Thursday, May 14, 2009

Nail Doc's Shoe to the Floor!

How many of us have felt like we needed to nail the doc's shoe to the floor to keep him or her from bolting from the room before we could get our questions asked? How often have you felt like you were struck deaf and dumb in an exam room after hearing an unexpected diagnosis that left you weak in the knees? Ever notice that your well thought out questions vacate your brain when your feet are in the GYN exam table stirrups?

Clear, effective communicating is not done easily when one is a patient in a busy clinic setting or when you feel awful and are an in-patient of the local hospital. The following have been noted to contribute to physician/client communication glitches:

  • Being undressed ( a bare foot doesn't compare to the GYN exam outfit!)

  • Sitting either above or below the physician

  • Competing with the computer for the doctor's eye contact and attention

  • 15 minute appointment allocations

  • Fear about diagnosis (the patient or the doc's distress or both...)

  • Stress (I'm late, you've waited a long time, I have someone in the ER that needs me...)

  • Topics I don't want to hear or talk about (sex, impotence, mental illness, addiction, etc)

As a client you are pretty powerless to change how your doc is feeling about his/her day, but asking for the first appointment of the morning or afternoon can be one way to find your doc on time and refreshed from a good night's sleep or lunch break - theoretically. (Keep in mind that emergencies have no respect for either sleep or meals so your doc may have slept little or "lunched" with a bag of peanuts thrown down his throat in the elevator.) However, there are things YOU can do for yourself to increase the odds of holding up your end of the communication skills.

  1. Don't ever go to an appointment alone. The buddy system works well - two sets of ears and two brains can be a bonus. (Keep in mind this person needs to be trusted with your personal medical information and identified in the doc's records as a trusted insider.)

  2. Talk with your buddy before the visit to fill them in on your concerns, what you want to accomplish in the visit with the doctor, and get their ideas.

  3. MAKE A LIST of questions you'd like addressed, or of symptoms or changes in your well-being. Prioritize what is most important as you may not get all the way through your list.

  4. When possible, put your clothes back on and sit in a chair facing your doc at eye level for the "talking" part of your visit. It evens the power.

  5. Ask your visit buddy to write notes during the visit, or use a tape recorder to track lab data, instructions for medicine changes, words you need to look up later.

  6. If you know ahead of time that you have many questions or will need time to talk about treatment choices, ask the scheduling person to make it a 30 minute appointment. If you need time to absorb a diagnosis before making a treatment choice, schedule a return visit in a few days. Go home and process, talk it over, feel, react, breathe deeply.

  7. Consider expressing what you appreciate about the visit with your doc - gratitude is a powerful shifter of moods and enlists your provider in appreciating YOU!

  8. When you are an in-patient, find out when your doc will likely make 'rounds' so your buddy can be present and advocate for your needs. Be sure to share with this buddy your concerns, questions, changing physical status so they can speak in an informed way if you are unable to speak for yourself. Consider making a copy of your "today notes" and give it to your nurses - they often can advocate/facilitate order changes far more quickly than waiting for a doc to arrive.

Finally, know that we are all imperfect humans living in an often challenging and scary world. There is plenty of room for forgiving foibles, finding humor to lighten instense times, and recognizing we're all doing our best. It may seem evident that your doc is far from a god and oh, so human......but maybe we're all God and just don't remember. So let's practice, shall we?

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