Doctor- Patient Communication

 

How to Choose a Doctor You Can Talk To

 

 

Finding a main doctor (often called your primary doctor or primary care doctor) who you feel comfortable talking to is the first step in good communication. How well you and your doctor talk to each other is one of the most important steps to getting good health care. This doctor gets to know you and what your health is normally like. He or she can help you make medical decisions that suit your values and daily habits and can keep in touch with the other medical specialists and healthcare providers you may need.

Taking an active role in your health care puts the responsibility for good communication on both you and your doctor. This means asking questions if the doctor’s explanations or instructions are unclear, bringing up problems even if the doctor doesn’t ask, and letting the doctor know if you have concerns about a particular treatment or change in your daily life.

If you don’t have a primary doctor or are not at ease with the one you currently see, now may be the time to find a new doctor. Whether you just moved to a new city, changed insurance providers, or had a bad experience with your doctor or medical staff, it is worthwhile to spend time finding a doctor you can trust.

People sometimes hesitate to change doctors because they worry about hurting their doctor’s feelings. But doctors understand that different people have different needs. They know it is important for everyone to have a doctor with whom they are comfortable.

Primary care physicians frequently are family practitioners, internists, or geriatricians. A geriatrician is a doctor who specializes in older people, but family practitioners and internists may also have a lot of experience with older patients. Here are some suggestions that can help you find a doctor who meets your needs.

 

Decide What You Are Looking for in a Doctor

A good first step is to make a list of qualities that matter to you. Do you care if your doctor is a man or a woman? Is it important that your doctor has evening office hours, is associated with a specific hospital or medical center, or speaks your language? Do you prefer a doctor who has an individual practice or one who is part of a group so you can see one of your doctor’s partners if your doctor is not available? After you have made your list, go back over it and decide which qualities are most important and which are nice, but not essential.

Make a List of Several Possible Doctors

Once you have a general sense of what you are looking for, ask friends and relatives, medical specialists, and other health professionals for the names of doctors with whom they have had good experiences. Rather than just getting a name, ask about the person’s experiences. For example, say: “What do you like about Dr. Smith?” and “Does this doctor take time to answer questions?” A doctor whose name comes up often may be a strong possibility.

If you belong to a managed care plan—a health maintenance organization (HMO) or preferred provider organization (PPO)—you may be required to choose a doctor in the plan or else you may have to pay extra to see a doctor outside the network. Most managed care plans will provide information on their doctors’ backgrounds and credentials. Some plans have websites with lists of participating doctors from which you can choose.

It may be helpful to develop a list of a few names you can choose from. As you find out more about the doctors on this list, you may rule out some of them. In some cases, a doctor may not be taking new patients and you may have to make another choice.

 

What Are HMOs and PPOs?

Members of a health maintenance organization (HMO) pay a set monthly fee no matter how many (or few) times they see a doctor. Usually there are no deductibles or claims forms, but you will have a co-payment for doctor visits and prescriptions. Each member chooses a primary care doctor from within the HMO network. The primary care doctor coordinates all care and, if necessary, refers members to specialists.

A preferred provider organization (PPO) is a network of doctors and other healthcare providers. The doctors in this network agree to provide medical services to PPO health plan members at discounted costs. Members can choose to see any doctor at any time. Choosing a non-PPO provider is called “going out of network” and will cost more than seeing a member of the PPO network.

 

What Is a “Board Certified” Doctor?

Doctors who are board certified have extra training after regular medical school. They also have passed an exam certifying their expertise in specialty areas. Examples of specialty areas are general internal medicine, family medicine, geriatrics, gynecology, and orthopedics. The American Board of Medical Specialties has a database of all board-certified physicians that is updated daily. You can also call toll-free to verify a doctor’s certification at 1-866-275-2267. Board certification is one way to learn about a doctor’s medical expertise; it doesn’t tell you about the doctor’s communication skills.

