These are the thoughts of a cantankerous ol' gynecologist who remembers when things were a little different. I try to find a little humor in my life and the people I meet along the way. Come meet the characters in my world.

Thursday, August 11, 2011

Communicating With Your Doctor 101

The Importance of Two Way Conversation

Many people are nervous or concerned about talking to their doctors.  Remember, we are here to help you get better.  The best way to do this is to have good communication.  It is important that you are comfortable telling your doctor everything that he or she needs to know about your medical problem.  Sometimes this is difficult on your first visit.  Hopefully this visit won’t be about a particularly sensitive subject. 

A good time to get to know your doctor is at a first visit for a physical for sports, school or other “annual” examination.  Since I am a gynecologist, this often is for a Pap smear and either scheduling a Mammogram, discussing hormones or birth control, or discussing other wellness issues.  You can discuss health issues that you are concerned about, like a family history of heart disease or osteoporosis, and get some recommendations about what things you can do to keep yourself healthy. 

Your doctor will want to get to know your history.  If you are older (like me), on many medications (ditto), have had several surgeries (sigh!), you might want to sit down before you go to the office and write all of this down.  You know you are going to be asked about all this stuff.  The older we are, the more there usually is to tell, and the longer it takes to fill out those forms.  I also have problems remembering dates for surgeries and doses of medications.  It doesn’t hurt to carry some of that information in your wallet or purse in case you need it in an emergency. 

We are also going to want to know whether or not you have any allergies or reactions to medications or other things.  An allergy is different than a reaction.  If you are not sure which it is, write down what the medication is, and what happened.  For example, Benadryl (a common over the counter antihistamine) will often make people sleepy.  This is a known reaction, not an allergy.  If, however, it makes you short of breath, slows your heartbeat, and someone had to do CPR, then you are allergic to it.  That itchy, red, bumpy rash is an allergy, too.

Things that you need to be prepared for the doctor to ask about include: smoking, legal and illegal drugs, sexual problems, birth control, urinary incontinence, domestic violence and sexually transmitted diseases. You should be honest about these. You may choose not to discuss these on the first visit. That's fine.  Your doctor is working on the information that you have given him or her. If you are not completely honest with your doctor, they cannot necessarily help you.  But don't wait until the doctor is on the way out the door to bring up a sensitive problem like pain with intercourse, loss of urine with coughing, or abnormal discharge. We need to address these problems before we do our exam, not after. If you bring them up at the end of the visit, you can guarantee yourself another visit.

You might want to write down a short list of questions you want answered. Remember that you only have a limited amount of time with the doctor, so limit the questions.  You should probably write down what the doctor recommends or ask to have written instructions. That way, you don't forget.

Then try to follow the directions.   If you can't, you need to be honest about why you can't. We as physicians assume that you did what we advised you to do and are still doing it. If you only took one month of your blood pressure pills and stopped, your blood pressure is going to go right back up. If your medications make you feel funny, call and make an appointment. If you took the hormones incorrectly, you will probably bleed. I can't fix it if I don't know what you really did. If you can't afford a medication, let me know that, too.  There are sometimes cheaper medications or places I know that sell medications cheaper.  Don’t be embarrassed.  I can often help. 

My oral surgeon tried to give me a medication that I was supposed to take 4 times a day.  I have three teenagers and a medical practice.  I bluntly told him that there was no way I could remember 4 times a day.  He thought about it for a minute and gave me a different medication that was twice a day.  Problem solved. 

Please call the office during regular office hours unless there is something really major wrong or your doctor told you to do something else. Remember that doctors usually have families and lives outside of the office. We tend to be asleep at 3:00 AM (unless we have newborns, in which case we don't really want to talk to you about your blood pressure medication at that hour either).

Also, don't insist on speaking to the doctor when you call the office. Most of the time the nurse or medical assistant can help you, or will speak with the doctor and call you back. If you need to speak with the doctor, you may have to wait several hours. S/he is probably trying to keep on time in the office. Some doctors have designated phone hours.  Or you may need to make an appointment if you need to talk to the doctor.  Ask when you call.  Your doctor is probably trying to keep the office from running behind!

I hope this has answered some of your questions on how to communicate with your doctor.  Most of us want to work with you to make you better.  I’ve tried to give you some help joining the team.


moviedoc said...

If I were your patient I might not want to think you would take time from our visit to "fill out forms." Also, I might like to be able to text you for quick stuff like "I need a refill." or "Can I reschedule."

Anonymous said...

Great can I borrow it.