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Why don’t we ask doctors to clarify information when we don’t understand it?

January 15, 2010

I’ve done it. Have you? Walked out of the doctor’s office scratching your head, telling your waiting family member or friend, or running to the nearest computer to get online…and figure out what the doctor was talking about. Why don’t we just ask?

First, it is a bit embarrassing if the doctor says something and doesn’t ask us if we have any questions. It seems like we should know what is going on. So, we don’t ask because we feel embarrassed that we don’t understand. These days, I try to ask myself, “Do I literally want to ‘die’ from embarrassment?” If I don’t understand and I don’t ask a question, what are the chances I could…fail to follow advice, fail to understand my diagnosis, and well—harm my health… 

Second, we have to admit to ourselves that we don’t quite understand what’s going on. Cholesterol called good cholesterol and bad cholesterol…what does that mean? Isn’t it all bad?  If I at least ask the doctor to spell it or write it out, I  find that most of the time, I get more information and I get it reinforced in writing.

…two ways to help myself out when I don’t understand……

What should I do if my doctor interrupts me when I am trying to explain why I am there?

January 14, 2010

Ahhh. A friend asked me this question recently. I’ve heard it from family members, too. And it has happened to me.

So, first, don’t take it personally. It feels hard not to because we use communication to regulate conversation, and we have learned cues that signal it is our turn, like the other person stops talking. When we haven’t stopped talking and someone interrupts us, it feels rude. We feel devalued. What? You don’t want to hear what I have to say??

Second, realize that time constrains a doctor. It is frustrating for us to wait in the waiting room. Then we wait in the exam room. Finally, the doctor appears. Then we seem to get about 10 minutes if we are lucky. Truth is that a doctor works for an organization. Even if it is the doctor’s organization or practice with a couple of others, it is an organization that has employees and must manage its resources–the doctor’s time in this case. A certain number of patients need to be seen to satisfy the organization. So the doctor really does not have the luxury to spend more time with you…unless an emergency necessitates it. 

Third, ask yourself, are you telling a story as a way to tell the doctor why you are there? A story about how we were gardening all weekend and then we noticed a thorn seemed to be lodged in our finger and then we tried to get it out but it now seems to be infected even after we washed it really well and kept it covered in antibiotic ointment for the past several days… Or a story about how we have been doing a lot of traveling for our job and it all began with the downturn in the economy and so in the past month we have spent more days on the road than at home and suddenly, we’ve noticed a sharp pain at the back of our knee. Or the one about how between our job and our family–with a lot of details built in–there is just no time to exercise.

Fourth, if you are telling a story, stop. The reason you are there is: an infected finger, pain in the back of your leg, an annual check-up and help to lose weight. See how much more concise that is? Then if the doctor has questions, elaborate. But again, come to the point.

Fifth, be direct about what you want as well. If you haven’t read Deborah Tannen’s book, You Just Don’t Understand: Women and Men in Conversation, it’s worth reading. Some of the lessons to be learned apply to talking with our doctors. There is an example about saying, “the trash is full” in hopes that a spouse will know to empty it and feeling frustrated when the trash doesn’t get emptied.  “Please empty the trash” is the more direct approach and more likely to lead to success. A story about how your friend has acne and her blemishes are not as bad as yours and her doctor prescribed such and such…still may not generate the doctor’s answer to your question, “Why aren’t you prescribing such and such?” In the age of internet searches for medical information, perhaps there is a list of things you think the doctor might do and none of them happens. So, ask about it in a straightforward way. No, you don’t need to tell about how you were googling the news and came upon a story about someone’s condition that sounded just like yours so you started paying more attention to your symptoms and it seemed like you should come and get checked out. Just say, “I have these symptoms and I wondered if such and such might help.” Doctors know we are using the internet to get medical information. It is no surprise to them. Sometimes, they are really happy about it. Other times, not so much.

It’s a start. See if it works.

What about public health care reform?

117_1784January 10, 2010

I never hear anyone talk about public health when they talk about ‘health care reform.’ This bothers me because we have a univeral system of public health in the U.S. and we spend quite a lot of resources on it. The services linked to our public health care system range from checking the quality of restaurants and ‘grading’ them to providing newborn screenings. We spend quite a lot of time deciding what services to provide in each state. Besides registering births and deaths, and newborn screenings, many states have prenatal care programs, other women’s health programs, and a wide range of programs from smoking cessation to drug prevention to cancer screenings.

We don’t talk much about public health. But what might a connected system of health care built on the system of clinics and services for public health look like? How would doctors and health care staff feel about building on their infrastructure? Some states have regional health care directors? How would they regard an effort to connect the services they oversee to a broader range of services for the public to consider as a choice for care?

Anyone?

New Year’s resolutions…

The beauty of winterJanuary 4, 2010

Everyone is talking about them. Diet. Exercise. Smoking. Alcohol. Getting cleansed. Staying cleansed. If only we could figure out how to bottle all those good intentions and keep them next to too much work and too little time. 

Where is ‘play’ on the list? That is what I love most about being with my grandchildren. They remind me that jumping rope and playing catch and swinging and wrestling shouldn’t be such work. They should be fun. And reading the comics in the daily paper…that’s fun, too. When was the last time your doctor asked you, “Are you having enough fun?”

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