How to talk so your doctor will listen

By Millisa Martin

My grandmother’s and mother’s generation believed medical doctors were the gods of medicine. Physicians were always right—and not to be challenged on diagnoses or treatment. Medical school dogma of the past firmly seated doctors with their crown of knowledge on the throne and ignorant patients on the examination table.

When I worked as a dietetic technician at a hospital many moons ago, I remember one doctor in particular. In order to ask or request something for one of his patients, I learned quickly that I had to approach his favorite nurse. Then she would relay the message to him. Zipping my lips is difficult for me in those types of irrational and unequal power situations, but I acquiesced for the sake of getting the patients what they needed—and to avoid getting fired.

Is change in the air? The current generation has the Internet at their disposable and a plethora of information as well as a Human Resource Dept. with policies, procedures, and protocol. And they appear to be more assertive.

Consider the 2014 book, When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests by Leana Wen and Joshua Kosowsky. Written by two physicians, the guide is for patients to read before appointments. The premise is that the doctor-patient relationship needs to be collaborative instead of one-sided. I recommend the worksheet in the book that is completed before the appointment. Answer the questions and take the form with you. The authors reveal how to deal with a doctor who seems too busy to listen to you; learning test risks, avoiding harmful tests, and evaluating whether they’re worth it; and how to get a working diagnosis.

In the appendixes, which include “21 Exercises Toward Better Diagnosis,” Wen and Kosowsky further elaborate on their recommendations. The following are 8 pillars to a better diagnosis:

  1. Tell your whole story.
  2. Assert yourself in the doctor’s thought process.
  3. Participate in your physician exam.
  4. Make the differential diagnosis together.
  5. Partner for the decision process.
  6. Apply tests rationally.
  7. Use common sense to confirm a working diagnosis.
  8. Integrate diagnosis into the healing process.

Listen to Dr. Wen’s Ted Talk at TEDMED 2014, “What Your Doctor Won’t Disclose.” www.ted.com/.

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