You show up five minutes early for your doctor’s appointment and wind up waiting 20 in the lobby and another 10 in the exam room. As you hear your doctor approach, talking in the hallway, you ready yourself. If you’re lucky, you have the next 15 minutes to voice your concerns, be examined, receive treatment recommendations and ask any questions.
It’s little wonder patients don’t feel listened to when they’re at the doctor; they’re hardly given enough time. When you consider you’ll spend only a small portion of that 15 minutes talking, you better have your well-rehearsed speech ready and anticipate your doctor’s questions in advance.
[See: 10 Questions Doctors Wish Their Patients Would Ask.]
Doctors Aren’t Listening
A classic study in the Annals of Internal Medicine found that patients were allowed to finish their “opening statement of concerns” in only 23 percent of doctors’ visits. A more recent analysis found patients speak for an average of only 12 seconds before being interrupted by resident physicians.
The problem when doctors don’t hear patients’ concerns isn’t just an interpersonal one. It can have a significant impact on care and contribute to issues ranging from missed diagnoses — as well as misdiagnosis — to medical error. “When something is missed, unfortunately something that should have been looked at doesn’t get done, and then things can go really, really badly for patients,” says Joe Kiani, founder of the Patient Safety Movement, which has a goal to eliminate preventable deaths in hospitals. One simple, proven way to reduce preventable patient deaths is patient and family involvement in their care, he says. That can improve outcomes not only for inpatient care, but outpatient treatment at doctor’s offices as well.
But experts say there are many things vying for a doctor’s attention today, including the need to enter information into a patient’s electronic medical record. Often a laptop is literally and figuratively getting between a patient and the doctor, as the clinician frequently enters patient data during the visit. And the already typically short medical visit affords patients limited time to discuss health care issues.
[See: 10 Seemingly Innocent Symptoms You Shouldn’t Ignore.]
What You Can Do
As a patient, you are not powerless when it comes to effective communication in the exam room and after you leave. There are things you can (and should) do to ensure your voice is heard and concerns addressed. While health providers are taking steps to improve patient engagement and monitor patient satisfaction, including surveying patients about their experiences, patients can also take steps to ensure their health concerns are heard.
1. Come prepared.
This is the biggest thing patients can do to maximize the limited time they have with the doctor, says Cindi Gatton, a patient advocate and owner of Pathfinder Patient Advocacy Group in Atlanta.
Know what you intend to talk about before you arrive for your appointment. Write down your concerns and questions, and make them specific.
2. Prioritize your concerns.
Know that your doctor may not have time to answer all 50 of your questions, so ask them in order of importance.
“Knowing what the most important thing is that you want the doctor to hear” is key, Gatton says. “Because we get sidetracked, and then we start thinking about this or that.” She recommends “staying focused on why it is that you’re there.”
Echoing that sentiment Kiani adds, “I think coming in prepared with kind of bullet points of things you want to get across would be really helpful to make sure in a quick fashion you can get everything out there … and [that] you don’t miss anything.”
3. Don’t be afraid to ask for another appointment.
Ultimately, you want all of your concerns addressed with ample time and attention. So rather than trying to rush through your list of questions, if you don’t finish, ask for a follow-up appointment.
It’s not uncommon for patients to have multiple health issues or complex medical problems that simply can’t be addressed in the space of a single visit. “The answer in that situation is to say, ‘Look, I’ve got a number of complicated issues, and I’m willing to schedule multiple appointments. Here’s my situation. Whatever you think is most urgent, let’s address it today, and I’ll come back again next week,'” Gatton suggests.
4. Be willing to communicate outside the exam room.
Find out what works best for you and your provider. More and more, Kiani notes, there are ways for patients and doctors to connect, if needed, outside the office — as he does via text with his doctor from time to time.
Electronic means like email or communication through a patient portal are particularly useful when a face-to-face appointment has already occurred and you have questions about what was discussed, or your treatment instructions.
You should also request to see the doctor’s notes from your visit if you don’t already have access to those. The point, experts say, is to stay informed, provide feedback as needed and to ensure that your health data is up to date and accurate, just as you should make sure what’s communicated face-to-face reflects what’s going on with your health.
5. Bring someone with you.
It can be particularly advantageous to have a patient advocate or loved one with you if you’re dealing with a complex health issue; and this is also the case for some patients who are older, have more involved, chronic conditions or who have health issues, like dementia, that make advocating for themselves more difficult. “The health care system is so fragmented,” Gatton says, which can be especially challenging for those seeing multiple specialists for treatment. “At a certain level, that gets really complicated, and having somebody there that can even just take notes, so that what the next steps are is clear, can be enormously helpful.”
That person can also help keep the conversation on track with the provider, ensuring questions the patient asks — and even ones an advocate might think to ask on that person’s behalf — get answered by the health provider.
[See: 11 Questions You Should Ask Your Cardiologist During Your First Visit.]
Your time with your doctor is limited, so making every moment count is crucial. Though it may seem like 15 minutes can’t possibly be enough, learning to use these precious moments wisely will help you get the most out of each appointment.
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How to Talk So Your Doctor Will Listen originally appeared on usnews.com
null: This story was originally published on March 3, 2015. It has been updated.
