The word is out about patients and their fear of asking questions of their doctors. Fearing being labeled as difficult patients and potentially harming their relationship with their doctors, patients are resisting speaking up, according to a new Health Affairs study.
Although it may not be as difficult for caregivers of patients, you too may feel some hesitation to speak up and ask questions of your loved one’s doctor.
I interviewed many health psychologists about this topic for my new book, The Take-Charge Patient: How You Can Get The Best Medical Care and many explained that patients tend to relate to their doctors as they do to authority figures in their lives. Others mentioned that patient health worries combined with the unfamiliarity of the doctor’s office and the power imbalance between patients and doctors factored into patients’ resistance to asking questions.
As caregivers, you are one step removed from these issues, but you too may have concerns about affecting the patient’s relationship with her doctor. Consider the patient’s vulnerability when she doesn’t feel well and she sees the doctor for an office visit, especially if the doctor is rushed and does not encourage patient participation. She is in an unfamiliar environment, is asked to take off her clothes and put aside her wallet or purse—there is a power imbalance between patients and doctors and that can leave her feeling vulnerable, nervous and timid. She is dependent on the doctor for an accurate diagnosis and treatment plan, something she probably isn’t capable of giving to herself. And we wonder why we as patients are nervous about speaking up to doctors! We are afraid of saying something that could turn them away from wanting to help us when we are in need.
It’s time to change that. As caregivers you can be instrumental in helping that change along.
As health care slowly turns away from the traditional doctor-patient relationship (the authoritarian approach), patients, their caregivers and doctors have to make changes to interact successfully with one another to increase patient satisfaction, prevent medical errors and increase patient compliance. It takes change from all parties before collaborative relationships between patients and physicians will be fully realized.
Tips to Increase Your Confidence to Speak Up with the Doctor
1. Nothing increases self-confidence more than knowledge and experience. If you are very familiar with your loved one’s symptoms, disease, medical condition, medications, any tests, procedures or surgeries she’s undergone and the nature of the medical encounters she’s had, you will feel more empowered.
- The first step to getting familiar is to obtain copies of your loved one’s medical records from her doctor(s). This includes copies of test results and reports, MRIs, CT scans etc. Look them over. Place them in a health file.
- Create a list of the patient’s current medications and their dosages, over-the-counter medications, herbs and supplements, and allergies to medications. You can put this list in your smart phone or simply on a piece of paper. Bring it with you to every doctor/medical office visit. You may think that your doctor has all of the patient’s information, especially from other physicians she’s seen, but in all likelihood she does not.
- Create a simple health history of major medical events over her lifetime such as births, surgeries, procedures, major tests and current medical diagnoses. This allows you to see for yourself where she’s been, what she’s been through, what medical conditions or diseases she has and what medications/treatments she is currently taking or engaging in.
You need copies of the patient’s medical records so you are never in a position of having to lasso the information from physicians, medical institutions or pharmacies when she is in need.
2. Create a list of questions for your loved one’s doctor before the appointment. Together, list your top three medical concerns. If you both are prepared for the office visit, you’ll both feel less anxious and more able to ask questions. If you see the questions in front of you, you’ll be more apt to stick to the point and not get sidetracked.
3. Be engaged and participate in your loved one’s medical care. This increases the effectiveness of your conversations with her physician, prevents medical errors and enhances the quality of her medical care. It also increases your confidence as a caregiver with the very medical professionals your loved one relies on. If you and your loved one become well informed, you both will be more willing to ask the questions you need answered. Make the decision to take a little time to get involved.
4. Humanize the patient to the doctor. You want your doctor to see your loved one as a whole person, not just as a set of symptoms. Find common ground. Does her doctor have pets? Does your loved one? Does your loved one share common interests with the physician?
If the patient is seen by the doctor as a set of symptoms, it makes it difficult to expose herself further by asking questions and engaging in a discussion about her health, diagnosis or treatment plan. If she is unable to engage in a discussion, humanize her and yourself so the doctor can connect to you both personally.
5. Do a little research. If a medical professional has given your loved one a diagnosis and/or treatment plan, do some research on credible websites such as academic, government or professional medical society/academy. These end in .gov, .edu, and .org. Do not Google her symptoms, disease or medical condition. If you do this, you will come across frightening and or/disreputable information. Anyone can put up a health/medical website. Learn about your her diagnosis, test, procedure, surgery or treatment. Doing some research gets you and your loved one more informed and in a place to evaluate what is best. It empowers and prepares you both (if she is able) to ask questions of the doctor.
6. Don’t be afraid that you are taking up too much time with her doctor. This is your loved one’s time and it is her doctor’s responsibility to manage it. Many patients and their caregivers are fearful of using up too much time in the office visit and therefore resist asking important questions. This backfires for the patient, the caregiver and the doctor because studies show that the more informed a patient is about her diagnosis, treatment plan, medical condition, etc., the more she will adhere to what the doctor suggests. If you start doubting yourself, think about the amount of money her doctor is going to charge. Your loved one is the customer. Be assertive! You and the patient are entitled to good service.
Just because the doctor has degrees and training that you and the patient don’t does not mean that you are not equals. You don’t treat your accountant or attorney like a god, why should you treat your loved one’s doctor that way? It’s time to change our perceptions to get more of what we need.
7. Find a doctor who welcomes your and your loved one’s participation. Look for a physician who accepts and welcomes both of your questions. Good communication is essential for a successful relationship with a doctor. A successful relationship with a doctor is crucial for quality medical care. Good doctors are good communicators and good listeners. If your loved one’s doctor is staring down at her notes and not looking you or the patient in the eye, think about finding another doctor. Your loved one deserves to be respected and treated like a human being. You both do that for her doctor, right? Mutual respect is essential for your own confidence as a patient or caregiver. If you feel that your loved one’s doctor does not value your or the patient’s contribution and isn’t really listening to either of you, talk to your loved one about finding another doctor. You and the patient must also respect the doctor and her professional skills, expertise and competence. If you or your loved one treat her as if you know it all, you risk offending the very professional you both need.
These suggestions are all about taking charge of you as a patient or as a caregiver. If you implement even a few of these strategies, I can assure you, you will feel more comfortable asking questions of the physician and interacting in a collaborative fashion. Keep in mind that no one is more invested in your health than you or the patient. If you meet your loved one’s doctor half way, you’ll find that most doctors will greet your efforts with respect. Many doctors who I interviewed said that if a patient is invested in her health care, then they will be more invested.
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