Partnering With Your Doctor

I have observed even the most strong-willed and assertive individuals become uncharacteristically timid and reticent when talking with a doctor about a medical problem. The fear of receiving a life-altering diagnosis—about ourselves or a family member–can cause even the strongest person to cower with apprehension. Even if the doctor is caring and empathetic, we can naturally feel vulnerable and uncomfortable sitting on an examining table, dressed only in a hospital gown. And, if the doctor is running behind schedule and comes across as impatient or even a bit brusque, we can easily become intimidated and reluctant to ask questions. We just want to get done quickly and get out of there! So, we often leave the office with a limited understanding of the condition, little knowledge about the prescription to be filled, and with few, if any, alternative treatment options and associated risks.

Many people just assume that the doctor is the expert so who am I to question him or her? If I just follow the doctor’s orders and do as I’m told, then I’ll get better, right? The dilemma, as you know, is that not all situations are alike. Many ‘standard’ or ‘routine’ procedures can go awry, and common medications can affect individuals differently.

So what can you do to take more accountability for your own health and well-being during a visit with your physician?

• First, approach the physician as a partner in your care. Partners talk honestly and openly with each other, sharing pertinent information about their needs and expectations. They may not always agree, but they work out their plans together to reach a common goal.
• Disclose your complete medical history including previous and current physical and mental conditions and treatments, and a list of all prescribed and over-the-counter medications and supplements. I have known individuals to withhold that they are taking anti-depressants, for example, out of shame and embarrassment.
• Share your concerns and expectations. Are you worried about how you’re going to pay for the treatment? Are you concerned that an elderly parent won’t remember which pills to take? How soon can you expect to return to work? Sometimes a physician will prescribe a treatment plan that you know won’t be followed for a variety of reasons; these should be discussed so that you can agree on the appropriate treatment.
• Do your homework. What more can you learn about the medical condition as well as alternative treatment options? Come prepared with a list of questions to ask (e.g., What are the side effects of the medication? What are the risks of having and not having the procedure?) I generally like to ask the question, “If this were you or your family member, what would you do?”
• Research who may be the best physician/specialist with the best outcomes. The nicest physician with the kindest bedside manner may not necessarily be the best practitioner. If I know someone who works at the hospital or is in the field, I ask for recommendations. Networking can help here. Then I interview physicians, either in person or by phone, to see who most closely meets my needs.
• Don’t be afraid to ask about cost. Health care is the one thing we purchase that we have no idea how much it will cost beforehand. When it comes to our health, we’ll do whatever it takes and worry about paying for it afterward. But, especially for the uninsured or underinsured, the costs can be staggering. In addition, costs for the same treatment or procedure can vary dramatically from one provider to another. Paying the highest price doesn’t ensure that you’re getting the highest quality care. It may be worth it to shop around.
• Listen, listen, listen. Often when hearing bad news, our emotions take over and we stop hearing what the doctor is saying. We are fearful of what’s going to happen. Many times we walk out of the office already forgetting what the doctor instructed us to do. It can be helpful to have a family member or friend accompany you who can write down the information for you.
• Ensure that your care is coordinated among different providers. When multiple health care providers are involved, treatment can become quite fragmented. Unnecessary and potentially dangerous outcomes can result. Be sure that one physician is managing your overall care, coordinating medications, and knows what the others are doing.

Sometimes, the physician-patient relationship just doesn’t work, and the respect and communication necessary in a partnership doesn’t exist. If a treatment isn’t working, and you’re not feeling better after discussing and working with your physician, it may be time to move on to someone else. Remember, you are the expert on your own body. Take charge of your own health and well-being by becoming a partner in your own care.