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Back in the day, a family doctor making a house call would probably carry his bag of medical equipment, knock on the door and take a seat next to the sick patient. He’d pull out his stethoscope, listen to the patient’s heart and breathing rhythm, inspect the patient’s eyes and ears and then close up his professional bag. He’d probably conclude the visit by saying: ‘Sally, I’m afraid you have the flu,’ or: ‘Mr Smith, stay away from any oily food until your stomach ache goes away.’
Neither Sally’s nor Mr Smith’s agenda affected the course of the visit and I bet they just ‘yessed’ and ‘noed the doctor’, following his orders, thinking ‘doctor knows best’. Nowadays, we have merely minutes to speak to our healthcare providers each visit, but we can use the time wisely and we can also influence the course of, and participate in, our own treatment by becoming the leader of our healthcare team.
Doctors and other healthcare practitioners (nurse practitioners, physician’s assistants and nurses) have only so much time to see each patient. Typically a visit to your primary care provider (PCP) will likely be 15 to 30 minutes, not to say that the visit can’t be extended if necessary. But you, the patient, can steer the course of the visit and be a captain of the team.
You can help your doctor understand how you work. Since our bodies work uniquely, you can help your healthcare provider diagnose and treat problems and refer you to appropriate services. Example: consider that when under stress, you recognise a tendency towards fatigue and have burning sensations in your abdomen. You’ve noticed this pattern every time. How helpful would it be for your provider, who may know how many bodies react under stress, know individualised information about how your body reacts? Potential medical exams saved. You don’t have to be your own doctor, but you can help them to help you.
An example from commonplace conversation among friends: ‘I’m going for my annual physical this week,’ Joe chimed. Teasing him, Ted added: ‘You know that because you’re so old, you’re probably gonna need one of those prostate exams, like where the doc does his proctology deal’.
‘Heck no, I’m not that old yet, and there’s no way I’m gonna ask the doc to do the exam. She should know how old I am and when I’m due for that stuff,’ Joe chuckled. Implying that his provider should know to ask these questions. This is what happens with doctor-patient communication: Someone doesn’t mention something; nothing gets addressed. Call it what you want, but Joe’s health may not be properly screened if he’s not proactive.
Joe is on target; his medical professional will likely check his age, see which tests he’s due for, etc. But by placing the onus on his provider, he is taking a back seat to his own self-care. What if he doesn’t bring up the fact that he may be due for this important preventive exam? Medical providers are human. They make mistakes; they see so many people each day. Let’s not expect them to remember all of the tests that we may need, because what if the test goes undone?
Another year until we have the opportunity to be screened? Silence or avoidance is not the most helpful route here. Nowadays, patients have more access to their own health information. We can truly become partners in our own healthcare.
Help them help you
- Before your visit, write down what you’re experiencing, when it started, anything that may have triggered it. And questions you have.
- Bring this plus medical records, medical history and list of all meds.
- Talk about stressors in your life.
- Jot down notes during visit.
- Ask for specific information: about specific medical conditions, risks/benefits/alternatives of treatments. Ask questions.
- Ask the provider to repeat information if necessary. Discuss your concerns.
Speak your needs
- Follow-up about findings from previous visits.
- Familiarise yourself on tests that may be given for your age group; ask if they will be performed
- When they say, ‘anything else’, ask anything that comes to mind.
Remember, it’s your health.
Dr Randi Dublin is a licensed clinical psychologist with specific interests in behavioural medicine.
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