Martine Ehrenclou, M.A., is a patient advocate and award-winning author of The Take-Charge Patient: How You Can Get the Best Medical Care. Learn more about Martine and her work at thetakechargepatient.com.
The word is out about patients and their fears of asking their physicians questions. Afraid of being labeled as difficult patients and potentially harming relationships with their doctors, patients resist speaking up, according to a recent Health Affairs study.
I interviewed several health psychologists for my book, The Take-Charge Patient, to find out why patients tend to be submissive and timid with their doctors. Several explained that patients tend to relate to their doctors as they do to authority figures in their lives. Others mentioned that a patient’s health worries combined with the power imbalance between patients and doctors factor into resistance to asking questions.
Consider your own vulnerability when you don’t feel well and you see your doctor for an office visit, especially if the doctor is rushed and does not encourage your participation. You are in an unfamiliar environment, are asked to take off your clothes and put aside your wallet, purse, or briefcase. You are reliant on your doctor’s skills, competence, and good will, and you are dependent on your doctor to give you an accurate diagnosis and treatment plan, something you probably aren’t capable of giving to yourself.
And we wonder why we 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.
Gaining the confidence to become an engaged patient
Forming partnerships with our medical providers is an essential component to quality care, and if we are afraid to ask questions we shortchange our physicians and ourselves. The more we engage in discussion with our medical providers, the more engaged we become and the more successful our treatment will be. If we leave the doctor's office with unanswered questions, studies show that we are less likely to follow doctors’ suggestions. If a physician frowns upon your quest for information about your medical care or what is happening with your body, then you’ve got the wrong doctor.
What you can do
Find a doctor who welcomes your participation. Look for a physician who accepts and welcomes your questions. Good communication is essential for a successful relationship with your physician. Good doctors are good communicators and listeners. If you feel that your doctor does not value your contribution and isn’t really listening to you, walk away.
Prepare ahead of time before your medical appointment. List your top three medical concerns and create a list of questions for your doctor. If you are prepared for your office visit, you’ll feel less anxious and more able to ask questions.
Create a list of your current medications. Be sure to include dosages, over-the-counter medications, herbs and supplements, and allergies to medications. Bring it with you to every doctor/medical visit.
Become familiar with your illness or condition. If you learn about your diagnosis, treatment plan, and the medications you are taking, you become knowledgeable about what is happening with your body. This enables you to have more effective conversations with your medical providers. Becoming well-informed increases your confidence as a patient.
Obtain copies of your medical records from your doctor(s). Do this every time you have a medical encounter. This includes test results such as MRIs, CT scans, and blood work. Look them over. Place them in a health file. This prevents you from having to lasso information when you may not be able to. It also gives you a sense of control over your medical information.
Do a little research. If a medical professional has given you a diagnosis and/or treatment plan, do some research on credible websites such as academic, government, or professional medical society/academy. These usually end in .gov, .edu, or .org. Doing research on your own gets you more informed and in a place to evaluate what is best for you. It empowers and prepares you to ask questions of your doctor.
Create a simple health history of major medical events over your lifetime. This would include things like births, surgeries, procedures, major tests, and current medical diagnoses. This allows a new doctor to see a full picture of what you’ve been through, which medical conditions or diseases you have, and which medications/treatments you are currently taking or engaging in. If you lose your job or your doctor stops taking your health insurance, you will have to begin again with a new doctor. This also familiarizes you with what medical interventions you’ve had. How many times have we all forgotten when we had that colonoscopy? Was it three years ago? Four?
Remember that the doctor is a human being. Most of us were trained to view physicians as demi-gods. Just because your medical provider has degrees and training that you don’t, it doesn’t mean you should put your needs second to his/her time constraints. Physicians are people just like you and me.
Understand this is your time with the doctor. Remember, this is your office visit and you are paying for it. Many patients are fearful of using up too much of the doctor’s time and then resist asking important questions. This backfires for the patient and the doctor. Be assertive!