five. Medical Providers and Medical Organizations

Doctors and patients rarely speak the same "language."

How can I get my doctor to listen to me and take me seriously?

This is by far the biggest complaint patients seem to have about doctors. Like everything else related to chronic illness, this problem has no simple answer. There are things you can do to improve the situation, however. Granted, doctors are usually very busy. Constraints put on them as a result of managed care might mean that they can't spend a lot of time with each patient. You can't change the system, and you can't change your doctor. That's sad, but it is reality. Doctors and patients rarely speak the same "language." What you can do is learn how the doctor likes to receive information and then, if necessary, change the way in which you communicate.

Often, patients have not prepared to maximize the time they have with the doctor. When they get into the exam room, they are already flustered, forget the most important things, and give ambiguous answers. The doctor has a hard time understanding. Instead of giving a clear picture of what they are experiencing, patients often give vague answers and hope that the doctor will ask questions to draw the information out of them. The following suggestions should make a difference in your doctor-patient relationship.

Come to your appointment prepared. Bring a written list of all prescriptions, medications, over-the-counter medications, vitamins, herbs, and supplements that you are taking. Include the name, dose, and frequency with which you take each. Have a copy for you and one for the doctor. This saves time and eliminates the possibility that your medications may not be entered correctly in your records. It is absolutely critical that you tell the doctor about everything you are taking. Some supplements work against certain medications you may be taking.

Others amplify the effects of your medication in undesirable ways. Still others can actually increase disease activity. You can't expect your doctor to be of much help if you hide this kind of critical information.

Learn to describe your symptoms clearly and in terms that will help your doctor help you. A symptom journal is an excellent way for you to track the information. Get a notebook, and record in it the following things: What is the symptom? When did it start? How often do you experience this symptom? What relieves the symptom? What makes it worse? How long does the symptom last? On a scale of 1 to 10 where 10 is the worst, how severe is the symptom? Does this symptom interfere with your ability to perform activities of daily living? If so, how? Make a short list of descriptive words regarding the symptom. Let's look at two hypothetical patients and their discussions with their doctors.

Patient 1

Doctor: Good morning. How are you doing today? Patient: Oh, I'm just kind of blah. Doctor: What's the problem? Patient: I feel achy. Doctor: Where?

Patient: Well, it kind of moves around. Doctor: Where do you feel it most often? Patient: Hard to say. Doctor: Can you describe the ache? Patient: It's just sort of, you know, an ache. You have to give me something to make it go away.

Patient 2

Doctor: Good morning. How are you doing today? Patient: Not too bad, but I am troubled by these aches and pains in my joints.

Doctor: Go on.

Patient: Every morning when I wake up, I am so sore and stiff that it takes me about 2 hours to get moving. After I have a long, hot shower I start to feel a little better.

Doctor: Which joints bother you the most?

Patient: The little joints in my hands, my wrists, and my feet and ankles.

Doctor: Let me take a look at them.

Which patient do you think will be taken seriously, listened to, and have his or her needs addressed?

 
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