There are many reasons why people clam up during a doctor’s appointment. Patients feel uneasy talking about their health woes — maybe they have only a vague sense of the discomfort and feel embarrassed they don’t know more. They might be nervous or scared. Or maybe they think they should just grin and bear it — not take up time in a doctor’s office.
Still, experts say it’s critical for patients to feel comfortable asking questions about their health. And asking good questions can be the key to improving communication between patient and doctor, ultimately leading to fewer medical errors and better health outcomes.
In recognition of Health Literacy Month this October, the Georgia Alliance for Health Literacy is making a push for Georgians to make the most out of their medical appointments by listing good questions. The alliance is a nonprofit, volunteer coalition consisting of educators, researchers, government officials, doctors and others concerned about public health.
“A lot of people feel they don’t want to make trouble and they know doctors are busy and they want to be good patients,” says Don Rubin, chairman of the Georgia Alliance for Health Literacy and a University of Georgia professor emeritus. “One of the messages we want to get across is when you ask good questions and make sure uncertainties are taken care of, you are helping your doctor and they appreciate you asking questions. They would much more appreciate you asking questions instead of just sitting there and nodding your head.”
Experts say a good place to start is with the following three simple questions: What is my main problem? What do I need to do? Why is it important for me to do this?
Patients get very little face-to-face time with their doctor.
The average length of time spent with a doctor — particularly a primary care doctor — is between 13 and 16 minutes according to a Medscape 2011 survey. Anesthesiologists, critical care physicians and neurologists tend to spend more time with each patient, closer to 25 minutes.
With such little time with the doctor, Rubin said it’s important to come prepared to maximize that precious time.
He recommends patients rehearse how they will explain their main concerns and symptoms, and come prepared with a list of questions jotted down on a slip of paper.
Rubin also made the point that effective communication between a patient and a doctor is a two-way street. He said it’s essential that doctors speak in an easy-to-understand language.
Dr Ruth Parker, a professor of medicine at the Emory University Medical School, agreed and said one technique to help improve communication between doctors and patients and ensure patients understand what they need to know is to employ the “teach-back” method. With this method, also known as the “show-me” method, patients explain the information from their doctor in their own words.
Meanwhile, Rubin plans to nominate his internist, Dr. David Spivey, as a health literacy hero. (For more about health literacy heroes, see accompanying box.) He said his Atlanta doctor posted a sign in his exam room that said, “If you feel you have not been listened to, please let us know.” He said in his experience, the doctor remains in the exam room until you finish “asking about whatever is on your mind.”
Health literacy and patient advocacy are very close to the heart for Dianese Howard of Atlanta. When her son Alan was born in 1970 with several medical problems, including heart woes, she researched medical information at the library and jotted down questions to bring to doctors appointments. In more recent years, she took advantage of being able to research health information on the Internet, particularly reputable sites such as WebMd. She found a cardiac pediatrician who made her feel comfortable asking questions and who went to great lengths to make sure he was communicating effectively, even drawing pictures when necessary. A couple of years ago, Howard had a mini-stroke. After being discharged from the hospital, she returned home and started feeling dizzy and lethargic. After discussing her symptoms with her children, she picked up the medicine bottle and realized she was experiencing potentially dangerous side effects from the medication.
“What if I wasn’t lucid enough or didn’t have my children to help me?” she said. “I could have just kept taking the medication.”
Howard, now 66 and semi-retired, is starting a Patient Advocacy Certificate Program at UCLA Extension this December.
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