This is cool. My article got published on MySeniors.com . It was also in HealthNewsDigest.com

Your Doctor Said What?

Make the Most of Your 15 Minutes

By: Dr. Terrie Wurzbacher DO 

Doctor-Patient Communication What your doctor does (and doesn’t) need to know

     Ok, you’ve got your appointment scheduled. You’ve kept your symptom diary. Now what? What is it your doctor needs to know – and conversely, what is it he doesn’t need to know? After all, you’ve only got those infamous 10 minutes to get everything accomplished – tell your problem, be examined, get a diagnosis, and ask your questions.

    What does the doctor need to know? Just about everything – but not in the conversational manner you’re used to. What’s your predominant problem and how long have you been experiencing it. Have you had this before – sometime in the past perhaps? If so, what was your diagnosis (if you went to have it checked)?    

    In addition, you should list the associated problems – pain, weight loss, nausea, vomiting, urinary symptoms, loss of appetite, cough, fever, chills, headaches, etc. It’s important to make sure you separate the two issues.

    What’s the character of the symptoms? Are they intermittent? Or constant? Are there periods of time when you don’t have any symptoms and feel pretty good?

    Have there been any changes in severity or location? Changes can indicate a lot about what’s going on.

    Why did you decide to come see the doctor now? Was it that it became intolerable? Was it that you finally realized it wasn’t going to go away?

    Remind the doctor about your past medical problems and your current ones. Take your index card and read off of it to him. Often times, your current symptoms may be related to your other problems or to their treatment.

    Likewise use your other index card – the one with your medicines listed on it.

    Tell him if you’ve had any other problems that you’ve seen another doctor for. Have your medicines changed? Have you run out of your medications? If so, when? If you’ve stopped your meds because of your symptoms, tell him when you stopped them.

    Have you been taking any herbal medications or other naturopathic remedies?

    What’s changed in your daily living or activities or abilities? Do you get out of breath faster, are you unable to walk up your stairs or go for your usual walk since you got sick?

    What doesn’t your doctor need to know? He doesn’t need to know all the details that go along with you telling your story. This is not a good way to describe your problems “I felt worse than when cousin Charles died” or “It started 3 weeks ago on a Friday and then that whole weekend we were at a high school reunion – you know my 30th – it wasn’t bothering me as much except when I went to bed. The long car ride made me more carsick than usual though. When we went to dinner with the Sullivans I wasn’t able to eat as much but I really didn’t have any bowel problems.”

    Eliminate the natural conversational patterns to get more out of the time you have with the doctor. Short and to the point makes it easier for him to hear the pertinent points.

    The doctor doesn’t need to know what you think the diagnosis is – unless you’ve had this same condition/symptoms diagnosed by a physician before. If you try to convince the doctor it’s something, then you may mislead him or lead him down the wrong path.

    Give your doctor your story in bullet points and don’t elaborate unless asked. Practice and write things down and you’ll do great!

This is a really good article that I found in Science Daily (and they took it from a press release from Indiana University)

Doctor-Patient Communication Has A Real Impact On Health

Science Daily — Good doctor-patient communication makes a difference not only in patient satisfaction but in patient outcomes including resolution of chronic headaches, changes in emotional states, lower blood sugar values in diabetics, improved blood pressure readings in hypertensives, and other important health indicators.

"In looking at these 36 studies we learned many things. For example, research on non-adherence to doctor’s instructions has focused on bad or poor behavior by patients rather than on the clarity of the physician’s instructions or whether the physician actually checked to see if his or her instructions were understood by the patient. The physician assumed that the patient understands and thus will comply.

But is this a logical assumption? We don’t assume that when a pilot and an air traffic controller converse that they have understood each until there is an affirmation of understanding. That acknowledgement is lacking in most patient-physician encounters," said Richard Frankel, Ph.D., IU School of Medicine professor of medicine and Regenstrief Institute research scientist, senior author of the study. Dr. Frankel is a sociologist who studies ways to improve the doctor-patient relationship. He is currently investigating how behavioral changes by both doctors and patients impact medical care.

"From previous work, including a well regarded 1999 study from the University of Washington, we know that doctors ask patients whether they understand what was discussed during a medical appointment only about 1.5 percent of the time," said Dr. Frankel. "It is extremely important that a patient be given the opportunity and probably even encouraged to ask questions. Doctors should be trained to routinely check for understanding to ensure that there is neither miscommunication nor mismatch between what the patient wants and what doctors assume the patient wants."

Co-authors of "Communication Interventions Make A Difference in Conversations Between Physicians and Patients: A Systematic Review of the Evidence" are Jaya K. Rao, M.D., M.H.S. of the Centers for Disease Control; Lynda A. Anderson, Ph.D. of Emory University; Thomas S. Inui, M.D. and Richard M. Frankel, Ph.D., both of the IU School of Medicine and the Regenstrief Institute.

Note: This story has been adapted from a news release issued by Indiana University.

Here’s an interesting article that hinges around communication differences between men and women and the diagnosis of  complex pain conditions.

More Difficult For Doctors To Diagnose Complex Sources Of Pain In Women Than In Men

It is more difficult for doctors to diagnose complex sources of pain in women than in men and the reasons for this are rooted in language use. This finding, which is of major importance for both doctors and patients, is revealed by a now completed project by the FWF Austrian Science Fund. The results of this research into how the two genders typically describe pain are to be presented at the 2nd International Congress of Gender Medicine on 2nd and 3rd June in Vienna.

For quite some time, we have all known that men are from Mars and women from Venus, but scientific research has now proven that, when it comes to describing complex pain, men and women are worlds apart. This finding comes from studies that investigated patients suffering from complex headaches. While female patients give doctors brief and vague illustrations of their complaints, men describe their pain in an extremely concrete manner. This means that male patients are at an advantage when it comes to treatment as an accurate analysis of pain is essential for both diagnosis and therapy. 

{Terrie’s note - I do not necessarily agree with the statement that women give brief and vague illustrations of their complaints - or if they do, perhaps it’s for multiple, complex reasons - perhaps it’s perceptions of how the doctor is dealing with them or many other things…this statement is not well qualified to me and it gives women a bad "name" again}

LACK OF COMMUNICATION

A team headed by Prof. Florian Menz of the Department of Linguistics at the University of Vienna established that these different approaches to describing pain are caused by language barriers. Prof. Menz believes that "Women are rather vague and less detailed when portraying their pain, often focusing on the day-to-day situations in which the pain occurs. However, this does not constitute a description of pain in medical terms, as doctors develop a largely symptom-oriented language over the course of their careers. Men, on the other hand, describe their pain in very concrete terms focusing on their symptoms, which is very compatible with medical diagnostics and makes it easier for doctor and patient to understand one another."

{Terrie’s note - so maybe doctors need to be aware of this and change their approach to women?}

By investigating other patients suffering from chronic pain, the study showed that doctor-patient communication is also inadequate on other levels and leads to misunderstandings. While doctors are again primarily concerned with analysing pain when they speak to patients, the patients themselves ¬ who have lived with their pain for a number of years ¬ are more focused on treatment options for example. In such a scenario, doctor-patient discussions often fall short of patient expectations, as they are keen to be involved in the decision-making process.