Tips for talking with your doctor
When things go wrong, it’s almost always about failed communication. The Office receives about 1100 complaints a year, most of them ultimately related to a communication problem of some sort. “It can be the way people were talked to, whether they were given enough information; whether they were given a chance to really participate in the decision-making” says Rae Lamb, Deputy Commissioner Complaints Resolution.
Under the Code of Health and Disability Services Consumers’ Rights, consumers have the right to effective communication in a form, language, and manner that enables them to understand the information provided. This includes the right to an environment that enables both consumer and provider to communicate openly, honestly and effectively.
Communication is about reaching a shared understanding of the issues under discussion — about talking and about listening, and recognising the messages that are conveyed by means other than words. Both parties need to feel comfortable in the environment for effective communication to occur. Exchange of information is an intrinsic part of effective communication and underlies the diagnosis and treatment processes: research indicates that the patient provides around 80% of the information their doctor needs to make a correct diagnosis;1 (other forms of information, such as physical examination, tests and medical records, provide just 20%).
Patient experiences
Even when patients know their doctor well and have a good relationship with him or her, there is potential for many issues to impact on the communication process during a consultation, creating barriers to effective exchange of information.
When visiting the doctor, patients report a variety of feelings including being nervous, embarrassed, afraid, vulnerable, powerless, resentful and frustrated. Under these conditions, patients may forget to provide all the information regarding the problem. Sometimes the patient avoids reporting the real difficulty altogether. Some patients may think they are wasting the doctor’s time, or perceive that the doctor seems too busy to have enough time to attend conscientiously to the patient and the presenting problem. Even if a patient feels quite relaxed about the visit to the doctor, it is still possible that he or she may be selective about what information to provide, filtering out what may seem to be irrelevant. For example, some patients may not recognise that a medicine, supplement or natural remedy they buy from a supermarket or health food shop could contain components that cause changes in the body similar to those brought about by prescription medicines, and that information about such products should be provided to the doctor.
In addition to giving information there may be difficulties in receiving information. Research shows that some patients pick up less than 50% of the information given to them by doctors, and are not able to pay attention to everything they are being told. Frequently, patients are still absorbing information from the first sentence when the doctor is well into his or her second point. It is particularly difficult for patients to concentrate when they have just received bad news, or are in pain or experiencing a health crisis. The situation is compounded if the doctor uses medical terminology that the patient does not understand.
Maximising information exchange
There are practical steps patients can take to facilitate the exchange of information between themselves and their doctor.
In giving information, patients can:
- be prepared. Prior to visiting the doctor, patients can:
— make a list of all the health concerns that they wish to discuss with the doctor, with the most serious or important at the top — make a list of all the medicines (including non-prescription products) that they are currently taking, or have recently stopped taking (and when)
— make a list of anything they have already done regarding their health problem, such as consulting other health professionals, for example a physiotherapist, or obtaining advice from a pharmacist
- take a friend or someone they trust to support them. This person may:
— ask questions on their behalf
— remind them of information to give
— provide moral and emotional support
— advocate for them and make specific requests
- give the doctor as much information about their health as possible, even if they think it is unconnected.
In receiving information, patients can:
- if in doubt — ask questions, especially if the doctor is using medical language
- ask the doctor to repeat or explain information that they do not clearly understand, or repeat information back to the doctor for confirmation
- take notes, or ask a friend to take notes
- share any internet information with the doctor. In this way the patient and the doctor can together discuss the various options.
Summary
Patients have the right to effective communication, and good communication is necessary for achieving good quality health care. Patients can take an active role in talking with their doctor, maximising the exchange of information, facilitating the communication process and contributing to better health outcomes.
1 http://www.bbc.co.uk/health/talking_to_your_doctor_/gp_communication.shtml.