The impetus for writing this article was a series of conversations I had recently with clients, patients and friends concerning their feeling of disempowerment regarding their own healthcare.
The relationship between patient and physician usually begins at the moment of birth. The first person most of us meet when we enter the world is someone who attended medical school and earned the right to use the title of doctor before his or her last name. This first introduction is usually one that is accompanied by blood, crying and joy; in this sense it often serves as a prelude to the doctor-patient relationship for years to come.
From 1969-1976, a medical TV show about an incredibly kind, compassionate and knowledgeable doctor aired weekly on ABC. The name of the show was “Marcus Welby, M.D.” The writers created a respected and beloved character, and for the next few decades, people would compare their own physician to Dr. Welby. When those my age and older were growing up, it was not uncommon to hear people state about their doctor, “He was no Dr. Welby” or, less frequently, “He was a regular Dr. Welby.” Only a fictitious character could actually be Dr. Welby, but he became the ideal, representing what all patients wanted from their own doctors.
Medicine has changed quite a bit since Dr. Welby was on television. For example, in the 1960s, it was not uncommon for physicians to make house calls. Today, only about 1% of all physician visits are provided in the home. Moreover, in the last 10 to 20 years, many privately owned physician offices have been purchased either by large medical groups or by hospitals, and many physicians no longer have autonomy over their own practices. As a consumer of healthcare, you may have noticed a difference in terms of your access to your doctor due to this change.
With the increase in medical knowledge and significant improvements in specific treatments, the need for specialists has increased and the average person will now therefore first see a primary care physician (PCP); this doctor should ideally act as the “quarterback” for the patient’s general care and coordinate the need for additional care from a specialist when required. It is not uncommon today for a person over the age of 60 to have a PCP and any combination of the following: a cardiologist, an orthopedist, a dermatologist, a rheumatologist, an endocrinologist, a gastroenterologist, an ophthalmologist, a urologist and, for a female, a gynecologist, in addition to a radiologist for routine screenings. If one has a history of headaches, neuropathy, neuro-pain or a stroke, a neurologist is added to the list; if one has a cancer diagnosis, an oncologist is seen as well.
The point is that depending on your health, or that of a loved one whose care you are overseeing at any age and for any medical situation, you can spend a lot of time seeing doctors. It is thus of great importance that you know how to speak to your doctor so that he or she understands you and will provide you with the care that you need.
Prior to making an appointment with a new doctor, do your research. Today, it is easy to do a search online about any doctor. Check their credentials, look where they went to medical school, and see if they have published any articles in peer-reviewed journals. Examine patient reviews. If most of the reviews are positive, you can ignore the one or two negative ones; nobody can make everyone happy. If, however, you see several negative reviews, note if the reviewers are all complaining about the same thing, and pay attention!
Communicating effectively with your doctor about your condition is another important element to good care. Poor physician-patient communication may lead to negative medical outcomes including medical errors due to misunderstandings. There are many reasons for poor communication between patients and doctors. The wait times in the waiting room and then in the exam room may make the patient feel annoyed and angry and thus lack the right emotional energy for a positive dialogue. Additionally, the doctor and patient often do not approach each other as equals. For example, the patient may meet the doctor for the first time wearing a paper gown, while the physician is neatly dressed. The doctor may introduce himself or herself by calling the patient by the first name and self-identifying as “Dr.” This can leave the patient feeling that because deference must be displayed, he or she is thus precluded from having an open conversation.
I have spoken to so many people who tell me that they thank the doctor as he or she is walking out of the room, but without feeling that the problem they came to see the physician for has been dealt with, and they often go home with no more knowledge or treatment than they had before the visit. If you feel that your primary concern for coming to see the doctor was not addressed, then feel empowered to say so. The best way to accomplish this is to be prepared for your visit.
Do not go into details that are not relevant to your current care. Try to avoid too much social conversation; keep in mind that you are there for a reason; do not get your doctor sidetracked by speaking at length about a play or concert you both just enjoyed. Doctors are on a very tight schedule. Their time—and your time—is valuable; use it wisely.
Prepare a few bullet points in advance. Write down the most important areas of concern that you want to have addressed. Because you may have additional questions after leaving the office, it is very important that you know your physician’s preference in communicating with his patients outside the office. Some doctors email or answer questions through the patient portal; make sure you know what the best way is to communicate.
You may not have a Dr. Welby to take care of you or your loved ones, but you can create a relationship with your doctor based on mutual respect, knowledge and open communication.
Beth S. (Bassie) Taubes, RN, CHC, CYT, is the owner of Wellness Motivations LLC. She motivates clients of all backgrounds, ages, and health conditions to engage in improved self-care through nutritional counseling, personal fitness training, yoga practice, tai chi, and stress reduction techniques. She is currently seeing clients in her outdoor and indoor studio or on zoom. She is also the rebbetzin of Congregation Zichron Mordechai in Teaneck. She can be reached at [email protected]; wellnessmotivationsbt.com.
