Communicating with your Doctor: Self-Advocacy
Introduction: Why is communication with your doctor important?
Communicating with your doctor is a special skill. The experience of leaving a doctor’s appointment feeling unheard, dismissed, and/or disappointed is universal among most people living with chronic pain. If you’ve ever felt like your doctor didn’t believe you or take you seriously when discussing your pain, you’re not alone.
Unfortunately, communication is one of the largest barriers standing between those with chronic illnesses and the care they deserve. There is a significant disconnect between doctor and patient.
The reality is that people living with chronic pain have to become unwavering self-advocates for their health. If you want your concerns addressed, you often have to fight for it.
In this article, we will explore this communication barrier and some ways to bridge this gap as a person with chronic pain.
Patient-Doctor Communication is Key
It’s not surprising that there is a direct relationship between patient-doctor communication and health outcomes: the better you can communicate, the better your chances are for experiencing improvements in your health. Therefore, communicating with your doctor is the key to the care you receive.
Patients who can communicate effectively with their doctors experience positive health outcomes like emotional support, symptom resolution, and pain control.
A lot of this falls on the ability of the doctor to ask questions and educate the patient about their condition/treatment options. However, knowing what should be happening during an appointment can help.
When the doctor takes your history, they should be asking a wide range of questions. They should ask about your physical symptoms as well as your feelings, concerns, and understanding of what’s happening. They should gauge your expectations for treatment, and how your whole life is affected. If they do not, it may be helpful to mention these things.
A major part of this effective communication is shared decision making. The doctor should encourage you to ask questions. If they don’t, you should interject with any questions you have.
You can’t be an active participator in the decision if you are not given clear information. During an appointment, the doctor should provide you with information verbally and/or with written information packets. If you feel you’re unclear on what they’re saying, ask them to clarify or provide you with more information/resources.
There should be a delicate balance of power between the patient and doctor. Neither person should hold all of the power. Your doctor should never make decisions without your involvement or consent. Conversely, you shouldn’t be making decisions alone either. Your doctor should provide you with the best options and support you through choosing what plan will work for you, reaching an agreement together. Communicating effectively with your doctor should make you feel empowered, not dismissed.
Preparing for your Doctor’s Appointment
There are several steps you can take to make the most out of your doctor’s appointment. Although you can’t control how your doctor will perform, you can come prepared and ready to ask questions. You can take control of the communication that occurs, making communicating well with your doctor the goal of the meeting.
Appointments are usually short and, odds are, your doctor is rushed, behind schedule. Making a list of your concerns, ordered by priority can ensure you don’t run out of time to discuss the most pressing issues. You’ll probably only have time to address 2-3 concerns. Make sure you know what they are and what to talk about first.
Gather any supporting items or documents that you’ll need to bring. For example, a vaccination record or a list of your prescriptions. It will be helpful to review them yourself and avoid waiting to the last minute to find them.
If needed, arrange for someone to come with you. Make sure they know the time and date of your appointment. Having someone with you can allow you to better advocate for yourself. This is also important if there are additional communication barriers like difficulty hearing, seeing, or if you and your doctor speak different languages. Your advocate/interpreter should be someone who can help you communicate better. Conversely, this person may simply help you get to your appointment on time/support you before and after.
Before your appointment, it may help to set some goals. Reflect on what exactly you want to get out of the appointment. This will help you to identify what your priorities are and what questions to ask.
If you already know what your condition is, do some preliminary research about it. However, ensure that you’re getting this info from reputable sources. Some examples are the Mayo Clinic, Centres for Disease Control, Cleveland Clinic, National Institutes of Health, and websites sponsored by federal government agencies.
It may help to connect with other people who have the same condition. Along with firsthand experience, they can offer support and encouragement. Online health communities are an excellent place for this. Studies have shown that people involved in online health communities are better advocates for their health and are engaged in their healthcare. Ask them what their experience was, what questions they recommend asking, and what the outcome was. However, keep in mind that everyone is different. Further, healthcare procedures, policies, and wait times can differ greatly between locations.
Lastly, mentally prepare. Don’t go into the appointment expecting everything to be solved quickly and easily. You will leave feeling disappointed, even if some things went really well. Think about each possible scenario: the least favorable one to the best possible outcome. This will help you to cope with what actually happens.
Having your Doctor Hear your Concerns
During the appointment, there are some things you can do to have your doctor hear your concerns.
First of all, set an agenda for the appointment. This will help you both set the pace and declare what you need to address right away. Be careful not to dictate the appointment though. This should be a collaborative effort, involving your doctor. If your agenda is unrealistic, be flexible and work with your doctor to revise it. For example: “Today I’d like to talk about issue #1, issue #2, and then if we have time, issue #3”.
The doctor will likely have to multitask during the appointment. They have to take detailed notes for documentation purposes. However, if they are not paying attention to you or listening, politely ask that they do while you talk about something important. For example, “I understand you’re taking notes, however, do you mind if I could have your full attention while I talk about X?”
Try to paint a picture for your doctor so they really understand what is happening. When describing your symptoms, tell a story. What was happening when you first noticed it? When did it start? How long did it last? Did it get worse? Try to describe it to the best of your ability. This will help them best assess the issue. This also provides a sense of validity to your experience.
In general, communication is best when both people are calm, responsive, and respectful. Listen to what your doctor has to say. Ask questions to enhance your understanding of what they’re saying. Additionally, be respectful and polite to them. If they say something you don’t agree with, try not to get upset and lash out. Take a second to think about it and respond calmly. If you show them respect, they will likely show you that same level of respect.
At the end of the appointment, try to summarize everything you talked about and agreed on. See if you can get a written treatment plan, a list of new medications, or referrals/tests. Clarify the decisions that were made during the meeting.
If you leave the appointment feeling like you still have questions or didn’t get to address something important, ask if you can speak further. It’s possible that you can set up a phone call, email about it, or even book another appointment.
Remember, it is your health and you are in control of how you seek help. You may not be able to control what your options are, but you can ensure that you get to choose what works best for you.
Conclusion
Doctors’ appointments can be anxiety-inducing and disappointing. Communicating with your doctor is not always easy. However, there are many things that you can try to improve communication on both sides. For instance, the way you prepare, describe your concerns, and ask questions. Make communicating with your doctor a priority.
References
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