WASHINGTON – Doctors are more crunched for time than ever, and it is important to make every precious minute of an office visit count.
Leana Wen knows that only too well. She watched her mother battle metastatic breast cancer after being misdiagnosed for nearly a year when Wen was a medical student.
“I saw for myself how much of a disconnect there is between what the medical system tries do to, and what it is that patients really need,” says Wen, now an emergency physician, and director of Patient-Centered Care at the Department of Emergency Medicine at George Washington University
In time, she wrote a book called “When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests” to help patients become better advocates for their own care — a tough task at a time when the typical appointment runs 10 to 15 minutes.
She says there are ways to help a doctor come up with a swift, correct diagnosis. Her first tip: Don’t just list your symptoms, but put them in context.
Wen calls it “telling your story — the history of your illness.”
She cites as an example, someone who just says, “I have a stomach ache.” A doctor gets more information from a patient who describes how she went to a family picnic a few days ago, ate some food, and has been feeling badly ever since.
“Eighty percent of diagnoses can be made just based on your story,” Wen says, adding “even if the doctor asked you 20, 30 questions, he or she would probably not get the same nuance or depth as if they just asked you for the story of your illness.”
But Wen admits supplying a narrative can be tricky when the appointment is short and the doctor may be rushed. She says it helps to write it down and practice it in advance.
Overall, Wen says every patient should be an active participant in the diagnostic process — especially when it comes to deciding on tests.
She acknowledges that it may be difficult for some people to speak up in a doctor’s office.
“There is a hierarchy in medicine — such that many patients feel that their doctor is almost like a parent — that they don’t want to say no when the doctor says to get a test or get a treatment,” she says.
But she stresses “it is up to you to speak up. Because only you know what is going on in your own body.” In the end, Wen insists, “the doctor may be the expert when it comes to medicine, but you are the expert when it comes to yourself.”