in similar situations had to say. One piece of advice turned up over and over: If you think that you might want to have reconstructive surgery after your breast is removed, talk to a plastic surgeon before you have the mastectomy.

Kimberly thought that this suggestion made sense.

Dignity and respect important for patients

James, age 64, was a successful businessman who had retired a few years earlier on his doctor’s orders, to reduce the stress in his life. His wife Helen, several years younger, was still working. When James suggested traveling, Helen declined, citing the press of work. She would retire in another year or two, and they would have plenty of time to travel then.

What happens if your doctor dismisses your symptoms?

Benjamin, 28, woke up Monday morning to find that he had severely swollen ankles and calves. In fact, the swelling extended almost to his knees. He told his wife, Theresa, “I am in heart failure.” She did not think that such a thing was possible, because of his young age. She did know that he had been fatigued ever since he had gotten a cold several weeks earlier.

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