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Communicating with Your Healthcare Team

Posted 6/25/2015

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  It is always (whatever IT is) always about communication. With family issues or work concerns or neighborhood problems, if we can just get the communication right, it is almost inevitable that progress will be made. That is surely true with our health care team. No matter how good your doctor or nurse or social worker or whomever is, if you can't reach them or depend on their response or honestly express your feelings, there is going to be trouble.

Much has been written about managing communication with your health care team. You may not be aware that there is an extensive medical literature about communication. Doctors worry about this, too. Remember that all relationships go both ways, and it is safe to assume that your doctor is invested in a satisfying bond.  Of course, your definitions of “satisfying” may differ.
In my role as an oncology social worker, I often talk with patients who are unhappy about their conversations with their doctors. They may feel misunderstood or disrespected, but the most common problem is feeling rushed during appointments. Other common concerns include not understanding what is being presented, worrying that something important is being withheld, feeling overwhelmed by information, feeling that the doctor is emotionally insensitive,  dissatisfaction with systems or routines of the office, and, sometimes, just bad chemistry.
It is easy to remind you that you are the consumer and are hiring your doctor. It is not so easy to feel that way. The realities of health care may mean that you have limited choices in selecting a hospital or physician. The balance of power is inevitably very much on the doctor’s side, and it is hard to feel empowered and entitled when you are undressed and scared.  There are strategies that will help you feel better connected and more in control in this important relationship.
1. Prepare for appointments and  phone calls. Make a list of your questions, and start with the most important ones. Recognize that your doctor likely does not have time to go through three pages of questions at every meeting, so prioritize and organize.
2. Take someone with you to every important appointment. The extra eyes and ears and memory will be helpful, and it may be useful, too, to hear how someone else experiences your doctor’s words and style.
3. Ask how best way to reach her between appointments. Are emails ok?  Will she herself or a nurse or Fellow return most calls? Don’t call with minor questions that can wait. Being respectful of her time will make her more respectful of yours.
4. Tell her a little about yourself. Force some normal social interaction. Your doctor should know that your daughter is being married next summer, and that your primary goal is to dance at her wedding or that your finances are very tight and you are worried about high medical expenses. Having information about your life will help your doctor relate to you as a “real person.”
5. Tell your doctor what you are worried and scared about. Be specific.
6. If you feel there are cultural misunderstandings, ask if there is a patient navigator who could be helpful. If not, try to educate your doctor about your background—succinctly.
7. Let your doctor know what your priorities are and remind her as necessary. One of my patients frequently repeats her goals: to minimize the difficulties for her family, to minimize her own emotional and physical pain, and to make memories. This clarity helps everyone.
8. Finally, remember always that you and your sense of security and comfort with your care are most important. If you don’t like, respect, and trust your doctor, find another. No matter how daunting that may seem, it is well worth the effort.


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