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10 things doctors say patients should know
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50Plus.com
A survey reveals 10 things physicians wish you knew -- and one they wish you didn't.
It can be a matter of life and death: the doctor-patient relationship is one of the most important ones in our lives, yet both physicians and patients feel the other half could do more to hold up their end of the bargain. In North America, it isn’t unusual for patients to complain of long waiting room times, hurried appointments, a lack of bedside manner and ineffective treatments.
But how do doctors feel about the situation? To get the other side of this healthcare story, Consumer Reports surveyed more than 660 primary-care physicians in the U.S. about the challenges they face everyday — and how they think patients could be getting more from this important relationship. Even though the survey focused on the United States, many of the lessons learned are universal.
Here are 10 things physicians wish their patients knew, according to the CR report and current research.
Come prepared
Would you walk into a meeting with a busy executive without an agenda or notepad? Like their Canadian counterparts, U.S. doctors feel the pressure of increasing workloads and busy schedules. It’s easy to feel hurried, or for patients to forget questions they had.
That’s why experts recommend being better prepared. How, exactly? Make a list of your top health concerns and write down any questions you have before your appointment. You may also have to prioritize because it may not be possible to cover it all during a single time slot. (If needed, ask your doctor for a follow up.)
Keep better track of your health
Even with electronic health records, doctors and patient advocacy groups warn that patients should be taking more responsibility for their health. Almost 90 per cent of doctors surveyed reported it would be valuable to take notes during appointments, keep track of your symptoms, make a list of any medications and supplements you’re taking and keep a log or journal of past appointments and procedures. Unfortunately, only one third of patients actually use these strategies.
What about backup? Nearly 80 per cent of doctors think it’s a good idea to bring along a friend or family member to an appointment, but less than 30 per cent of patients do. (See Become an empowered patient for more ways to take charge.)
Know your medical history
Though the CR survey only touched on this issue, other studies have warned that knowing your family’s medical history is crucial for understanding your risk of many chronic illnesses like cancer and heart disease. In fact, a family health tree can be even more effective than genetic testing.
Why is this important? Not only can it help you and your doctor gauge your risk, you’ll also be able to target strategies to prevent the illness or catch it in its earliest and most treatable stages. For example, if you have a family history of a certain cancer, your doctor might suggest screening at an early age. (Read A family tree for better health for tips on compiling your family medical history.)
Understand your coverage
Unfortunately, many people face unpleasant financial surprises when it comes to healthcare costs, so experts warn to keep tabs on your coverage. Stateside, most doctors surveyed felt that rules and restrictions impacted their ability to provide care.
And no, that’s not just an issue for Americans. Even in Canada it’s helpful to know what is or isn’t covered by your province’s healthcare plan or your company’s benefits plan. For instance, your group insurance may cover certain medications but not others, and it may reimburse the cost of seeing a physiotherapist. Knowing the details means your doctor can better suggest treatments that won’t cause undue financial stress.
Follow instructions
The biggest gripe doctors have about patients? They don’t always follow instructions or take their medications. Almost all of the doctors in the CR survey reported that non-compliance affected their ability to provide the best care. One third were especially concerned about this issue.
However, the issue isn’t just simple misbehaviour. Sometimes treatment plans can be confusing or cause unpleasant side effects — issues that can be resolved by better communication between patient and doctor. Experts warn to discuss any concerns you have with your doctor and make sure you understand instructions before you leave the office. If you experience side effects, don’t make changes yourself — talk to your doctor first.
Be honest
While not covered in the CR survey, honesty is closely connected with compliance. When patients aren’t upfront about not following orders, doctors are basing their decisions on faulty information and they can’t address the patient’s concerns — like switching to a medication that causes fewer side effects.
Other lies that can be risky include alcohol or drug use, use of complementary or alternative therapies (which can interact with prescribed medications), memory problems, depression and problems in the bedroom or bathroom. (See 10 secrets not to keep from your doctor for more details.)
Respect goes both ways
Are patients playing nice? Over 60 per cent of doctors in the survey felt that patients would get better care if they showed more courtesy and respect. Unfortunately, 70 per cent of doctors reported that since they started their practices they’ve seen a decline in respect and appreciation from patients.
However, being nice doesn’t mean that you have to simply smile and nod. The majority of doctors also felt it was “somewhat helpful” or “very helpful” for patients to ask questions and even question their recommendations. Many educational campaigns — like the Manitoba Institute for Patient Safety’s It’s Safe to Ask program — encourage communication that gets answers without causing offense.
Rapport is important
The most important thing you can do to get better health care? Have a long-term relationship with a single provider. Three quarters of doctors noted that continuity is important, especially when serious and chronic health issues are at stake. Jump from doctor to doctor and you won’t receive the same level of care.
That’s why many American doctors wish people would do a little research before choosing a physician. Learning more about a doctor’s approach, personality and treatment style was key to finding a good fit.
Unfortunately, some Canadians are lucky to even find a family doctor let alone hand pick the best one — and many physicians won’t accept new patients looking to “break up” with their current provider. Still, a little research could be useful if you’re seeking alternatives, like integrated medicine or complementary and alternative medicine practitioners.
Be cautious online
Many surveys about Internet use report the same trend: the majority of people go online to research their symptoms and conditions. However, not everyone is convinced that websites are quite so useful. In fact, only 8 per cent of doctors thought the Internet was “very helpful” — and almost half thought it had little or no value at all.
That’s not to say you shouldn’t be better informed, but rather you should be choosier about your sources. Medical and media experts alike recommend skipping the search engine and sticking to reliable sources instead. (We’ve got tips and sources in Beyond Dr. Google.)
Some conditions are tough to treat
Chronic conditions, especially where chronic pain is involved, can be difficult to diagnose and treat effectively — often leaving patients feeling frustrated and dissatisfied. In a previous survey of patients conducted by CR, those who suffered from a chronic condition like an autoimmune disorder or chronic pain were more likely to complain of ineffective treatments. Only one third were “highly satisfied” with the doctor overall.
However, doctors are hard on themselves too: in the physician survey, only 37 per cent of respondents felt they were “very” effective at treating chronic conditions, while 60 per cent more thought they were “somewhat” effective. Unfortunately, medical science doesn’t always have the answers, but a little patience and good communication can go a long way. The most satisfied patients had doctors they felt were willing to listen, learn more about the condition and involve them in decisions.
Doctors talk to sales reps
While there are many things doctors want their patients to know, this is one they might want to keep secret. According to the survey, U.S. doctors spend a few hours a week dealing with pharmaceutical salespeople. The majority of doctors reported they were contacted by sales reps about 10 times a month, and one third reported their calls were double that amount.
Why is that an issue? According to the patient survey, one quarter of respondents thought their doctors were a little too eager to prescribe medications, and many felt their doctors weren’t willing to consider alternatives. What do the experts at CR say? If you’re concerned, talk it over with your doctor at your next appointment.
Overall, it’s important to note that most patients and most doctors are satisfied — at least in the U.S. However, there’s always room for improvement, and the message from experts continues to be that patients need to be more active and involved in their care — and that means managing their doctor-patient relationship too.
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