My healthcare motto as of late is quit bitching and start thinking. Yes, the health care system sucks and we need to vent about it big time. But, we also need to learn how the system and its players work so we can use them to our advantage. We cannot do this if we think patients are never to blame.
In my book Everything Changes: The Insider’s Guide To Cancer in Your 20s and 30s, I write a lot about how I and other young patients have wrangled the system, fought like hell, and got the care we needed. You can’t win these battles by only thinking like a patient; you sometimes have to think like a doctor.
Last week, Kevin MD posted about patients who annoy their doctors. A commenter complained about cancer lit that suggests patients bring a friend or family member to appointments because it turns the appointment into “a side show.” Instead of getting in a defensive-patient tizzy, brewing up an us patients vs. the rest of the world rivalry, I thought I’d try to see if there was value in the comment.
I want my doc to absorb my medical history, perform a good hands on exam, and answer my questions, all in 10 minutes. So maybe the maxim shouldn’t be ‘bring a friend to appointments’ but bring a friend who is medically astute and a skilled communicator. Is it really helpful to have a flighty chatterbox with me in my appointment, who will distract and annoy my doc? I think not.
Tonight on the Stupid Cancer Show, Matthew Zachary and I will be interviewing Wendy Harpham MD, a mom of three and general practitioner diagnosed with cancer at 36. Her great new book, 10 Seconds to Care: Help and Hope for Busy Clinicians, helped me better understand the pressure cooker in which my docs work and the ways in which I can actually make their jobs easier. Considering that their job is to save my life, I’d like to help them all I can.
Are there times when empathizing with your docs works to your advantage? Do you ever read doctor blogs? Have you ever brought someone to an appointment who actually made the process more complicated rather than easier?
“Everything Changes is, without doubt, the most forthright, emotionally sophisticated, and plain-old valuable book of its kind I've seen.”
June 29th, 2009 at 3:19 PM
I take my mother (who is fairly medically sound and does research before going to any appointments, and has her own health problems so she has to keep knowlegable) or someone else that is intelligent and together to at least take notes. I have cancer – have been battling it for 2.5 years and in my experience when you recieve bad news or when you are in an appointment you are focusing on what the doc says but don’t absorb it all. Sometimes you can’t remember afterward about what you discussed, sometimes you get hit hard with some news and your brain shuts down, sometimes you have a question you want to ask and are thinking about that and miss a sentance in there. I do not think that a doctor should be upset by having not only emotional support but also someone to help you remember what is said. I also think that if his appointments turn into a side show, it’s his own fault.
I am guilty of annoying my doctors in other ways – I call too much when waiting for results. I am impatient when waiting for an appointment to come open. I do my own research, and though I’m intelligent and try to use qualified sources, I know I did not go to medical school and I don’t believe my own research over the doctor. However walking into the appointment with research behind you CAN bother a doctor.
However, if my doctor ever becomes annoyed with me bringing my support system with me, I will immediately look for a new doctor.
June 30th, 2009 at 2:45 PM
For me, it boils down to 1) finding the right doctor for YOU and the kinds of conversations you need to have and then 2) balancing your doctor’s needs with your own. For instance, I was receiving treatment in a university hospital and had to repeat my story at least 3 times in every visit, for various students and interns. Was it annoying? Yes. Did it hurt me? No. It was completely worth it because it allowed me to stick with a doctor who understood that I wanted to hear the medical details and not just the simplified version, and would talk with me about my research but give his honest opinion. Like any relationship, it’s about finding the right match. And then collaborating.
June 30th, 2009 at 3:31 PM
OK, here’s a question: How does one FIND a good doctor who works well with you?
June 30th, 2009 at 5:05 PM
Thanks Greyash and others for your comments. Here’s what I think about how do you FIND a good doc who works well with you: I break the equation into two categories #1 A doc with knowledge and skills. #2 A doc who communicates well and runs an organized office. To find a doc with knowledge and skills I take a multipronged approach a. word of mouth b. extensive internet searches c. pubmed searches. (I’ve provided tons of in-depth info about these approaches in the “Working the System” section of my book Everything Changes.) To find a doc who communicates well and runs a good office, you just have to see him or her in action, how they treat you, what it is like trying to make an appt. I believe that the majority of docs do not fall into both categories because there are far fewer really top-notch docs out there (same with excellence in any field) and many of whom I have met are not great communicators. I personally prefer knowledge and skill over communication and organization. As a proactive patient, there are many tactics I can learn to compensate for my docs’ infuriating communication and organizational skills. Yet, while I can research the hell out of my disease, I will never come close to their level of knowledge and skill. Each patient has to make the trade off that is right for them. And, if you have luck, and/or insurance that allows you to search long and hard enough, you might find a doc who has both. My current doc has both and it is amazing what a difference it makes in my cancer care.