Doctor-Patient Communication

My mother is 87 and yesterday we were at her docs. Now she was brought up to think of docs as "gods" and authority figures that are never to be argued with or questioned or even to converse normally with. The docs were doing them a favor by taking care of their medical concerns. I saw this attitude with her yesterday, nodding and smiling and agreeing with whatever the doc said. This is not how to have a conversation with a doc! Luckily, her doc questioned her more thoroughly to elicit the type of information she needed to address my mother's current medical condition.

Being diagnosed with and treated for cancer as Beth above mentioned, makes one more comfortable with docs and other medical personnel. Once diagnosed I insisted on a second opinion and received one. I must say that experience was eye-opening! I had never been treated so shoddily by any doc, young or old, male or female. He was AWFUL, patronizing, cloying, with an attitude of "I'll tell you, you will not question me". I high- tailed it out of there and ran back to my original oncologist. As with any professional, respect should be showed by the patient to the doc but also the other way around! The doc should also show the patient respect and if she/he does not, then find another doc! Good customer service is expected wherever you go for whatever service you need. Medical care is no different. You and/or your insurance company is paying the bill for your medical treatment. If you are not shown respect and treated professionally, find someplace else to go! If you went to get your car fixed and the service people had a bad attitude and treated you and your car inappropriately, wouldn't you not find another car repair shop? As the old saying goes, "(s)he who holds the dollar makes the rules". You or your insurance co. holds this particular dollar, so if your needs are not being met find someone who will meet ALL your medical needs, including the need for humanity and respect.

Providing patients with information and encouraging conversation and exchange of ideas and thoughts and treating them with kindness and empathy would go a long way to encouraging them to ask and question. That starts with the medical personnel other than the doc. Having a pleasant and caring person taking vitals and other things that have to be accomplished in a medical office goes a long way in making a patient feel comfortable enough to participate in their own treatment, recovery and healing. I think if there is more discussion about this matter the general public will eventually demand more than medical information from their medical personnel.

Absolutely need to take along an advocate. Clear thinking is almost impossible when your defenses are down and fear takes over. A family member with experience is great; if not, a cancer coach can be quite helpful to ensure the questions are asked and the patient heard. Too often patients leave with many unresolved questions and feel pushed into a treatment they are not comfortable with or do not completely understand.

I think this is a difficult choice for many women faced with this decision. Historically, mastectomy was the only operation available for breast cancer, and when the early clinical trials were conducted comparing mastectomy to lumpectomy, the surgeons and researchers faced a lot of criticism as it was a widely held belief that a radical operation was necessary if there was any chance of cure.

We now know thanks to that research, that there is no difference in the overall survival if a woman undergoes a mastectomy or a lumpectomy. However lumpectomy alone will result in a higher rate of the cancer returning in the breast, so radiation therapy after lumpectomy is necessary.

Absolute contraindications to breast conservation are multifocal cancer (cancer in multiple quadrants of the breast), inability to achieve an acceptable cosmetic result, and contraindications to radiation therapy (certain collagen-vascular diseases such as scleroderma). A history of prior radiation therapy to the breast is often a contraindication to breast conservation as well, but several clinical trials are examining the safety and effectiveness of limited radiation therapy in patients who have previously undergone whole-breast radiation.

Other than that, for most women with early-stage breast cancer, they do have choices. We tend to think having options is a good thing, but many women do struggle tremendously with this decision.

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