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Cyndi Sarnoff-Ross is a licensed psychotherapist with almost twenty years of clinical experience in the fields of clinical psychology and organizational management br br She has worked extensively with a wide variety of…
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When You Talk – Does Your Doctor Listen?
The other day I had a client refer to her medical doctor as, "the kind that doesn't run out of the room when you start talking." This happens to be a very lovely person who I would not consider a challenging patient but she is an informed one - which unfortunately some doctors find challenging. As a psychotherapist I am often in the position of referring people to medical doctors. Whether it is a psychiatrist, a general practitioner, an OB/GYN, a reproductive endocrinologist, a pediatrician or even a dermatologist I have a very short list of doctors in each specialty that I am comfortable referring to. I live in Los Angeles, a large city with a huge number of excellent medical doctors, and yet knowledge of medicine is not the only criteria by which a doctor should be judged.
My clients are often dealing with emotional ramifications of medical problems such as auto-immune disorders, infertility, or unexplained exhaustion to name just a few. So when I make a referral I want to be sure that the doctor they will be seeing is capable of providing that human element. I frequently counsel clients on how to get their questions answered by their doctor and help them to build their self-esteem and assertiveness so they can accomplish this task.
I realize that the medical profession is not what it used to be back in the days of home visits and more flexible schedules. Many doctors are overworked and underpaid and I won't even begin to address the insurance crisis here. Taking all of that into consideration I still feel strongly that patients have rights and that sensitive (not just expert) medical care can make the difference between health or recovery and continued suffering.
Some of the advice I offer my own clients is the following:
1) Whenever possible, get a referral from a trusted source. Even if you are on a plan that requires you to see a certain doctor you still have options. If you are not getting your needs met switch to another doctor on the plan.
2) Have a list of questions ready for your doctor before you get to the appointment and make it your goal to get them all answered. Your appointment is YOUR time and most doctors would prefer to spend a little extra time with you than to have repeated phone calls with random questions.
3) Let your doctor know upfront that you have a list that you want to address at THIS appointment. Don't get pressured into making another appointment because she couldn't answer all your questions. If your doctor is clearly rushed (maybe she has a true emergency waiting) request that she call you on the phone later so that you can get your questions answered.
4) Some doctors (not all) are annoyed by knowledgeable patients because they don't want to be second guessed and they don't want to have to clear their treatment through you - a non-medical person. That is never a good sign and it is certainly not a good reason to be uninformed. A truly good doctor will welcome your input and opinions. After all, it is your body. That said, you need to find a doctor that you trust enough to make the final call about your treatment.
5) You are just as important as any other patient that doctor is seeing that day. Your situation may not be as critical as someone else's and you should respect that but it is incumbent upon the doctor to be clear about their own limitations on any given day and to make themselves available to you at another time if they are not able to answer all your questions.
6) Arm yourself with knowledge. Find out as much as you can about your own condition and treatment options. Become a part of your own treatment team.
7) If all else fails, ask for help. Bring in a family member or trusted friend to advocate on your behalf and help you get your questions answered. When you talk, your doctor should listen because the information you are providing about your own body is a crucial part of your treatment.
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I have had a couple docs who not only admire my knowledge but have thanked me, and even "consulted" with me for my opinion !
I try to dumb myself down , depending on the attitude of a particular doctor. Which is ridiculous.
but it makes life easier..
RAAFBRAT , you made so many great comments; thank you!
To make a long story short, my advice to doctors and DENTISTS too, is that by taking out a second, to smile, or give the patient a feeling of being on their side, any small gesture... to ease their anxiety, goes a long way for both the patient and the doctor. I have tried to explain this (esp. to dentists) that if I am real scared and worried about a procedure, I will be far less of a challenge to deal with, if you take a
moment to make me feel comforted.
p.s. I love the idea of asking a busy doc if I could talk to them on the phone to finish answering my questions if they are too busy right now.
then after the second miscarriage still refused any testing, I had to go to the ER to get a blood HGC to prove my pregnancy on paper.
Thank God I did, because he re-wrote my notes to make it appear as if I had only had a chemical pregnancy, when there was much more substancial evidence that this was most certainly, beyond any doubt a lot more than a chemical pregnancy.
I went to an RE at yale, he's a GREAT Dr. and I also like his personality too, double whammy!
Well I got some basic tests done, and I am infertile and will be in menopause within 2 years also.
Thank God I didn't stick with the OBGYN!
Now we're asking God for another good thing as we try at our 20% of IVF ever working within 2 years.
And at somepoint I will see what other screening I need to have for the mosaic Turner's Syndrome I was diagnosed with.
Good luck to you all.
I tried to have a civil and respectful discussion with Dr Sharo Orrange one of the Dr's here at DS about her dated views she expressed regarding Fatigue, Chronic Fatigue and Chonic Fatigue Syndrome. She was not accountable for what she maintained. She ddn't enter a rationalle dialogue. She seemed to put on an invisable cape that professes ALL Doctors are RIGHT. All patients are wrong.