 

Collect Information About the Doctors You Are Considering

Once you have narrowed your list to two or three doctors, call their offices. The office staff is a good source of information about the doctor’s education and qualifications, office policies, and payment procedures. Pay attention to the office staff—you will have to communicate with them often!

You may want to set up an appointment to meet and talk with a doctor you are considering. He or she is likely to charge you for such a visit. After the appointment, ask yourself if this doctor is a person with whom you could work well. If you are not satisfied, schedule a visit with one of your other candidates.

When learning about a doctor, consider asking questions like:

  • Do you have many older patients?
  • How do you feel about involving my family in care decisions?
  • Can I call or email you or your staff when I have questions? Do you charge for telephone or email time?
  • What are your thoughts about complementary or alternative treatments, such as…?

 

Choose a Doctor

When making a decision about which doctor to choose, you might want to ask yourself questions like:

  • Did the doctor give me a chance to ask questions?
  • Was the doctor really listening to me?
  • Could I understand what the doctor was saying? Was I comfortable asking him or her to say it again?

Once you’ve chosen a doctor, make your first actual care appointment. This visit may include a medical history and a physical exam. Be sure to bring your medical records, or have them sent from your former doctor. Bring a list of your current medicines or put the medicines in a bag and take them with you. If you haven’t already met the doctor, ask for extra time during this visit to ask any questions you have about the doctor or the practice.

 

How to Prepare for a Doctor’s Appointment

 

A basic plan can help you make the most of your appointment whether you are starting with a new doctor or continuing with the doctor you’ve seen for years. The following tips will make it easier for you and your doctor to cover everything you need to talk about.

Make a List and Prioritize Your Concerns

Make a list of what you want to discuss. For example, do you have a new symptom you want to ask the doctor about? Do you want to get a flu shot? Are you concerned about how a treatment is affecting your daily life? If you have more than a few items to discuss, put them in order and ask about the most important ones first. Don’t put off the things that are really on your mind until the end of your appointment—bring them up right away! Discussing Your Concerns with the Doctor: Worksheet can help.

 

Take Information with You to the Doctor

Read and share this infographic for tips on how seniors can effectively communicate with their doctors.

Some doctors suggest you put all your prescription drugs, over-the-counter medicines, vitamins, and herbal remedies or supplements in a bag and bring them with you. Others recommend you bring a list of everything you take and the dose. You should also take your insurance cards, names and phone numbers of other doctors you see, and your medical records if the doctor doesn’t already have them.

Consider Bringing a Family Member or Friend to the Doctor’s Office

Sometimes it is helpful to bring a family member or close friend with you. Let your family member or friend know in advance what you want from your visit. Your companion can remind you what you planned to discuss with the doctor if you forget. She or he can take notes for you and can help you remember what the doctor said.

Don’t let your companion take too strong a role. The visit is between you and the doctor. You may want some time alone with the doctor to discuss personal matters. If you are alone with the doctor during or right after the physical exam, this might be a good time to raise private concerns. Or, you could ask your family member or friend to stay in the waiting room for part of the appointment. For the best results, let your companion know in advance how he or she can be most helpful.

Getting Started with a New Doctor

Your first meeting is a good time to talk with the doctor and the office staff about some communication basics.

Introduce yourself. When you see the doctor and office staff, introduce yourself and let them know by what name you prefer to be called. For example: “Hello, my name is Mrs. Martinez,” or “Good morning, my name is Bob Smith. Please call me Bob.”

Ask how the office runs. Learn what days are busiest and what times are best to call. Ask what to do if there is an emergency, or if you need a doctor when the office is closed.

Share your medical history. Tell the doctor about your illnesses, operations, medical conditions, and other doctors you see. You may want to ask the doctor to send you a copy of the medical history form before your visit so you can fill it out at home, where you have the time and information you need to complete it. If you have problems understanding how to fill out any of the forms, ask for help. Some community organizations provide this kind of help.

