The Patient Speaks!

In September of 2005, WALL STREET JOURNAL editor Laura Landro wrote in her column “The Informed Patient” an article entitled “Teaching Doctors How to Interview”.  The article related how some doctors are being trained in the “Four Habits of Highly Effective Doctors” model in how to quickly and accurately get to a patients real medical issues.  There are doctors who feel stressed and frustrated when attempting to diagnose patients as the information the patient gives is not always easy to “translate”.  Because of this difficulty, sometimes unnecessary or premature testing is performed which is in no ones interest and an aura of distrust may emerge.  All of this plays in to exactly what I’ve been preaching in these pages for years. The PATIENT should be the most informed person in the room during the first couple of visits.  After all, it’s the PATIENT who is suffering and the doctor must make a decision based upon what the PATIENT tells him/her.

OK, I’ll stop yelling now.  I have literally had conversations with friends who complain about an ache or pain but, when asked, can not give the slightest clue to help.

Example:

Them:  Hey, Rich.  I’m really dying here.  Can’t stand it.

Me:  So what’s wrong?  Where does it hurt?

Them:  I don’t know.  It’s killing me.

Me:  You said that.  But where, exactly, does it hurt?

Them:  In my head, I think.

Me:     You “think”?

Them:  Yeah, my head, kind of.  I dunno.

Me:  And what did you do about it?

Them:  I went to the doctor, but that idiot didn’t do anything.  Said he didn’t know what my problem was.

Me:  And you told the doctor exactly what you just told me?

Them:  Yeah.

Me: And you don’t understand why the doctor couldn’t do anything?

Them:  I knew I wouldn’t get any sympathy from you.  All I wanted were some pills, or something.

Me: Uh-huh.  (Secretly rolling my eyes)

Before some of you start rolling your eyes at me, I fully understand there are some medical symptoms which can best be described as “vague”.  But simple answers like “My head hurts” or whatever shouldn’t be too hard to determine. After all, you are the one with the medical complaint.  Assuming your visit is not an emergency, take a couple of moments to jot down your symptoms as they occur, as well as any questions you think of.  Be as specific as you can.  If it’s your right arm that hurts, say it’s your right arm, not simply “my arm hurts”.  Bring your medication/allergy sheet with you so the doc has an accurate, up to date listing of all your issues.  The average doctor visit is not social time, stick to the issue.  Remember how annoyed you were because you sat in the office for two hours PAST your appointment time?  Maybe some of that was because the doctor was trying to figure out my friends ailment because my friend was not prepared.  If you have the luxury of a doctor who really spaces out appointments so you can chat – lucky you!  I think I’ll e-mail Ms. Landro and see if she’d be willing to write an article entitled “Teaching PATIENTS How to Interview”.