How to be smart and effective when you talk to doctors

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When I talk to a medical professional, I let them know a where I’m coming from and what I’m looking for. When you are a prepared and active participant in the conversation, the results are far more useful than what you get from just sitting and listening. If you want your doctors to treat you with respect and as an equal partner in your care, here’s how to make that happen.

Why it’s frustrating to talk to doctors

There are two basic problems that happen when you are speaking to doctors or other medical professionals about your health, and they are mirror images of each other.

The first problem is when the doctor needs to explain a complex condition and starts flinging jargon at you that is very confusing. It’s easy to get lost and confused.

The second problem is when the doctor explains everything from the most basic possible level even though you already have a lot of knowledge about the topic. In those cases, it’s easy to feel condescended to and resentful.

I don’t necessarily blame the doctors. They have to make assumptions about what you know and don’t know, and if they guess and get it wrong, they’ll either aim too high (confusing you) or too low (insulting you). Don’t just get frustrated. Tell the doctor what you need.

Since I don’t like wasting time, I calibrate my conversations

You should enter every medical conversation after having googled the conditions or test results you’ll be discussing. You’ll also have information from your past experience with the condition, or with others who had it.

So tell the doctor what you know and what you’re looking for. For example, I’ve opened conversations with medical professionals this way:

  • I know we’re going to talk a lot about probabilities as we decide which path to take next. It may help you to know that I was trained as a mathematician and worked extensively with statistics in my work. So if you want to talk about probabilities, I’m in a good position to understand what you’re saying.
  • I’ve been on blood pressure medication for a while now. Here’s what the last two weeks of readings from my home blood pressure cuff have been, on average. Can you help me to understand your strategy for treating this will be and what goal we’re aiming for?
  • I see there is an out-of-range test results in my recent blood test. Here are some things that may have changed in my medical condition recently that might have something to do with that result. Do you feel this test result is problematic, and if so, what should we do about it?
  • I know you are likely to recommend changes in diet and exercise. I’ve been working with a talented dietitian and I walk an hour a day at least four days a week. I’ve also lost about 20 pounds in the last year on that regime. Based on that, what do you think is the best strategy?
  • What specifically changed since last year that caused you to recommend treatment rather than “active surveillance?”
  • It appears there are two main treatments for my condition. Can you explain the main pros and cons of each treatment and which one you recommend?
  • I’m seeing you after a back injury. Here is the pattern and location of my pain and the medication I’m taking to manage it. I’ve had this problem many times over the years. I’m specifically looking for exercises that can strengthen my core to help me recover more quickly and avoid future recurrences.

These statements are all on the same template. They say “This is what I know, this is what I need to learn from you.” They treat the doctor as an expert, but position you, the patient, as an intelligent consumer of care.

A patient who does not start with such statements is basically communicating, “I’m the patient, take care of me.” This can lead to a dynamic in which the doctor is like a parent treating the patient as if they are a child who needs to be told what to do. I’m an intelligent consumer who does research on everything else — I wouldn’t buy a car without researching everything about it — so why would I allow a doctor to treat me like an ignorant and powerless child?

In my experience, doctors actually like to hear this kind of thing from patients. It relieves them from the burden of taking full responsibility for the patient’s care. It allows them to show off their expertise and concentrate on the reasons for their recommendations. And it leaves them feeling like the patient is an active partner in their own care, which is more likely to generate a successful result.

Fixing the imperfections in medical conversations

Medical conversations are fraught. Your health is in jeopardy; even your life may be in jeopardy. You’re going to talk about things that are uncomfortable, like your weight, your sexual problems, what you experience in the bathroom, your mental health problems, and even how much you can afford to pay for treatment.

That’s pretty stressful. So you’ll probably forget things or realize there were things you didn’t get answers for.

Don’t kick yourself over that — you’re not an expert in medical conversations and this stuff is stressful as hell.