Share former doctors’ names. Give the new doctor all of your former doctors’ names and addresses, especially if they are in a different city. This is to help your new doctor get copies of your medical records. Your doctor will ask you to sign a medical release form giving him or her permission to request your records.

Keep Your Doctor Up to Date

Let your doctor know what has happened in your life since your last visit. If you have been treated in the emergency room or by a specialist, tell the doctor right away. Mention any changes you have noticed in your appetite, weight, sleep, or energy level. Also tell the doctor about any recent changes in any medications you take or the effects they have had on you. Discussing Changes in Your Health: Worksheet and Tracking Your Medications: Worksheet can help you get organized.

Be Sure You Can See and Hear As Well As Possible

Many older people use glasses or need aids for hearing. Remember to take your eyeglasses to the doctor’s visit. If you have a hearing aid, make sure that it is working well and wear it. Let the doctor and staff know if you have a hard time seeing or hearing. For example, you may want to say: “My hearing makes it hard to understand everything you’re saying. It helps a lot when you speak slowly and face me when you’re talking.”

Request an Interpreter if You Need One

If the doctor you selected or were referred to doesn’t speak your language, ask the doctor’s office to provide an interpreter. Even though some English-speaking doctors know basic medical terms in Spanish or other languages, you may feel more comfortable speaking in your own language, especially when it comes to sensitive subjects, such as sexuality or depression. Call the doctor’s office ahead of time, as they may need to plan for an interpreter to be available.

Always let the doctor, your interpreter, or the staff know if you do not understand your diagnosis or the instructions the doctor gives you. Don’t let language barriers stop you from asking questions or voicing your concerns.

Using an Interpreter at the Doctor’s Office

  • Consider telling your interpreter what you want to talk about with your doctor before the appointment.
  • If your language is spoken in multiple countries, such as Spanish, and your interpreter does not come from the same country or background as you, use universal terms to describe your symptoms and communicate your concerns.
  • Make sure your interpreter understands your symptoms or condition so that he or she can correctly translate your message to the doctor. You don’t want the doctor to prescribe the wrong medication!
  • Don’t be afraid to let your interpreter know if you did not understand something that was said, even if you need to ask that it be repeated several times.

 

What Do I Need to Tell the Doctor?

 

 

Talking about your health means sharing information about how you feel physically, emotionally, and mentally. Knowing how to describe your symptoms and bring up other concerns will help you become a partner in your health care. Discussing Your Concerns with the Doctor: Worksheet and Discussing Changes in Your Health: Worksheet can help.

Share Any Symptoms You Have

A symptom is evidence of a disease or disorder in the body. Examples of symptoms include pain, fever, a lump or bump, unexplained weight loss or gain, or having a hard time sleeping.

Be clear and concise when describing your symptoms. Your description helps the doctor identify the problem. A physical exam and medical tests provide valuable information, but your symptoms point the doctor in the right direction.

Your doctor will ask when your symptoms started, what time of day they happen, how long they last (seconds? days?), how often they occur, if they seem to be getting worse or better, and if they keep you from going out or doing your usual activities.

Take the time to make some notes about your symptoms before you call or visit the doctor. Worrying about your symptoms is not a sign of weakness. Being honest about what you are experiencing doesn’t mean that you are complaining. The doctor needs to know how you feel.

Questions to ask yourself about your symptoms:

  • What exactly are my symptoms?
  • Are the symptoms constant? If not, when do I experience them?
  • Does anything I do make the symptoms better? Or worse?
  • Do the symptoms affect my daily activities? Which ones? How?

 

Give Information About All Your Medications

It is possible for medicines to interact, causing unpleasant and sometimes dangerous side effects. Your doctor needs to know about ALL of the medicines you take, including over-the-counter (nonprescription) drugs and herbal remedies or supplements. Make a list or bring everything with you to your visit—don’t forget about eye drops, vitamins, and laxatives. Tell the doctor how often you take each. Describe any drug allergies or reactions you have had. Say which medications work best for you. Be sure your doctor has the phone number of the pharmacy you use. Tracking Your Medications: Worksheet can help.

