How to Be a Partner in Your Care
In my medical practice, it was important specifically to have patients tell me they wanted to proceed with a recommended procedure. When both the doctor and the patient agree on a plan, it’s called “shared decision-making.” It also means that in advance of this shared decision, I have laid out the pros and cons of moving forward. In doctor-speak, I told patients the goals, risks, possible complications both mild and severe, and alternatives they should consider. This is technically termed “informed consent.” With the wealth of information on the Internet, making shared decisions and obtaining informed consent is more complicated, since a lot of medical sites provide incorrect information. It’s your doctor that has or should have the most up-to-date and correct information. If not, it’s time to look elsewhere.
We used to speak about the “doctor-patient relationship.” Well, a relationship means being connected to a person or persons or merely interacting with them. My preference, as a doctor, has always been to have patients be a partner in their care, with mutual trust and responsibility.
How does that happen?
The most important thing is to find a doctor who supports your active involvement in your care. Some doctors may say that they welcome your involvement – that is – sharing in the decisions about your treatment – but it’s only through their actions that you’ll ultimately know.
The first test is to offer thoughts and opinions and gauge their reaction. If your doctor gets upset with questions or challenges, a “second date” may not be in the offing. Many doctors
practice “cookbook medicine.” It’s what they are used to doing, and what has worked in the past. So, if your doctor is truly open to forming a partnership with you, you’ll know, but be respectful and not adversarial, as you would any potential partner. Just be sure to express your needs, concerns and desires clearly.
When it comes to your own body, you are the expert. If you have a particular concern, it’s important to state your concern or concerns clearly, but don’t go on and on. Doctors have limited time to spend these days with each patient. Get to the point and tell your story in as concise a manner as possible. If told in a wandering fashion, your doctor may just tune out. A good history and physical examination most often lead to the correct diagnosis so that the right treatment can be given.
Here are 10 tips to consider so you can get the most out of your appointment and have a treatment plan that’s right for you:
With the availability today of so many common and complex tests, there’s a lot to know about what each test is, and what the results might tell your doctor. When your doctor orders a battery of tests, don’t be afraid to ask about any and all of these so you understand why they were ordered, and what might be gained. If the reasons behind these tests don’t make sense to you, it’s OK to have a discussion. Sometimes, it is better to proceed by steps rather than take a “shotgun approach,” ordering a bunch of tests all at once, which can cause confusion and conflict. Again, if your doctor seems disturbed by your questioning, it may be time to look for another doctor. As a reminder, risk is generally minimal from most tests. However, with x-ray type studies, you typically receive small doses of radiation in each. If you have had a number of x-ray studies and therefore too much radiation exposure, there can be potentially serious consequences – mainly an increase in your risk of getting cancer during your lifetime. So ask about the necessity and expectations of each test.
Once you have given an accurate and concise history, been examined, and test results are complete, it’s time to get a diagnosis and treatment plan. find out what your doctor thinks is wrong and what the treatment plan will be. If more than one diagnosis is being considered, know the usual course for each and which is most likely. This is where shared decision-making comes in: you both need to agree on the path forward meaning what your treatment plan will be. You can also continue to communicate with many doctors through their patient portals when available to you.