Dr Orrange's recomendations are three years old at best, ten years old at worst. I tried to illustrate to her that for some Chronic Fatigue sufferers reading her advice that they could in fact end up suffereing much worse by following her advice and not going and getting a Mitocondrial Dysfunction (MD)test performed. MD became globally available in January this year. But what do I know. I am only a CFS sufferer of 5 years who seeks to read every peer reviewed published Medical research finding on CFS so that I might grt better. Patients hate being treated with contempt. I feel Dr Sharon Orrange treated me with contempt.
Ali5tair
www.rawarrior.blogspot.com
Arthritiswarrior - ditto to the comment about doctors not seeing us as equals. If there's a problem you gotta stand up say so.
I feel compelled to point out my Mother always taught me that "it takes two to tango". Which would mean that it's not just doctors who are responsible for this situation. In other words is it just the doctor who is behaving like a demi-God or are the patient's expectations of that doctor unrealistic as well? Sorry, just a question I thought should be asked.
Either way, it's really hard to maintain faith in folks whose attitude towards their patients is aloof and/or who treat you as though you owe them eternal gratitude just for letting you in the door. I understand that doctors have to protect their own emotions too and I understand that most of them really are very busy and that they must often meet folks they just don't like but a smile, a little understanding, a hint of well placed humour or perhaps an occasional kind word isn't going to kill them. Your life is what you make it and you only get from life what you put into it - everyone should remember that - but Doctors should also remember that a positive attitude with their patients can not only make the patient feel better but also themselves. That workload might not feel so damn heavy if they did. My Grandmother was a better healer than most of todays doctors and all she did was give you a cup of tea and listen. My GP actively listens to her patients and believes that they know themselves better than anyone else does. That's why I go to her.
Doalan - I'm really sorry to hear about your brother's experiences. I can easily imagine how the not knowing and being dismissed by his doctors would have made him feel. Except for those who actually saw what I went through even my own family was beginning to think I was imagining it all. After my surgery, one of them said to me "I will never doubt your instincts again". I think that's the part that doctors often miss - they may have all the knowledge etc. but we're the one's who actually live with our bodies every day and know what is or isn't normal for them.
cora
My brother had a similar problem. He had pain and just a feeling that something wasn't right. He went to his PCP who told him he was outside the age for testicular cancer (50's), he went back several times about the pain there and in his back. When he didn't get the answer he was looking for he went to a second Dr. who agreed with his PCP. He told them he just didn't feel it was right, the 3rd Doctor found his testicular and kidney cancer. He said the 1st doctors acted like he was a imagining things, etc. He is a pretty strong personality or he would be dead today. Me, I have problems with embaressing situations and feel Dr.'s often completely ignore this part of care so if I would have been told, don't worry you don't have testicular cancer...I would have thought...great no embaressing exams I am out of here....and eventually I would have been, dying tends to take you our of everywhere. He caught his becasue he refused to accept what they knew was right, becasue he knew how he felt...something they dismissed for statistics
This is such a difficult situation. I agree most doctors are under pressure to perform these days with busy schedules and so forth but I just couldn't help relating one of my own experiences. For years I was considered a difficult patient by many doctors. Ironcially, after a phone call with a radiologist late last year, I concluded that labelling a patient as "difficult" was a doctors way of avoiding looking at their own behaviour. It's easier for them to call me difficult - because I feel entitled to ask questions about my own health - than it is to admit they behaved badly.
Were it not for my "difficult" nature I would likely be dead by now. In the year and a half before May last year my Ovarian Cancer was misdiagnosed on three separate occasions. One doctor even telling my family that I would need open heart surgery. This doctor completely ignored what my husband told him about the hard lump in my abdomen - the lump that turned out to be a 10cm by 20cm tumour that began it's life as my right ovary. This particular doctor just didn't like me. It was only a personality thing. No more, no less but he was unusally arrogant, even for a doctor, and he only treated me after he found out that we could indeed afford his services ... he actually said "well, lets spend your Mother's money". Then he proceeded to ignore what he was told and we get to the diagnosis of open heart surgery. I didn't care one whit whether or not he liked me. I only cared whether or not he was doing his job properly. I will not likely hurry to forgive him for frightening my parents unnecessarily. It seems he wrongly assumed the cost of open heart surgery would be prohibitive and I would seek help elsewhere. A very nasty man whom I wish Karma upon.
I've had many bad experiences with doctors. It's true I am intelligent, stand on my own two feet, am knowledgeable and take responsibility for my own life and health. I don't understand why I should be labelled as difficult because of this. Nor does my newest GP, the woman ultimately repsonsible for a correct diagnosis of Ovarian Cancer. She tells me that she finds me very easy to get along with. Frankly I should think that a doctor would be grateful for a patient who takes an active interest and responsiblity for their own health. I would think it makes the doctors job easier.
And yes ... just noticed doalan's first comment ... some doctors do think they are demi-Gods. I would prefer a doctor with the balls to say "I don't know. Let's find out," than one who pretends they know.
I myself have been blown off by doctors and don't go unless absulutely neccesary once every 3-5 years.
I think the health industry needs a make over!!!!