The Importance of a Partnership with Your Doctor
This month I have been focusing on being involved and aware in your health care. We talked about The Importance of self-Awareness in Your Health Care and I provided resources for ADHD Awareness Week. This week we'll talk about how to talk to your doctor to foster a partnership.
It is easy to be intimidated in the doctor's office. Some doctors believe you are the patient and they are the doctor, they are the knowledgeable ones, you need to just listen and do what you are told. They may seem too busy to really listen to your concerns or brush them off as insignificant. You walk out of the office feeling as if you didn't get your questions answered or you don't understand what you are supposed to be doing.
The previous model of medical care included a doctor who diagnosed, prescribed medication and gave instructions without much input from the patients, but this is slowly changing. The U.S. National Institutes of Health states, "Today, a good patient-doctor relationship is more of a partnership. You and your doctor can work as a team...to solve your medical problems and keep you healthy." In order to do become a partner, you need to know how to talk to your doctor and what to say. The following are guidelines to help you make the most of every doctor's appointment.
Know What You Want
When calling to make a doctor's appointment, know exactly what you want to accomplish. If this is a "med check" let the receptionist or nurse know. If you want to talk about changing medications, tell the receptionist. If you have additional concerns, state them (or at least explain that you have additional concerns) at the time you are making the appointment.
Most doctors' appointments are 15 minutes long. This is usually enough time to go over one or two medical concerns. If you have additional concerns, ask for a double appointment. Explain there are a number of issues that need to be discussed and you would like additional time to make sure all your issues are addressed.
Knowing what you want to accomplish at the time you make the appointment will help you achieve your goals.
Before walking out the door to go to the doctor's office, make sure you are prepared. I have often advocated creating a "medical care journal" which is simply a notebook that you use specifically for health care. It should include your doctors' names, addresses and phone numbers, a list of all medications you take (including over-the-counter, supplements and vitamins) and a summary of every doctor's visit. As soon as you make an appointment, write down the date, the reason for the appointment and any questions you have for the doctor. Bring the notebook with you for every appointment and write a summary of the visit when you are done.
Your doctor should welcome your questions. He (or she) should want you to understand why he is suggesting a certain treatment or what side effects you should expect from your medication. Start by asking the questions you listed in your notebook, the main reason for your appointment. If he suggests a certain treatment, ask why and what you can expect to gain from the treatment. If he recommends a certain medication over another, ask why.
Be sure to ask your doctor to clarify any information you don't understand. Doctors may sometimes speak in medical terminology, because they are comfortable with the language, and forget that you may not understand. Ask for further information and clarification.
If your doctor is prescribing a new medication or suggesting a change in your medication, ask what he expects to change when you start the new medication. Ask about possible side effects: what are the common side effects and when do side effects warrant stopping the medication or calling the doctor?
If you aren't sure whether or not you understand, repeat back what you think the doctor is saying, "So you are saying I should take this medication only once a day, not twice like I took my previous medication?" This helps you be confident that you have understood correctly.
Let Your Doctor Know What Else is Going On
There may be situations in your life that are impacting your ADHD symptoms. For example, many adults with ADHD have said that during times of high stress, symptoms worsen. If you are going through a stressful time, let your doctor know, he needs to be aware that there may be a reason for your increase in symptoms. Or you may be having problems sleeping, which you see as unrelated to your ADHD, but your doctor may want to adjust medication or may have additional ideas to help you sleep better.
While we often see our life as different compartments: family, work, school, they are often inter-related and all can impact our health (and ADHD symptoms). No matter what is going on in your life, even if you don't see the connection, let your doctor know.
If you can't afford to have a prescription filled, let your doctor know. He may know of some resources (such as patient assistance programs) that can help. If there is a reason you cannot or do not want to follow through with a certain part of your treatment, let him know. Together you can come up with a plan that will work for you.
There is probably nothing more frustrating for doctors than spending time with a patient, working out a treatment plan and then having that patient walk out of the office and do nothing, only to call months later stating that the problem is still there, or is worse. Once you and your doctor decide what the next steps are, whether that is medication, therapy or an exercise program, follow through. Do what you have agreed to do. And, if your doctor requests you come back in 30, 60 or 90 days for a follow up, make sure to set another appointment.
Keeping lines of communication open mean that you expect respect and inclusion from your doctor in your medical care, but it also means you must give respect by following through and taking responsibility for your own health.
"Talking With Your Doctor: A Guide for Older People," Updated 2010, Jun 2, Staff Writer, U.S. National Institutes of Health
"Tips for Talking to Your Doctor," Updated 2010, Nov, Staff Writer, American Academy of Family Physicians