HOW TO SPEAK UP TO YOUR DOCTOR
A professor of mine back in medical school used to say that a carefully taken history alone could lead to a correct diagnosis about 80 percent of the time. But getting an accurate history is often easier said than done.
With some patients, the physician becomes more like a dentist—when getting all that information is like pulling teeth. And of course, many doctors—whether because of temperament or time constraints—don’t pursue the patient’s account as aggressively or even listen as attentively as they should. Either way, it’s up to you to see that your story is told and your message gets through.
Here’s what to tell your doctor during an office visit—and how to tell it.
Tell why you’re there. If you have more than one reason for the visit, make a list in advance so you won’t wind up kicking yourself on the way home for forgetting to ask an important question. Try to be specific when describing each problem. Saying something hurts, for example, is not enough. You need to describe when the pain began, exactly what it feels like, whether it comes and goes, and what makes it better or worse.
Tell what’s bothering you most, first. Make sure your doctor realizes how important each complaint is to you. In one study, one in every four complaints mentioned by patients wasn’t even recognized as a problem by their physician. In another study, doctor and patient disagreed about half the time on exactly what the main health problem was.
Tell it like it is. Don’t minimize or trivialize your complaints, or your doctor may do the same. Don’t attribute problems to “normal” aging—especially problems involving depression, dizziness, forgetfulness, or sexual dysfunction. Think of the nonagenarian who complained of knee pain only to have his doctor suggest that this was to be expected at the age of 92. “But my other knee is also 92,” the man pointed out, “and it’s fine.” There may be an underlying, treatable disorder—at any age.
Tell it straight. Try to present your problems in a focused manner, without flitting from one symptom or complaint to another. Doctors tend to butt in quickly—on average, within 20 seconds after the patient starts talking, according to one study—so avoid rambling, which invites interruption. When your doctor interrupts anyway, remember to pick up the thread where you left off. Check your list to make sure you fully cover one problem before going on to the next. Also, since doctors tend to pride themselves on making quick diagnoses, make sure you get a chance to put all the clues on the table first.
Tell your primary-care physician all. I often encounter patients who are seeing several other doctors for problems involving various body parts. Such a splintered approach to health care runs counter to the concept of treating the whole patient and can produce disastrous results. Of course, there are legitimate reasons to go to different specialists for different conditions. But it’s essential to keep your primary doctor informed about all the care you’re receiving. That includes care from any “alternative” practitioners as well.
Tell about the drugs you take. Bring all of your medications—over-the-counter as well as prescription—to each office visit. Have your doctor check each drug against what’s written in your chart. Discuss lowering dosages or even stopping medications you may no longer need or that might interact with other drugs. Make sure your doctor knows about any recent drug reactions you may have had, including allergies or side effects.
Tell about the “dietary supplements” you take. Just because herbs are “natural” doesn’t mean they’re safe. Like drugs, they can cause side effects or interact with each other, with medications, or with foods. Many vitamins and minerals, too, can pose risks, especially in high dosages. But although vitamins, minerals, herbs, and other dietary supplements can behave like drugs, they’re not regulated the same way, and the risks—and the possible benefits—are still largely unknown. , Even if you suspect that your doctor might not approve of your supplement regimen, it’s still important to provide that information.
Tell about your family. Your risk for many serious diseases—including cancer, coronary heart disease, and diabetes —can be strongly influenced by your family medical history. Be sure to keep your physician up-to-date on any recent illnesses or deaths.
Tell your end-of-life wishes. Keep your doctor, your lawyer, and close family members informed about the sort of life-prolonging care you’d want if you were incapacitated. But don’t rely on conversations, and don’t wait until you’re faced with a terminal illness or, even worse, become unable to communicate: Make out a living will and appoint a healthcare proxy now.
When all is told
Of course, good communication with your doctor involves a two-way flow of information. So ask lots of questions—and be a good listener. Take notes, or bring a tape recorder or a second set of ears. Then, to make sure you heard correctly and to increase the chance that you’ll remember what you heard, tell your doctor what your doctor just told you.
Health handbook introducing you to read the article: ARE TWO MEDICAL OPINIONS BETTER THAN ONE?
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