The very best medical care happens because of good communication – both for patients and for doctors. Without both sides doing their parts to ensure accurate information reporting and adequate listening, diagnosis and treatment can be incomplete or even in error. Both parties need to understand everything about the patient’s symptoms, or the partnership between patient and doctor can break down.
This isn’t as easy as it sounds, in part because of gender differences. On a recent episode of the show, my colleagues and I talked about the different styles of communication between men and women, and how we, as women doctors, know how to listen differently than men doctors do. We are aware of the nuances of communication between men and women, which I believe enables us to hear things on a different level. I’m not saying a better level, exactly, but in some ways I think it is a more complete level. Women doctors sometimes “hear between the lines.”
I see a similar distinction in patients. Female patients tend to describe their symptoms in a different way than men, and that can be problematic when the female patient’s doctor is a man.
The communication between doctors and patients has long been the focus of discussion. The American College of Cardiology Foundation released a health policy statement about patient-centered care that reveals how often doctors don’t fully listen to their patients. As I wrote in my book, Dr. Suzanne Steinbaum’s Heart Book: Every Woman’s Guide to a Heart-Healthy Life:
“One of the things that stood out for me in the policy statement was this … upon asking a patient to describe his or her concerns, the clinician interrupted the patient after an average of 18 seconds; most often, the physician redirected the patient following the first expressed concern, with subsequent discussion focused solely on that concern.”
Clearly, it is challenging to be heard and it is also challenging to listen, but even for those patients who are able to express their concerns, they have about 32 seconds to complete their thoughts.
So, how do you get the most from the time you have with your doctor? It really boils down to four things you have to remember:
- Tell your doctor your symptoms, not your diagnosis of what you think you have.
- Bring your medical records, but don’t interpret them. Let the doctor look at them thoroughly.
- Don’t tell your doctor too many things at once. Start with the few things that bother you the most.
- Rather than challenge, test, or lecture your doctor, just ask questions. Maybe you’ll get exactly the answers you need.
I hope doctors are doing their part, too. In my practice, we have several ways we try to enhance good doctor-patient communication:
- Every patient is given sufficient time to explain their problem and symptoms.
- We ask the patient to come in with a written list of questions, so they don’t get nervous and forget to ask something important.
- We give the patient a record of all test results, in writing.
- We make a heart diagram together, so the patient understands how his or her own heart works.
When doctors give patients the chance to really communicate how they feel, patients become their own health-care advocates and everything that happens becomes part of the patient’s record.
Even if you aren’t visiting the doctor today, why not get started? Keep track of your healthcare visits, medications, test results, and include the questions you ask your doctor and the answers you got. Take this information with you to appointments. It’s the ultimate communication tool because it’s written by you.
In this age, when fast and superficial are more common than comprehensive, detailed, meticulous, and methodical, you can improve your own health-care quality by taking on some of that record-keeping yourself.