Q: I have a somewhat offbeat question and wonder what we, as patients, can do to help our physicians give us prompt and thoughtful care. This is difficult for me to put into words.
As a patient I find it frustrating to feel that my doctor is not listening to what I am saying but rather insists on asking questions for which I often do not have answers. There are times when I can’t see how these questions are related to the purpose of my visit. Medicare demands a 15 minute visit so that is what we get. How can I know how to prepare for a visit so that we can work together efficiently in the time we have allotted rather than going in circles around one another. How can we gauge or not if we are getting good medical care. I once trusted a physician whose judgment, it turned out, was out to lunch. It wasn’t until a friend insisted I go to Mayo Clinic that I learned how dearly that trust cost me physically. Sadly, I learned that doctors make mistakes. Is there any way we, as patients, can help prevent that from happening?
A: I will begin, not in defense of physicians, but by making a simple statement. Doctors are human and as such, they make mistakes. They work long hours, are fatigued after visiting their patients at hospitals, in nursing homes, in the office and at home if that is a part of their daily routine. They return phone calls after hours, phone pharmacies with prescriptions, and invariably pick up an emergency case at the least opportune time. Having said that, there is no excuse to short a patient. When it occurs, a frank face-to-face discussion may be appropriate. It doesn’t matter what kind of a day he or she has had, the present patient always comes first.
You don’t give an example of what type of questions your doctor asks you. He or she may trying to put the pieces of a puzzle together and feels a “history” of what preceded your complaint is appropriate. If the questions asked are medical, that’s all well and good. If they aren’t, simply look your doctor in the eye and ask the relevance, but keep an open mind. What may be immaterial to you may be the key to what is going on. For example, if you went out to dinner the evening or two prior to your office visit and complained of diarrhea, constipation, abdominal pain, or even a rash, the information you provide could shed some light on whether you had an allergic reaction, food poisoning, ate spices you are unaccustomed to, and so forth. If you took a hike two or three days prior and presented with ankle pain, a sunburn, lightheadedness, rash on your arm, or diarrhea, appropriate questioning would center around whether you twisted your ankle, were exposed to too much sun, might have become partially dehydrated, drank from a cold, tainted stream, or got contact dermatitis from plant life that caused contact dermatitis. It’s when the questioning takes on an entirely different tack with no medical basis that you need to put the brakes on.
If your doctor truly dropped the ball and your health suffered because of his decision or lack there of, you should make an appointment to try to get answers to your questions. Fortunately, you had the common sense to listen to a friend who had your well being in mind but if you are still suffering from the ill consequences, I recommend you document what transpired and contact your county medical society to make an official report. While this may appear harsh, you may be saving the next patient in line from falling prey to poor medical judgment.
With regard to the future and whether you choose to stick with your old physician or make a change to someone new, your next visit should begin with a frank discussion regarding the fact you want to have a good working relation but expect to be met half way. Nothing short will do. You will determine good medical care by the way you feel when your 15 minutes are up. Either he or she is with you and on the same team or is the opposition. Don’t stand for the latter.
