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A Prescription for Talking to Your Doctor

A Prescription for Talking to your Doctor
By Kathleen Donnelly..San Jose Mercury News; Orlando Sentinel ..Tuesday, April 2, 1996

For those lucky enough to enjoy good health, seeing the doctor is an event. After all, how many times a year do you go to the doctor: once, twice, maybe three times? And, if a recent study is any indication, many of those appointments last less than 10 minutes - hardly enough time to ditch your clothes and check your blood pressure, let alone ask about all the commercials you've seen that end with the sincere admonition, "Ask your Doctor" - as if you're in the habit of dropping by around 4 every afternoon for a little chat.

So, you perch on the padded table - blue paper gown scrunched up around your hips, glassy eyes glued to the weight chart on the office door - and you silently go over all the questions you've been saving up for months...

Suddenly, the door opens and the moment arrives. "Any questions?" the doctor asks. "Anything you want to talk about?"

You stare at the goose bumps on your knees, hesitating only momentarily. "Nope!" you chirp.

Exactly where your presence of mind goes during office visits is a mystery as yet unsolved by medical science.

"I know what you mean," says Susan Campbell, an information specialist at the Community Breast Health Project in Palo Alto, Calif., who often helps breast cancer patients learn to communicate effectively with their doctors, "In fact, I had an appointment myself last week, and when I got outside I thought, "I didn't follow my own advice."

After all, it's not exactly a situation conducive to conversation, You're in an unfamiliar setting, wearing disposable clothes asnd trying to formulate intelligent questions for an authority figure who, no matter how sympathetic, has other demands on his or her time. No wonder you suffer from performance anxiety.

Get over it. Your health depends on it. Certainly it's the physician's responsibility to help ellicit those questions and to answer them clearly. But patients have a responsibility to communicate clearly too.

These things aren't easy to do,people are intimated. The waiting room is full of patients. The doctor's already 20 minutes late. They're afraid they're going to cut into other people's time.Which is why patients should ask for enough time at the beginning - when making an appointment.

Ask for the amount of time you think you're going to need. Tell them you have questions you want to ask, and you'll need 15 minutes , or a half -hour. You have to be a little bit assertive. That's the trick.

Assertive, howeverdoes not mean rambling or rude. Take a watch, and when your 15 minutes are up, realize the doctor has to go. Schedule another appointment if you need it, or ask a nurse if it would be possible for him or her to get your remaining questions answered and call you back.

Be prepared. Write down your questions as they come to you, and if you have time before you go in, organize them. Often, doctors will help you go down the list. Listen to the answers - carefully. Take notes, or - if both you and the doctor are comfortable with it - use a tape recorder. Recorders are especially good for consultations with specialists, or when receiving a new diagnosis.

Feel free to take your spouse, a family member, a friend or even a patient advocate to your appointment, In most cases, doctors shouldn't balk at your choice of observer. If you don't understand what he or she is telling you, don't be embarrassed to ask for clarification. And if you still don't understand when you get home, call back, You can't expect a doctor to drop everything and take your call, but if you leave a message a doctor or a nurse will usually get back to you.

"Part of our job is communication" says Dr.Stanley Goldstein. "If you chose to be a physician and you're taking care of patients, you chose to be available 24 hours a day."

Tips for Talking With the Doc

*Prepare. Think about what you want to ask before you show up for your appointment. If you have a specific illness or condition, do some preliminary research and come to the appointment with a base of knowledge.

*Make a list of questions. As you think of questions, jot them down in a notebook.

*Take notes. Write down what your doctor says in answer to your questions, or take a tape recorder.

*Bring along an observer. Two heads are better than one.

*Don't be afraid to say you don't understand. It is the physician's job to make the explanation clear to you.

*Call for back-up. It's ok to call after the appointment and ask a doctor or nurse for clarification.

*Always fire off questions about new medications: How often should I take it? When should I stop? Should I stop completely or taper off the dosage? How long before the medication takes effect? What are the side effects? And which side effects are an indication that I should contact the doctor again?

*Make sure you know if you need a follow-up visit. If you've gone in with a specific problem, ask how long to wait before scheduling another appointment if you don't feel better.


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