What questions should you ask your doctor about a new medication?

Tell the Doctor About Your Habits

To provide the best care, your doctor must understand you as a person and know what your life is like. The doctor may ask about where you live, what you eat, how you sleep, what you do each day, what activities you enjoy, what your sex life is like, and if you smoke or drink. Be open and honest with your doctor. It will help him or her to understand your medical conditions fully and recommend the best treatment choices for you.

Share Other Concerns in Your Life with Your Doctor

Your health has a big impact on other parts of your life. Your doctor may ask you how your life is going. This isn’t being impolite or nosy. Information about what’s happening in your life may be useful medically. Let the doctor know about any major changes or stresses in your life, such as a divorce or the death of a loved one. You don’t have to go into detail; you may want to say something like: “It might be helpful for you to know that my sister passed away since my last visit with you,” or “I recently had to sell my home and move in with my daughter.”

You may have some concerns or wishes about your care if you become seriously ill. If you have questions about what choices you have, ask your doctor. You can specify your desires through legal documents called advance directives. In general, the best time to talk with your doctor about these issues is while you are still relatively healthy. Medicare and private health insurance may cover these discussions with your doctor. One way to bring up the subject is to say: “I’m worried about what would happen in the hospital if I were very sick and not likely to get better. Can you tell me what generally happens in that case?”

Discussing Health Decisions with Your Doctor

 

Ask About Different Treatment Options

You will benefit most from a treatment when you know what is happening and are involved in making decisions. Make sure you understand what your treatment involves and what it will or will not do. Have the doctor give you directions in writing and feel free to ask questions. For example: “What are the pros and cons of having surgery at this stage?” or “Do I have any other choices?”

If your doctor suggests a treatment that makes you uncomfortable, ask if there are other treatments that might work. If cost is a concern, ask the doctor if less expensive choices are available. The doctor can work with you to develop a treatment plan that meets your needs.

Here are some things to remember when deciding on a treatment:

  • Discuss different treatment choices. There are different ways to manage many health conditions, especially chronic conditions like high blood pressure and cholesterol. Ask what your options are.
  • Discuss risks and benefits of treatment options. Once you know your options, ask about the pros and cons of each one. Find out what side effects might occur, how long the treatment would continue, and how likely it is that the treatment will work for you.
  • Consider how a treatment may affect your life. When thinking about the pros and cons of a treatment, don’t forget to consider its impact on your overall life. For instance, will one of the side effects interfere with a regular activity that means a lot to you? Is one treatment choice expensive and not covered by your insurance? Doctors need to know about these practical matters so they can work with you to develop a treatment plan that meets your needs.

Questions to Ask About Treatment Options

  • Are there any risks associated with the treatment?
  • How soon should treatment start? How long will it last?
  • Are there other treatments available?
  • How much will the treatment cost? Will my insurance cover it?

Talking with Medical Specialists

Your doctor may send you to a specialist for further evaluation, or you may request to see a specialist yourself. Your insurance plan may require you to have a referral from your primary doctor. A visit to the specialist may be short. Often, the specialist already has seen your medical records or test results and is familiar with your case. If you are unclear about what the specialist tells you, ask questions.

For example, if the specialist says you have a medical condition that you aren’t familiar with, you may want to say something like: “I don’t know much about that condition. Could you explain what it is and how it might affect me?” or “I’ve heard that is a painful problem. What can be done to prevent or manage the pain?”

You also may ask for written materials to read, or you can call your primary doctor to clarify anything you haven’t understood.

Ask the specialist to send information about any diagnosis or treatment to your primary doctor. This allows your primary doctor to keep track of your medical care. You also should let your primary doctor know at your next visit how well any treatments or medications the specialist recommended are working.