Here are some tips to help you make up for those challenges:

  • Before you talk to the doctor, talk to your spouse, a parent, or a close friend about what’s on your mind; get as much of the emotional side of it as you can handled before you go to the doctor’s office. Then it’s more likely you can be calm and mature in that conversation rather than blubbering and unable to get important facts settled and decisions made. (When it comes to your health, nearly everybody blubbers at some point.)
  • Prepare a list of questions. Write them down and bring them with you.
  • Take notes on paper at the meeting. Pencils and paper function even when you’re half naked in a patient gown.
  • If the doctor uses a term you’re not familiar with, ask about it. You have a right to get a clearer explanation that doesn’t use mysterious medical jargon.
  • Always ask about alternative treatments. Often, there may be other ways to treat your problem and the doctor can tell you why they may or may not be appropriate for you.
  • Ask about side effects, so you can be prepared for what might happen as a result of the treatment.
  • Follow up. If you have additional questions, you can often use tools like messaging in MyChart to get follow-up answers from the doctor. (In my recent prostate cancer conversation — when the original meeting with the doctor had thrown me off a bit — I did this to get an accurate answer to exactly what had changed that caused a change in treatment recommendation.)
  • If you are uncertain, ask for a second opinion. Doctors don’t resent this, it’s totally normal. And it often helps you to hear a different perspective.
  • Ask for additional resources. Are there nurses that you can check in with regularly, or financial counselors that can help with understanding the cost? (In my recent decision to get treatment for prostate cancer, the medical practice offered to refer me to financial counselors, who were very helpful: they were able to get the people doing the treatment to answer questions about the amount of cost I’d be responsible for, without me having to spend hours on the phone with people. And the counselors cost me nothing.)

Compensating for unhealthy dynamics

The doctor-patient conversation can go awry due to the doctor’s perception of status differences. For example, the patient is younger and the doctor is older; the patient is a woman and the doctor is a man; the patient is a person of color and the doctor is white; the patient is disabled or has a chronic condition and the doctor writes off all symptoms based on that condition; the patient is obese and the doctor blames everything on obesity; or the patient is transgender and the doctor has biases or inexperience with transgender people.

None of this is fair. Doctors shouldn’t be racist, ageist, sexist, ableist, fatphobic, or transphobic, and if they are, that’s on them. They are humans, and have the full range of human flaws.

I make no excuses for a doctor like that. But even if you’re dealing with a doctor like that, your health is still the most important part of the conversation. Getting crucial health information has to take precedence over teaching the doctor a lesson.

Your best strategy is to be prepared, calm, professional, and intelligent. This shows the doctor that you are a thinking, rational partner in your own care and focuses the conversation on your health.

If this fails enough, get another doctor. But in the meantime, you may as well get what you can out of the knowledge of the person sitting across from you.

Patients are consumers. They need to be smart about getting the most out of their health care professionals. Because in the end, that’s how to get the information you need to make smart decisions about the only body you’ll ever have.

5 responses to “How to be smart and effective when you talk to doctors

  1. This was a huge help, Josh. I’m having a difficult time with a specialist and this really gave me a better idea of how to be proactive. Thumbs up.

  2. This was an enormous help. It is great to find someone who does not insult your intelligence and who will work with you as a partner and problem-solver. Going through the process of finding a doctor who can do that can be frustrating and challenging. Personal referrals work well for me, which provided by someone who knows me well. I have recently not returned to two doctors (well, one nurse practitioner). The NP (an ex-military nurse) strode into the examining room with my file in his hand (he knew my name) and said, “Well, hello young lady!” (I was 69.) The other began lecturing me on how to not eat processed food and how to shop without even asking me about diet. I am hoping that my current doctor does not go anywhere any time soon!

  3. Not all doctors appreciate a patient’s input. I went to the hospital with a searing pain that I was almost positive was a kidney infection. I had taken into account prior conditions and googled symptoms. I told the emergency doc my suspicions and he told me that he was the doctor and he didn’t want to hear my self-diagnosis. Of course I was correct.

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