What can I do to establish and maintain an effective relationship with my doctor? I've had some pretty lousy experiences in the past, but I'm having some health problems and I know I shouldn't put off getting the attention I need. A friend just told me about a new doctor that I'm considering seeing. What can I do to make this a good experience?
It's not clear from your question what made your previous experiences with your doctors so "lousy," or what you're planning to see a physician about, but there are some things you can do to help get things off to a good start and maintain a good relationship over the long haul.
Consider a "get acquainted" visit. If you're looking for more information about a particular provider or office, it isn't unreasonable to set up a "get acquainted" visit. Some offices and medical groups have a patient representative or office manager who can answer your questions and even show you around. If you want to meet the physician but aren't certain whether you are going to become a patient, make sure this is understood when you call, and clarify whether there is a charge for this visit. If you're not going to be charged, don't expect a half-hour conversation, and don't suddenly ask for medical advice. (If you want medical attention, you need to establish a formal relationship with that practice.) During this session you can get a sense of how you are treated on the phone, see what the office looks like, learn what services are provided and determine if the practice seems to be a place you can comfortably call home, medically speaking.
When making an appointment, state your agenda as best you can. You need much more time for a complete physical or an evaluation for chronic fatigue than for a sore throat or a wart. If the visit will focus on issues that you don't feel comfortable explaining to the front office staff (for example, a problem related to sexuality), let the person know that the concern is of a personal nature. If she presses the issue, ask if you can speak with a nurse in the office to clarify what you need.
Avoid the fateful phrase, "by the way..." If you have a list of five concerns for a given visit, let the caregiver know all five topics, and which is most important to you, as you begin. Few things are more disconcerting to a provider than spending time discussing a cold or a sore ankle, and then hearing, "By the way, I've been having some terrible headaches recently." When this occurs, the caregiver must either give an off-the-cuff answer (not a good idea), delay everyone else in order to evaluate the complaint properly (necessary if it sounds urgent), or schedule a follow-up visit (usually the best solution, but not what most patients want to hear).
Respect – and better yet, become good friends with – the office staff. A physician depends on his or her staff to help a demanding day go more smoothly. Some patients make the mistake of being all smiles with the doctor but repeatedly rude or hostile to the office personnel. An angry exchange that rattles or upsets anyone on the office staff can actually disrupt the care of other patients for the rest of the day. On the other hand, if someone who works for a physician has in fact treated you poorly, the doctor will certainly want to know about it. Your best course of action would be to send a note marked "personal and confidential" to the caregiver and explain in a straightforward way what happened. Hot tip: if the doctor has a nurse who works with him or her on a regular basis, do your best to be friendly and cheerful with that person. Most often she (or he) is the physician's right arm and "control tower," and can help you deal with a variety of questions and concerns.
Respect your caregiver's boundaries. Believe it or not, the vast majority of physicians do not like to be on call 24/7 to answer medical questions, and few are excited about being accosted in the store or at church for an informal "consultation." Don't be offended if you get what is, in fact, the most appropriate response, both medically and legally (assuming the situation isn't an emergency): "Why don't you give the office a call on Monday so that we can set a time to talk about this?" If you have a medical question after hours, check with the exchange to find out who is actually on call, and contact that person.
Don't hesitate to be seen by a physician assistant or nurse practitioner. These allied health professionals may be an integral part of your physician's medical office – indeed, they may become your primary care provider. In many practices, these individuals are able to address acute problems on short notice, and you may find that they give you more time than the physician. If you have a problem that is beyond their scope of care, they can still "get the ball rolling" with an initial assessment and then bring the doctor into the room to continue the evaluation.
These tips will go a long way toward establishing and maintaining a good relationship with a physician, but there's more to navigating the health care maze. While your health-care provider's goal is to give you quality care, it's also important for you to become a confident advocate for yourself. The following recommendations can help you receive the best care possible.
Bring pertinent information to your first (and any other) visit. If you have records from another physician, lab results, a summary of your health history, and a list of medications you are taking (including supplements), by all means bring them. Some people who have trouble keeping track of their medications may find it valuable to bring a Ziploc bag containing all their pill bottles to their visit.
Don't hesitate to ask questions. If you don't understand what your caregiver is saying about your problem(s) or have concerns about the tests and treatments that are being recommended, ask questions until you have a reasonable grasp of the information. You might ask if the office has any written information or handouts that would be helpful. If you have concerns that you might not know what questions to ask, you may want to bring your spouse or a trusted friend with you who can help you discuss with your doctor (with your permission) about problems or treatments options.
Take notes if necessary. If your visit results in a "to-do" list involving several items – diagnostic tests, medications, perhaps a referral – hopefully the caregiver will write these down or print them off for you. If not, write them down yourself. You should not leave the office without a clear idea – which should be in writing – of what you're supposed to do next.
Don't be afraid to do your own research. This does not mean that you should search the Internet for an alternative diagnosis if you don't like what your doctor tells you. There are countless "medical" Web sites that will offer you nothing but false promises and bad information. However, whenever you do receive a new diagnosis, it might benefit you to visit a reputable Web site such as a university-sponsored health site for further information. Many university Web sites host a wide range of information that has been properly vetted by the scientific and medical communities. Feel free to discuss those findings with your doctor. If your physician is truly interested in your receiving the best care possible, he or she won't feel threatened if you raise questions based on information from another reputable source. Keep in mind, though, that your physician has amassed a wealth of knowledge and expertise through years of experience and training. Diagnosing or treating yourself based on one or two hours of Internet research rather than relying on your doctor's judgment may not be in your best interest.
Feel free to get a second opinion. This isn't always possible, and certainly not advisable in an emergency situation. But in general, an honest doctor should be willing to help you get a second opinion. Reputable physicians always want their patients to be as informed and equipped as possible before committing to a specific treatment or procedure, and sometimes that involves receiving counsel from more than one source.
Christian Medical & Dental Associations