Questions to Ask Your Specialist

  • What is my diagnosis?
  • What treatment do you recommend? How soon do I need to begin the new treatment?
  • Will you discuss my care with my primary doctor?

If You Need Surgery

In some cases, surgery may be the best treatment for your condition. If so, your doctor will refer you to a surgeon. Knowing more about the operation will help you make an informed decision about how to proceed. It also will help you get ready for the surgery, which makes for a better recovery.

Ask the surgeon to explain what will be done during the operation and what reading material, videos, or websites you can look at before the operation.

Find out if you will have to stay overnight in the hospital or if the surgery can be done on an outpatient basis. Will you need someone to drive you home? Minor surgeries that don’t require an overnight stay can sometimes be done at medical centers called ambulatory surgical centers.

Questions to Ask Your Surgeon

  • What is the success rate of the operation? How many of these operations have you done successfully?
  • What problems occur with this surgery? What kind of pain or discomfort can I expect?
  • What kind of anesthesia will I have? Are there any risks associated with its use in older people?
  • Will I have to stay in the hospital overnight? How long is recovery expected to take? What does it involve? When can I get back to my normal routine?

Getting a Second Opinion

When patients are diagnosed with a serious illness or surgery is recommended, patients often seek a second opinion. Hearing the views of two different doctors can help you decide what’s best for you. In fact, your insurance plan may require it. Doctors are used to this practice, and most will not be insulted by your request for a second opinion. Your doctor may even be able to suggest other doctors who can review your case.

Always remember to check with your insurance provider in advance to find out if a second opinion is covered under your policy, if there are restrictions on which doctors you can see, and if you need a referral form from your primary doctor.

Do you have questions about palliative care and hospiceRead about how to care for the seriously ill.

Discuss How Prevention Can Improve Your Health

Doctors and other health professionals may suggest you change your diet, activity level, or other aspects of your life to help you deal with medical conditions. Research has shown that these changes, particularly an increase in exercise, have positive effects on overall health.

Until recently, preventing disease in older people received little attention. But, things are changing. We now know that it’s never too late to stop smokingimprove your diet, or start exercising. Getting regular checkups and seeing other health professionals, such as dentists and eye specialists, helps promote good health. Even people who have chronic diseases, like arthritis or diabetes, can prevent further disability and, in some cases, control the progress of the disease.

If a certain disease or health condition runs in your family, ask your doctor if there are steps you can take to help prevent it. If you have a chronic condition, ask how you can manage it and if there are things you can do to keep it from getting worse. If you want to discuss health and disease prevention with your doctor, say so when you make your next appointment. This lets the doctor plan to spend more time with you.

It is just as important to talk with your doctor about lifestyle changes as it is to talk about treatment. For example: “I know that you’ve told me to eat more dairy products, but they really disagree with me. Is there something else I could eat instead?” or “Maybe an exercise class would help, but I have no way to get to the senior center. Is there something else you could suggest?”

As with treatments, consider all the alternatives, look at pros and cons, and remember to take into account your own point of view. Tell your doctor if you feel his or her suggestions won’t work for you and explain why. Keep talking with your doctor to come up with a plan that works.

Many doctors now recommend that older people try to make physical activity a part of everyday life. When you are making your list of things to talk about with your doctor, add exercise. Ask how exercise would benefit you, if there are any activities you should avoid, and whether your doctor can recommend any specific kinds of exercise.

Questions to Ask Your Doctor About Prevention

  • Is there any way to prevent a condition that runs in my family—before it affects me?
  • Are there ways to keep my condition from getting worse?
  • How will making a change in my habits help me?
  • Are there any risks in making this change?
  • Are there support groups or community services that might help me?

CINTAA Elder care shares useful information regarding healthcare on weekly basis. The post is only for information purpose only. Please check with your health care professional before using this information. To keep yourself updated with many other health tips, stay with us. We provide certified caregivers for seniors at home. If you need any help regarding eldercare, please feel free to call us today at 561-963-1915.

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