Conversations With Doctor

I agree with the above answers. Statistics only tell part of the story. Medicine is a science, but it is also an art, and people overcome insurmountable odds. Feel free to tell him that you don't work well with statistics and that you cannot deal with pessimism.

You can also get a second opinion from a doctor who is hopefully more optimistic. Sometimes hearing another doctor's opinion can be healing to the soul.

I appreciate when my doctor takes genuine interest in my story - asking about life, family, activities, exercise, diet. Yes, we cover the medical bases and essential information, but it's great when, for just a second, everyone is normal and a nice conversation happens. Like Bernie says, it creates a shared respect.

Because I feel my doctor has a genuine interest in my life, it's easier to trust him.

Write down your questions, make sure you get all of them addressed and take someone with you. A second set of ears is always helpful!

Selecting a doctor that suits your individual needs and situation can be difficult, especially if you have moved and are living in a new community. Start by asking co-workers, neighbors, and friends for recommendations, but ultimately rely on your own intuition and research when making the final decision.

Do some preliminary research about the doctor’s specialty interests, credentials and history. And don’t let concern about ruffling anyone's feathers keep you from doing your homework. Richard Klein, M.D., author of "Surviving Your Doctors: Why the Medical System Is Dangerous to Your Health and How to Get Through It Alive", said in a recent interview that "arrogance and ego are real problems in the medical profession, but good doctors welcome involved patients.” http://tinyurl.com/3mhr98t

When you meet or speak with the doctor for the first time, listen carefully for the tell-tale signs that will suggest whether or not he or she is a good fit. Does he demonstrate a genuine interest in you? Is she taking the time to get to know you, your medical history and that of your family? Does he try to put you at ease and encourage questions, or do you feel so rushed you can’t even remember what questions you meant to ask?

Statistics should be given to a patient when they are making treatment choices, ie... if you do lumpectomy with radiation as opposed to mastectomy, your chance of recurrence is X. There are SO many choices when dx'd in most cases thanks to early detection. All medically sound options should be presented with the statistically differences so the patient can make the best decision for themselves. (chemo or not, too) To start quoting survival rates for a specific stage of cancer or a rarer type of BC, not unless pressed by the patient for information. My two cents! AnneMarie

PreparedPatient your answer was excellent advice, and I think the article is a very helpful resource. I'd add that as physicians, we're used to hearing personal, intimate and embarrassing information - if you can't ask your doctor, who can you ask? We're here to give support and advice, not to judge. It's important to get answers to your questions. And I agree - if you don't feel comfortable opening up to your doctor, it's probably time to find a new one!

Be clear and persistent! A recent report in the New England Journal of Medicine found numerous studies showing that doctors often downgrade the severity of patients' self-reported symptoms, particularly when it comes to medication side effects. This is case when keeping a symptom diary can come in handy—specific data can help both you and your health care team.

For more advice about talking to your providers about symptoms, see our full-length feature article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue8.cfm

Wow, Glen. How wonderful your doctor is taking the time to study his communication with his patients. Asking your permission and then explaining why respected your boundaries and also reflects that he cares about the quality of your interactions. Very refreshing as I often end up having to coach my clients on how to better engage their medical team in listening to their needs.

As for the general topic raised here regarding potentially embarrassing questions, though doctors may know all about anatomy and proper medical terminology, this doesn't always make them comfortable talking about issues around intimacy, sex or even dying and death. In three years of appointments, the doctors treating my late husband never once asked us if we needed any help or support regarding intimacy issues or how the roller coaster ride of cancer might be impacting our marriage.

Unless we broached the tough subjects, like asking about the impact of chemo on fertility since we were in the middle of trying to start a family when he was diagnosed, information was never offered. Only then did they suggest that he may want to bank sperm before starting chemo.

A technique I coach my clients in is opening the conversation with sharing what's true for them. Expressing that they feel shy, embarrassed or afraid to ask a question they know they need to ask is a great ice breaker and let's the doctor know they need some support with whatever it is they are about to discuss.

Sometimes I coach them to use tools such as magazine clippings on the topic so they can just hand it over and ask the doctor for more information specific to their illness. Preferably we work doing role plays and other exercises to get them to a point of being comfortable speaking their questions.

Empowering clients to see that this is about their health and that if their doctor isn't comfortable talking about issues important to them then they have the right to ask for a medical professional better equipped who can have an open conversation with them.

Thankfully, there is increasing emphasis on better patient/doctor communications and more tools (including coaching techniques) being provided to medical staff these days in some treatment centers.

You should immediately consult your doctor. Remember always prevention is better than cure.

Share any effects of a treatment in the same way that you might describe symptoms. Give your health care team a basic description of the side effect. Tell them when and how often it happens. Let them know if anything makes you better or worse. Share whether the side effect has changed over time. If possible, make a note of the side effects as you experience them, so that you will have a written record to jog your memory and share with your doctor during your next visit.

In some cases, it may be best to wait and see if a problem gets worse before deciding how to treat it. Doctors call this strategy “watchful waiting.” Watchful waiting also gives more time for patients and doctors to figure out what kind of treatment (if any) might be best.

For more information about watchful waiting, see: preparedpatientforum.org: http://www.cfah.org/hbns/preparedpatient/Vol4/Prepared-Patient-Vol4-Issue5.cfm

What usually happens when someone has this problem?

If I wait, will my condition be harder to treat later?

What kinds of tests or monitoring do you recommend while I am waiting?

Is there anything I can do to slow or stop the course of this health problem?

For more information about watchful waiting, see: preparedpatientforum.org: http://www.cfah.org/hbns/preparedpatient/Vol4/Prepared-Patient-Vol4-Issue5.cfm

1.Office Contact information: Obtain phone and fax numbers, office hours, web address, e-mail policy, hours of operation.

2.Office Location: Get the address, locate public transportation, and learn about parking options including whether and how much you have to pay to park or if there is free parking (perhaps a parking ticket will need to be stamped by the doctor's office).

3.Making Appointments: What are the hours to call for appointments? Are there no-show policies? Can they provide estimates of waiting times (both for an appointment and when waiting to see the doctor after arriving)?

4.Medical record: Ask about any instructions for bringing a summary of your medical history, current health status and recent test results or if referral documentation is needed (especially important for specialists and testing).

5.Special needs: Inquire if and how the provider can accommodate any unique or special needs (such as physical navigation, hearing or visual impairments, translation services, etc.) and how to arrange for assistance if needed.

6.Payment: Inquire about the health insurance documentation and/or payment process required for receiving care. Get the contact information for staff administrator or the billing manager.

7.Tests and test results: Request a description of what types of tests are commonly conducted in the practice, by an external provider (with names and contact numbers for commonly used laboratories and radiology facilities), and the practice policy about patient notification of test results.

8.After-hours and emergency care: Inquire about when to seek, who to call and where to go for after-hours and emergency care.

9.Prescriptions: Obtain instructions for securing prescription refills, reporting adverse side effects and decisions to discontinue medication or change any agreed-upon treatment plans.

10.Care companion: Notify your physician group if you would like to bring a companion along with you to visits.

For more information check out the Prepared Patient 411
ttp://www.preparedpatientforum.org/patient411