Trying to clearly communicate a medical problem can often be challenging, but it’s especially difficult when you feel like the doctor you’re talking to isn’t listening or taking you seriously. Research has found that this is more likely to be the case with female patients and for people of color— a fact recently highlighted by tennis superstar Serena Williams. In a recent study in the Journal of General Internal Medicine (JGIM), researchers looked at interactions between clinicians and patients and found that the medical professionals directly asked their patient the purpose of their visit in only 36 percent of cases. In over two-thirds of those cases, doctors interrupted the patient, allowing them an average of just 11 seconds to talk before interjecting.
Not allowing a patient to explain their condition can lead to less effective treatment. Dr. David D. Clarke, MD, who is based in Portland, OR and is president of the Psychophysiologic Disorders Association, explains, “Doctors begin formulating a hypothesis when patients start describing symptoms, and they want to narrow the range of possibilities quickly by asking questions. However, interrupting the patient tends to prevent disclosure of all relevant information, resulting in a less accurate diagnosis.”
So how do you make sure your appointment is on point? Here’s what doctors want you to know.
1. Make sure your doc has done their homework. A valid reason that doctors jump right in is that they already know why you made the appointment. “By the time a patient sees the doctor, they’ve usually stated the purpose of the visit to an assistant or nurse,” explains Dr. Kaushal Kulkarni, MD, a board-certified ophthalmologist in San Diego, CA. “A good physician will review this beforehand, as well as the patient’s chart and history, and will know the nature of the visit before they walk in.”
This is particularly true when it comes to specialists. The JGIM study found that specialists were less likely than primary care doctors to ask the patient why they sought medical help, asking in only 20 percent of cases as opposed to 49 percent respectively. But Kulkarni points out that this is the marker of someone who has done their homework, not necessarily someone who doesn’t care. “Most patients prefer a specialist who demonstrates that they have reviewed your case beforehand and are aware of the problem. It’s much more comforting to hear that than to be asked to tell your story all over again.”
2. Be assertive. Another reason doctors may accidentally take over an appointment is that they sense you’re feeling shy or embarrassed. Dr. Joseph Davis, DO, New York City-based board-certified OB/GYN, says, “If patients start with a question or say little, doctors may feel the need to fill in the silence, which could result in them taking over the conversation. Begin the appointment with a strong statement like, ‘I would like to give you some background,’ which tells me as a doctor that I should wait for you to say everything you plan to say.” Also, never be afraid to ask if you don’t understand something. “Doctors become so accustomed to medical terms that they forget that the rest of the world doesn’t speak that language,” Davis notes. “If the doctor uses technical terms that you don’t understand, insist on an explanation until it’s clear.” This meeting is about you, after all.
3. Not all interruptions are bad. Most doctors agree that letting a patient describe their experience uninterrupted is the best way to get all the important information. The results of the JGIM study are somewhat misleading, since they don’t clarify the nature of the interruptions. Kulkarni points out, “It is often in the best interests of the patient for the physician to ask for clarification during parts of the story. For example, they might ask about a timeframe, or for more details of a particular symptom, or even say something like, ‘I’m sorry to hear that.’ In this study, all of these useful points were counted as interruptions.” Compare it to talking to a friend: You can tell the difference between someone who’s about to hijack the conversation and relevant interjections that actually prove they’re paying attention.
4. Come prepared. It’s totally normal to draw a blank on your symptoms the moment you’re sitting opposite your doctor. To help, Clarke recommends bringing a physical list of what you want to say. “Write down in advance everything you want to communicate,” he advises. “If the doctor interrupts, politely ask them to wait until you are done, or answer their question and then immediately resume reading your list.” He also suggests you list all your medications, “and how you are actually taking them. Be honest about tobacco, alcohol, drugs, and major stresses in your life, such as violence from an intimate partner,” Clarke says.
When explaining the problem, start at the beginning. “Physicians think about problems chronologically, so relating your story in that way makes it much easier for your doctor to help you,” Kulkarni explains. “Use exact dates, rather than days of the week, which can be vague.” This isn’t a public speaking exam; notes are definitely encouraged!
5. Prioritize your questions. It’s an unfortunate fact of medicine today that doctors are under a lot of time pressure. Make sure you’re getting the most from the minutes you have with them. “I appreciate when patients ask, ‘How much time do we have? I want to make sure we cover XYZ,'” Davis says. “This ensures we’re working on the same schedule, and gives us a list of things to tackle in the time available.” And raise your most pressing concern first. “It’s okay to have multiple concerns or questions,” says Kulkarni, “but decide beforehand which is the most important, or if there is one overarching fear that you want alleviated. Most doctors will be eager to address it.”
All of the doctors interviewed stressed that while this study raised an important point about listening to patients, most healthcare providers really do want to hear what you have to say because it helps them do their jobs. Be organized and confident in your ability to assess your symptoms, and speak up for yourself. With the help of a good doctor, you have a prescription for success.
Is your doctor a good listener? Share your experiences @BritandCo.
(Photo via Getty)
