Andrew Siegel, MD Blog #117
Doctor-patient interactions are simply not what they used to be. Patients now have access to an infinite amount of information that they were previously not privy to. The Internet, medical websites and social media offer some potentially excellent sources of medical enlightenment that can easily be tapped into. Many patients now arrive to the office much better informed than years ago, although the source must always be considered, as not all information is reliable. In some circles, these Internet-informed patients are referred to as “e-patients”! At times, too much searching for the source of their signs and symptoms can lead one to be a “cyber-chondriac” a new form of a hypochondriac.
Clearly, time with your doctor is limited and it is important that at the conclusion of your visit your questions have been addressed satisfactorily and you have a good understanding of the advice and guidance delivered. Many physicians now consider their relationship with their patients in terms of a “collaboration,” with both parties actively engaged in the health and welfare of the patient. It thus becomes of paramount importance that there is direct communication between patient and doctor and doctor and patient. Therefore, prior your visit it is a very good idea to think about exactly what issues you would like addressed. Consider creating a list of questions or concerns to focus the conversation and home in and prioritize the problem list. Even consider writing a short narrative detailing the important details of what you would like communicated. Please recognize that there may not be sufficient time to discuss all of these, but a written list or narrative allows the patient and physician team to prioritize.
It is imperative that your doctor have access to labs, imaging studies, and any other relevant information, so if you can obtain copies and have them in hand, it will be a real bonus, particularly for second opinions. If you have had imaging studies, see if you can pick up the disc, as physicians like to view the actual films in addition to reading the report of the radiologist. It is also crucial that you either know—or preferably have in writing—all medical history including medical problems, medications, surgeries and their dates, allergies, etc., as well as up-to-date insurance information.
It is essential that you leave the office with a clear understanding of what your doctor has advised and recommended for you. It is a fine idea to take notes, and some doctors—myself included—supplement the verbal information delivered with handouts, brochures, booklets, or educational videos that review the salient take-home points. If the medical issue is a very serious one, such as cancer or a problem that will require surgery, it is a very good idea to have a family member or friend accompany you to act as a second set of ears. We doctors often use a very complicated language—“medical-speak”—and as much as we try to translate into understandable English, at times we fail to do so. Additionally, we use some very confusing terminology—with physicians, sometimes “no” does indeed mean “yes.” For example, when we speak of a test being “negative” we do not mean “bad” or “unfavorable,” but simply that the test was normal. Similarly, when a test is “positive,” it does not imply “good” or “favorable,” but that the test was abnormal—“your biopsy came back positive for prostate cancer.” How confusing is that? So, never hesitate to ask your doctor to clarify a statement if you don’t grasp it, or medical jargon if you don’t understand it.
It is crucial that you receive the results of important tests that have been ordered. In my office, we make every effort to call back the results of all laboratory tests if not discussed at the time of an office visit. Never assume that not receiving a call means the test was okay—the assumption should be that if you have not received the results, your physician never saw them…even if he/she has, it is always wise to confirm test results.
Tips to ensure a meaningful interaction with your physician:
· Have a plan. In advance of the appointment, think about the reason for the visit, write down any questions that you may have, and consider writing a narrative of your issue and concerns–this helps you focus and organize your thoughts and will help you clearly communicate the problems to your doctor and to help prioritize them. I have had many patient encounters in which the patient was at a total loss as to why they were in the office!
· Bring a written copy of your pertinent medical records including medical history; surgical history with dates of surgery; medications with doses; and allergies. If there have been studies that will have bearing on the office visit, please have copies of relevant labs, pathology reports, imaging tests, etc., with you at the time of the visit.
· Consider bringing a family member or a friend if you have a complicated or serious issue or simply want another pair of ears present.
· Make sure you clearly understand the information and advice you have received from your doctor—do not hesitate to scribble notes and ask questions.
· Be patient with respect to delays—as much as we diligently try to remain on schedule and often experience anxiety when we are behind schedule, we are often faced with unpredictable emergencies, phone calls from emergency rooms and other physicians, and complicated patients that prevent our schedule from functioning like dinner reservations at a restaurant. If truth be told—ironically—the integration of electronic medical records has slowed down the function of our offices substantially, because of the time it takes to enter and update data.
· It is a terrific idea to keep a medical file at home that has your test results including lab reports, imaging, pathology and other tests. We will be more than happy to give you copies of your reports to contribute to your personal medical database. This can prove very useful in the future as reference points.
· Be an educated patient. Sy Syms’ (of the now defunct Syms discount clothing fame) mantra was, “An educated consumer is our best customer.” I borrow and modify it to be “an educated patient is our best patient.” By educated, I do not mean having a doctorate in rocket science but simply knowing why you are in the office and having access to the details of your medical history to facilitate a smooth and effective physician-patient interaction.
Andrew Siegel, M.D.
Author of Promiscuous Eating: Understanding and Ending Our Self-Destructive Relationship with Food: www.promiscuouseating.com
Available on Amazon in Kindle edition
Author of: Male Pelvic Fitness: Optimizing Sexual and Urinary Health, in press and will be available in e-book and paperback formats in the Autumn 2013.
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