How can I be a ‘good patient’ during a visit (in the eyes of my provider), so that we can have a constructive, collaborative relationship?
There are several simple steps you can take to be a great patient in the eyes of your provider:
When scheduling your appointment, be as comprehensive and candid as possible in stating your Reason for Visit.
Most physicians’ schedules and check in processes vary based on the Reason for Visit. For example, different blocks of time might be allocated for an annual physical, an update visit to manage a chronic condition, the diagnosis of a patient who ‘just isn’t feeling quite right’, and for testing for a suspected venereal disease. When you schedule your appointment, demonstrate your respect for their time by being as forthcoming as possible when stating why you’re coming in. Physicians cringe at what they call the ‘doorknob syndrome’: they go into an exam room, take care of the stated Reason for Visit (say an annual exam), complete it, then as they say their goodbyes and grab the doorknob on the way out the patient says something like “By the way, Doc, as long as I’m here, I have these other ongoing symptoms that I’ve been meaning to ask you about”.
Two thoughts immediately go through the physician’s head:
1.) They’re going to have to rush your remaining exam/diagnosis and likely can’t afford to give you all the time they’d like to; and
2.) Because they’re going to spend more time with you than they allocated their schedule, they’re now automatically behind on all of the rest of their patients and will have to rush at least some of them as well.
If you have an issue you consider so personal you don’t want to be specific, tell the scheduling clerk exactly that, and they may ask you some questions to at least know how much time to allocate.
Be as accurate, complete, and comprehensive in your history and current circumstances as possible. Ideally, have them prepared in advance.
When your circumstances require a diagnosis, your physician is going to ask questions about your current and past conditions, allergies and medications, your family and social history, and others. If you are embarrassed or don’t know, say so. The lack of information may result in an inefficient or sub-optimal diagnosis or recommended treatment. But inaccurate information can result in a potentially dangerous diagnosis or recommended treatment.
If there are circumstances, values or beliefs that are important to you in your treatment, make them known early.
If your values or beliefs may impact your ability or willingness to follow through with an agreed up treatment plan, say so. The earlier the better. It’s far better to get this on the table than to remain silent and later not comply with the agreed upon treatment.
If there is discretion in setting goals for treatment, then make your personalized goals clear.
Two patients have a relatively similar shoulder problem. One is a competitive amateur golfer. The second is a retired school teacher with a relatively sedentary lifestyle. The distinction may not be apparent to the physician unless the patients speak up. If both are vocal in informing their physicians of their lifestyles, activities of daily living, hobbies, and how these impact their treatment goals, they will likely end up with different treatments unique to their circumstances.
If you want available options for different treatments to achieve your goals, ask.
Since most patients still expect a paternalistic relationship, classically trained physicians will be inclined to diagnose and treat, with their treatment recommendation being the only one offered unless you ask. While they may find this refreshing, they will likely be surprised. Prepare yourself.
Understand that the diagnostic process, the human body, and medicine in general is part art and part science.
One of the most misunderstood concepts between patients and physicians is that the human body is still something of a mystery to us. In some cases the condition, diagnosis, and treatment can be very straightforward and doesn’t vary much if at all from patient to patient. Outcomes can be predicted.
But in many other cases, especially when patients have more than one condition, a diagnosis can be more difficult and different treatments impact different patients in different degrees or in different ways. To some extent, medicine still has a trial and error element to it. This reality is often masked by a degree of confidence in the tone and body language of a physician that hides the underlying reality that they’re really just making their best, albeit informed, guess as they deliver their diagnosis and recommended treatment. As a patient, you have to appreciate a level of uncertainty in some diagnostic processes, and have the resolve to try different treatments if the first doesn’t accomplish your goals.
Now that you’ve collaborated on a treatment plan and chosen one, follow it!
Keeping in mind that virtually every physician went into their profession to help people, there is nothing more frustrating than to have a patient who has been shown a path to getting better, but doesn’t follow it. Treatment plan adherence hovers below 50% according to most sources, especially when it comes to medications. And the only thing worse is that patients often mislead their physicians regarding their own adherence. Patients who return to their physicians in worse condition than when originally diagnosed, and tell their physician that they had been following their treatment plan (when in fact they hadn’t, or did so only partially), usually get a different treatment. If you can’t or won’t follow your agreed upon treatment plan, tell your physician why so they can either help remove impediments to your care or at least help you find a treatment option you can comply with. You both want to reach your treatment goal. Help them help you.
Remember: We coach, support, educate, and empower. We illuminate options you may not have known you had. But we don't decide what's right for you in your unique circumstances; only you can do that. And we don't provide medical, financial, or legal advice; nor do we replace the valuable counsel of those who do.