Imagine watching a train go by. You are looking for one face in the window. Car after car passes. If you become distracted or inattentive, you risk missing the person. Or, if the train picks up too much speed, the faces begin to blur and you can’t see the one you are seeking.
Imagine that your doctor is the one standing on the platform. Searching, trying to figure out how to help all these blurs going by. The blurs are the many patients and many symptoms that go by in a day.
How can you stand out in this crowd? How do you make your face, your symptoms, your concerns come into focus for your doctor?
According to Jerome Groopman, MD in his book, How Doctors Think, cognition and emotion are inseparable. In other words, it is difficult to separate our emotions from our thoughts. Or, how we are feeling affects how we are thinking. When we are having positive emotions such as happiness, we likely think better than when we are having negative emotions such as anger. Imagine what important information we are missing if we do not recognize or admit our emotions. As physicians, we have been taught to suppress our emotions. We do this so that we can continue our day, continue seeing our patients, or move on with the next surgery.
Suppose your doctor has had a bad day. Her schedule has been overbooked, she had a patient die, her child is misbehaving at school. She hasn’t slept well in so long that she can’t remember what it feels like to be rested. She is not in touch with her current emotional state. She is moving through her day like a robot, trying to get it done.
Now the two of you are together. Your doctor needs to focus on you and your symptoms. You are angry because of something that’s happened in your day or because the experience of your appointment is not going the way you wish. Can you see how this appointment may not go well if one of you does not do something to get the other to a different emotional state? Neither of you is likely to be heard. Your likelihood of being misdiagnosed has increased significantly. Your likelihood of having testing that may not be 100% necessary has gone up. The cost of your care has just increased. Not just in dollar terms, but also in life terms. A misdiagnosis can lead you down a very long, expensive highway. In addition to potentially unnecessary testing, you could receive medications that you do not need, medications that can have side effects that need to be fixed with other medications.
How can you help this situation?
- If you feel that your anger is deserved, that your doctor has truly offended you, speak with her like you would anyone you care about. How would you speak to your friend if you felt they had wronged you? Remember, your doctor is human, your doctor is your advisor, and wants to do her best for you. Treating your doctor in a friendly manner may actually get your doctor out of her head and in the room paying attention to you. Now your chances of having a meaningful conversation are going up.
- Come to your appointment prepared. Be able to discuss your concerns and your symptoms. In other words, know your agenda.
- Speak the language of your doctor. I do not mean medical jargon. I mean when, how long, how bad, what helps, what worsens, regarding your symptoms. Be able to talk about what is worrying you.
Do what you can to get your doctor to focus on you. Sometimes it is as easy as asking, “How are you doing today?” I have been asked this question by a patient, and it made me actually look at how I was doing. That act changed my thoughts and got my head in the room with THAT patient. How you are feeling can affect the way you think. How your doctor feels can affect the way your doctor thinks. Pay attention, work to get a sense of how your doctor is doing, emotionally, at the time of your appointment.
Remember, your health is your responsibility.
