How to Help Your Doctor Work Better for You - Part I

Some people are very, very lucky and have open, two-way lines of communication with their doctors. They are treated with respect and included in their own health care, and they know that their needs are being considered when they make appointments, need prescriptions refilled or are asking for more information.

Unfortunately, for too many of us that isn’t the case. We either wish that our doctors would speak in English, or would actually listen to what we’re saying when we talk with them – or maybe we have both problems with the same doctor. We are often left waiting well past the agreed appointment time, and we generally feel as if we’re being treated in a very casual manner as an uninterested (or uninteresting?) observer in our own health care.

Two basic obstacles to communicating with any doctor are simply due to circumstances. The first is that doctors are human beings, and any communication between two people can become dicey at any given time, without one or both knowing that a failure has occurred. The second is that doctors see patients all day long almost every working day, and it would be surprising if the symptoms and the names don’t tend to blur together by the end of a single day, let alone a whole working week. (Given the short time that doctors now have with patients, these obstacles alone have increased.) However, other obstacles to communication and to a good working relationship with your doctor exist that aren’t due to circumstances alone.

In hopes that some of them can be reduced or eliminated, I’ve written this multi-part helper. I’ve organized the problems and solutions into specific sets in an effort to help you to read only the parts that apply to your needs. Hopefully, this will help you to either remove or reduce any obstacles to a good working relationship with your doctor. (Soon I’ll publish, Should You Fire Your Doctor?, where I’ll discuss what to do if the situation doesn’t improve enough to make you comfortable.)

When you’re thinking of your relationship with your doctor, you may first need to overcome your own set of perceptions about what’s allowed and not allowed when you communicate with your doctor, and about what you have a right to expect from your doctor. Most of us have a lifetime of both subtle and not-so-subtle training to overcome.

If your doctor seems to disregard your wish to participate in your own health care, you can insist on having a voice. This may sound intimidating, but it’s very necessary for both your doctor and you to participate, if you want a good outcome. Your doctor should regard you as the source of information about symptoms, the only source of answers to some questions that may come up and a partner in considering what might be wrong. In short, your doctor should regard you as a major member of your own health team.

When you look at making changes to the relationship, the communication on your side depends on eliminating your hesitance, and being open with your doctor about what the doctor is doing or not doing that you consider obstacles to good communication – and, as a result, to better health care for you. You are, after all, paying for the services your doctor is providing. You may even be paying without health insurance. You have a right to be treated with respect and to have your input regarded.

For a comparison, think of some other highly-skilled, highly-paid contractor that you might hire. Would you allow that person to disregard what you say, to keep you waiting for long periods of time, or to be rude? Would you allow mistakes to occur that affect your home or your car? No. So if you wouldn’t put up with that from other contractors, no matter how highly skilled or highly paid, why would you put up with it from your doctor? Especially when you consider that the consequences to you are potentially devastating. If healing your body is mishandled, poorly-done, or not done at all, why would you not keep a tight rein on what you allow and don’t allow in the health care that you pay for?

In the United States, the medical culture currently expects people to leave their health care to the doctor, period. While that is changing a little at a time, too many doctors still expect to take control and to have exclusive command of the situation. Too many patients are expected to leave their life experience, common sense and intelligence outside the door before they enter a doctor’s office, particularly if it means questioning or disagreeing with the doctor. This attitude is one of the biggest mistakes the medical profession has made, because as people give up decision-making in their own health care, they also tend to abdicate from responsibility for maintaining their own health as they go through their daily lives. Doctors criticize their patients for making ignorant mistakes or for not maintaining their own health, but those are the natural result of a patient abdicating all power to a doctor.

This is a teaching that we, as patients, need to correct for our doctors. We need to reverse that trend, to remove the overbearing privilege from the doctor’s role and the stigma of ignorance and submissiveness from the patient’s role. We now have access to massive amounts of information from reputable online sources, through community health classes and in print. This information is no longer available only to the doctor. And we are taking advantage of it as never before. We want to be a part of our own health care. Not only is this need to know and participate desirable, but it provides an important additional protection from the mistakes that too often happen in the medical profession. Armed with this knowledge, we can learn to speak up when we are not being listened to, or when errors have become obvious to us.

The doctor-patient relationship becoming skewed almost totally in the doctor’s favor hasn’t happened by chance. The mainstream medical profession has been shaped based on that unbalanced relationship, and doctors have been trained to think of themselves as the superior person in the doctor\patient relationship. It’s time to turn that unequal and, to the patient, unsatisfying relationship around.

The first problem area that most patients have, but that few recognize as a problem is how you and your doctor address each other. Do you address your doctor as “Doctor” and does your doctor address you by your first name? If so, you are participating in the normal expression of extremely unequal status between two parties. Generally, the person with the most status is addressed by a title and last name (Baron, President, Doctor), which is a formal address. The person with the least status is addressed using a first name, which is a familiar address.

There is no reason that, if you are required to call your doctor by his or her title, you shouldn’t be called by your title and last name. This may seem like a minor point to you - maybe even an over-the-top point - but the fact that your doctor has to remember to address you in a more formal manner reminds him or her that another adult who demands respect is being addressed. I know that using the doctor’s title is a show of respect for the long years and hard work it takes to become a doctor. However, if you are naturally showing respect to your doctor, shouldn’t the doctor also naturally show respect to you and to what you have been putting into your life? When I brought this up to a friend who’s also a doctor, but whose degree is a PhD rather than an MD – and any doctor knows that a PhD takes a lot of hard work to achieve – she said that her medical doctor still called her by her first name!

If this happens with your doctor, and you want that to change, after you’ve been addressed by your first name, reply to your doctor by his or her first name. “Hello, Shannon.” “Well, hello, Sidney, how are you?” Then, when the shock shows, or when the doctor says that he or she prefers to be addressed as “doctor”, you can reply that this seems very formal to you, so you have decided that you would prefer to also be addressed in a more formal manner, by your title and last name. You may not want to take that step, but if you’re having trouble with your doctor listening to you and treating you with respect, this point is one to consider.

Even if you don’t want to take this step, you can still change other components of the relationship. These will be categorized in upcoming hubs. They will include relationship imbalances, such as; the rude doctor, the overly costly doctor, the preoccupied doctor, the overly casual doctor, etc. I’ve broken these categories into other hubs, because you hopefully don’t have all of the problems described. As I add the hubs, I'll add the link below this line.

Part II is now available

I won’t be discussing other pro-active patient activities, such as bringing a list with you and writing down instructions, because numerous medical websites have thoroughly covered advice for improving your role as a patient. If you’d like to read one of those sites from a patient point of view, this diabetes management newsletter has 10 good tips for you.

If you vote up or vote down an author's writing, you will show the people who follow you what you feel the quality of the writing is. Please support writers by voting up their work.