Wednesday, October 06, 2004

How to Get Your Doctor to Listen to You!

Have you ever been diagnosed with a serious illness, or known someone facing such a health crisis? Do you recall how anxious you were to get the true facts about the situation? At such a time we all rely on our doctor to communicate clearly the details of the illness and the plan to treat it. Unfortunately, many doctors possess meager skills in counseling; others are talented speakers but poor listeners, and all doctors are rushed for time. This often leads to an unsatisfying visit.

A patient or caregiver always has the right to ask multiple questions about the diagnosis, prognosis and treatment of an illness - I get asked these questions every day, and have learned to answer them as faithfully and completely as possible. Notice I said I have learned - when I started my career I too was a novice at patient counseling. Caring for cancer patients creates expert listeners of most oncologists.

Thus I am amazed when I hear again and again that a doctor "didn't say much" about a patient's recent diagnosis. Is the physician really ignorant or too busy to educate the patient, or is the subject bypassed because he or she has nothing encouraging to say? It is unfortunate that some doctors look at the disease cancer with nothing but hopeless nihilism.

Therefore, as a public service, The Cheerful Oncologist, with only a modicum of sardonic delight, would like to reveal some helpful tips in ensuring that your doctor doesn't race in and out of an office or hospital visit without adequately answering your questions. These little secrets, some practical and some psychological, increase your odds of gaining the answers you need without resorting to exhortation or outright hostility, which tends to freeze the doctor with suspicion and make the tongue spout vague platitudes. No matter how extraordinary these tips seem, take it from one who has had them used on him - they work! I only ask that you apply them judiciously, as overusage can be interpreted as adversarial, and lead to mistrust. Remember, our common goal is to care for the patient with excellence and compassion!

The Practical Tips

1. At the beginning of the visit, tell the doctor you have questions - this warns him or her that counseling will be a part of the visit.

2. Write down your questions, and give a copy to the doctor so you both can go through the list together.

3. Do not be shy about asking the doctor to repeat the answer, or phrase it in more easily understandable language. A good doctor does not assume patients understand esoteric medical terms.

4. Invite the doctor to sit down, which brings all to eye level, and creates a less hurried setting.

The Psychological Tips (which create leverage - use with caution!)

1. Bring lots of family to the visit - the more the merrier. We docs tend to spend less time counseling the solitary patient.

2. Don't hesitate to announce any relatives in the room who are attorneys, whether they litigate or not. Attorneys get the doctor's rapt attention! If you don't have a lawyer in the family, dress all males in suits - looks impressive, if not intimidating.

3. If any family member is a doctor - sibling, offspring, nephew, niece - let it be known at once, whether they are in the room, or live nine states away. Rare it is to find the physician who would disappoint a physician's family member.

4. Produce a tape recorder, and say, "You don't mind if I record this, doctor? My family will want to hear what you have to say." This is the ultimate weapon against the lackadaisical counselor!

Now go, and be an advocate with confidence!


At 5:58 PM, Blogger PKD said...

I am Lucifer the Morningstar. Your blog is like unto a Serpent dispensing the knowledge that induces Evil among otherwise Good Men.

Thank God for me.

At 8:18 PM, Blogger Nick said...

Good advice, but I'm a little skeptical of your point to "bring a lawyer along" to a counseling session... in my brief experience, it seems having a lawyer present makes doctors less candid, not more. Ditto with tape recorders -- I can just imagine it being played back in a courtroom.

Maybe I've just absorbed the blogosphere's lawyer-paranoia. But what about good old pamphlets and web downloads? In a lot of the clinics I've rotated through, no patient with a new diagnosis left without some kind of literature to review. The documents are comprehensive, point to new sources, and are already vetted for accuracy and minimizing liability!

At 9:17 PM, Blogger Dr. Craig Hildreth said...

To Nick:

Well, the tongue might have been in the ol' cheek with my advice about lawyers or tape recorders - even though they have been used on me with great results!

As to pamphlets - I use them all the time, as well as internet sites such as

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