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How to talk to a doctor

Posted by: David Patton
December 04, 2007
Topic: Patient Empowerment

By Kim Painter, USA TODAY You are an empowered, assertive and knowledgeable patient. You can Google like nobody's business.

But if you lack one crucial skill, you still may get lousy medical care.

That skill: talking to doctors.

"The old technique of having a conversation is 99% of what a successful doctor's visit is about," says Peter Salgo, a professor of medicine and anesthesiology at Columbia University in New York and host of the PBS medical series Second Opinion.

We hear a lot, of course, about doctors who don't listen, don't answer questions or don't remember their manners.

But communication is a two-way endeavor. And sometimes it's patients who fail Communication 101.

That's why growing numbers of patient advocates - including physicians who coach people on how to get better care - are teaching patients what to say, how to say it and when to listen during those precious few minutes in a doctor's office.

Among the do's and don'ts:

  • Do think ahead about what you will say, especially if this is an important appointment about a serious condition. Type up a list of questions, suggests Marisa Weiss, a cancer specialist in Philadelphia and the author of 7 Minutes: How to Get the Most From Your Doctor Visit (it's available at breastcancer.org).
  • Do start with some pleasantries, but don't get caught up in small talk. "You can waste time talking about your grandchildren, but you may not realize that is going to come out of your main appointment time," Weiss says.
  • Do tell the doctor about your most pressing concerns as early in the visit as possible. "Don't wait until the doctor is on the way out to say, 'By the way, I'm having chest pain,' or 'My husband is beating me,' or 'I'm crying all the time,' " says Delia Chiaramonte, a Baltimore family physician who works as a private patient adviser.

•Don't lecture the doctor about everything you've learned on the Internet or from your brother-in-law. "Patients don't like to be lectured to by doctors, and doctors don't like to be lectured to by patients," Salgo says.

•Do ask your doctor to help you understand what you've learned elsewhere. "You do want to show respect for his expertise," Weiss says. Ask "how this information applies to me," she says.

  • Don't let the doctor do all the talking. Sometimes people "just let doctors keep talking and talking," even though they don't understand a thing, Chiaramonte says. "You have to stop them and say, 'I'm sorry, doctor, I didn't understand you. Can you repeat that?' " Weiss suggests paraphrasing the doctor and then asking, "Do I have that right?"

•Do take notes or ask to use a tape recorder. Most doctors won't mind if you explain that you want to remember the conversation or share it with loved ones, Weiss says.

  • Do consider bringing a friend or loved one as a second listener. But set ground rules, Weiss warns: For example, you might ask your spouse to jump into the conversation only if he gets a cue from you.

•Don't give up if all your questions aren't answered during one appointment. Instead, ask the doctor if you can make another appointment, follow up by phone or e-mail, or seek help from another member of your medical team.

•Do say "thank you" from time to time.

Keep in mind that the patient/doctor relationship is just that, a relationship. "It needs to be nurtured and coddled," Weiss says. "It's a business relationship, but it's emotional and personal and intimate as well."



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