Disrespect shown by doctors towards patients is a major reason for unhappiness with present day healthcare. You are the customer buying professional services and advice, and you ought to be treated with importance. As a satisfied customer, leaving your doctor-patient visit you should, by all rights, be feeling better than before you went in—healthier, happier, and more hopeful. Has this been your experience? If not, then why not?
A doctor’s primary, if not the sole, duty is to improve people’s lives. Physicians are rigorously trained for 7 to 12 years to become experts on the mental, emotional and physical complexities of the human being. These professionals are supposed to be the authorities on the healing arts. Every encounter should leave you with an enhanced state of well-being.
Unfortunately, too often patients leave their 7-minute office visit feeling dissatisfied, frightened, angry, saddened, hopeless, rushed and out of control. Something is seriously wrong and it is not the patient’s fault, nor is it the patient’s obligation to remedy this dysfunctional relationship. The medical profession needs to fix itself; but it won’t, because there is little motivation for change—since almost all doctors are very busy, making buckets of money under the present system.
Because of their pivotal position in all medical decisions these professionals have the potential to do you great good—as well as great harm. Let me offer you these suggestions for getting the due respect and the very high quality care you deserve when you must visit a doctor. (In my October 2005 newsletter, I discussed how to find the right doctor.)
Make an Agenda
Prepare for your next doctor’s appointment as you would for an important business meeting—your life could depend on it. You would never hold a conference without a written agenda of the matters to be discussed. Your doctor’s appointment requires the same diligent document preparation.
The agenda serves many purposes:
Take the Lead in the Conversation
Most of the time, the diagnosis of your problem is based upon the story you tell the doctor. Seldom does the physical examination and subsequent laboratory or imaging tests make the diagnosis. Therefore you must communicate effectively to get the best care possible. Talk freely to the doctor about how you feel. Don't wait to be asked! Don’t be embarrassed.
Finally—and after the doctor has had a chance to give you his or her opinion—don’t hesitate to tell the doctor exactly what you think about your problem. After all, no one knows you better than you do—you are the expert on you. Tell the doctor what you have concluded—your diagnosis—based on living with your troubles. Explain, also any fears you may have about your condition—that you might have cancer, heart disease, diabetes, etc. Your insights will be crucial to resolving your health problems.
Research before the Meeting
The better prepared you are when you arrive at your office visit the more effectively your time will be spent. Investigate any topics that should be discussed, like choice of treatment for diabetes, high blood pressure, coronary artery disease, etc. The Internet is your ideal research tool. General search engines like Google or Yahoo are invaluable. You will find most of what you read to be of value, and you should be able to easily sort out the nonsense. My favorite medical research site is the National Library of Medicine at www.nlm.nih.gov. Enter your questions using “and” – for example: diabetes and treatment and diet. This is a free site.
Are You Really Going Alone?
A new car salesman once told me that a man alone on the showroom floor was an easy “mark.” However, when his wife was along the sale could take him all afternoon, and the customers always got a better deal when they worked together. Having someone—a spouse, parent, child, friend—accompany you to the doctor’s office puts you at an advantage. You have changed the balance of communication—now it’s two against one; and you have created a more even exchange with the “all-knowledgeable doctor.” Your companion will be able to ask additional questions, and hear and remember important bits of information that you might miss. Plus the emotional support is invaluable. When there are important decisions to be made, such as a life-time of medication or a possible surgery, then take along your support.
Demand Respect for Your Time
Maybe they call it the “patient’s waiting room,” because you are expected to wait—patiently? Long delays before seeing the doctor are so common that bringing a book to an appointment is routine. A reasonable delay may be 15 minutes—any longer than that sends a clear message that your time is of little value. Occasionally an emergency for the doctor can happen; but routine hour-long waits are a clear case of poor business practice—and you should not tolerate it. This frustrating beginning spoils the chances for you to get the excellent care you deserve—an hour spent fuming in the waiting room will, for one thing, raise your blood pressure sky-high.
I have found several reasons for this disrespectful business practice. Offices overbook, maybe anticipating a cancellation, so the doctor is always busy. It is also an “ego thing” for the doctor to have lots of people waiting just to see him or her. One office nurse told me that her boss would peek into the waiting room upon arrival each morning. If the room wasn’t packed he sulked all day long. However, I believe this practice continues mostly because it is tradition and few people have complained loudly enough to make any change. In truth, respect in most offices is limited to a demand for respect for the doctor’s authority. It is time for you to speak up.
Explain to the people at the reception desk that your time is valuable and you do not want to be kept waiting. Call before your appointment and ask if you will be seen on time—or sarcastically ask, “How far is the doctor behind today?” When it seems that you will have to wait, offer your cell phone number and ask to be called with an updated time for the appointment. You might also try for the first appointment in the morning or after lunch.
Proper Office Behavior
Your initial visit with the doctor should be to gather information. Ask lots of questions. If you don't ask then the doctor may think you understand everything. Pictures drawn by the doctor may help explanations. You should be taking notes. Ask the doctor to write down any specific instructions you need. Some doctors won’t mind if you make a tape recording of the visit—but ask first. Before leaving ask for any instructional materials (video tapes, brochures, etc.), especially research papers that are available.
By the end of the visit you should have a clear idea of the doctor’s investigation and treatment plans including any tests, specialists, and follow-up appointments that need to be made. If after you leave, things become unclear or other problems develop, then you should feel welcome to call or e-mail the office and communicate with the doctor and/or a staff member for more information.
Don’t Be Sold on Your First Visit
Most salespersons know this cardinal rule: If they fail to sell the customer on the first contact then they have less than a 10% chance of ever making the sale. Most patients allow themselves to be sold too easily. After one high blood pressure reading they are placed on a lifetime of medication. They agree to schedule surgery for the next available opening without a pause for thought. No!
Get off the showroom floor—out of the doctor’s office—and give yourself some time to think, and do some research, before you buy—just as you would if you were buying a TV or a washing machine. Your health-care purchase deserves more consideration than household appliances.
While sitting in the waiting room you should practice an exercise of saying “No”—maybe 1000 times—so the word easily rolls off your lips when the doctor dictates what treatments you must follow and what drugs you must take.
After Visit Evaluation
You should feel good, or at least better, after leaving the office. Was a good job done of relieving some or all of your suffering, or was your discontent increased?
If you are satisfied with the experience you had with the doctor and staff, GREAT! Tell your friends. If your visit was not pleasing, remember, the choice is yours—you are the customer—try another doctor.