In recent posts, I wrote of the importance of a shared agenda when you meet with your doctor, and the importance of bringing forth all the items on your agenda – your list – when you book the appointment and clarifying this with your doctors’ staff in the examination room before you see the doctor.
Once you meet with your doctor, how do you negotiate the agenda?
In every human encounter – between parent and child, boyfriend and girlfriend, best buddies, and strangers, there may be a shared and differing priorities.
For your medical visits, however, your wellbeing is the primary concern of both parties. Your doctor may have some other peripheral priorities –his duty to protect and help others, another sicker patient who requires urgent care, the pressure to stay on time and please many people.
It is unlikely that your doctor’s more pressing priorities are a golf date or the hockey score. Most doctors put their patients needs ahead of their own and often ahead of their own families and partners.
In fact, I have often heard colleagues complain that they were so busy in the clinic or attending to hospital patients that they had “no time to pee” or stop for lunch or dinner.
Ironically, the most common conflict in patient-doctor encounters is their different approaches to the patient’s health concerns. In every conversation, there are two voices. At your visit with the doctor, there is your voice – the voice of the patient: a human being who has not only one or more medical concerns but also your own ideas, feelings, fears and expectations about those problems, how they affect the rest of your life and how they should be managed.
The other voice of course is that of the physician. We tend to be focused on problem solving. While you are talking, through the doctor’s head runs a background program that is working through that diagnostic process – looking for patterns in the presentation of your symptoms and working from many possible diagnoses (the differential diagnosis) to the right diagnosis.
Next: What goes on in your doctor’s head?
Any suggestions for improving patient-doctor communication? Please share your comments.