The last time Juan met with his physician, she had suggested they should meet again in three months to combine his annual physical with his quarterly follow-up on a chronic condition he is being treated for. That sounded like a good idea to Juan, who has to drive over an hour to get to her office.
As Juan expected, he and his doctor accomplished a lot during this appointment. In addition to his annual physical, they reviewed the results of his blood tests, which Juan had completed the week before his appointment. She made some self-care suggestions. And when Juan talked to her about the pain that he experiences occasionally, she mentioned another pain medication that might be more effective.
They scheduled Juan’s next quarterly follow-up. He left her office thinking their time together had been productive, and that her recommendations all made sense.
Making Sense of It All
But the next day, Juan had an uneasy feeling about his appointment. He thought she had recommended an additional blood test but they hadn’t actually scheduled it. Was she thinking sometime in the future? And what about his pain medication? She had talked about an alternative but hadn’t given him a new prescription.
Juan is wondering whether accomplishing so much at a doctor’s appointment is a good idea after all, now that he is left with so many loose ends. And he’s also wondering if he should make another appointment with his doctor, or try to call her, to get clarification. Or should he just wait?
Have you ever left your physician’s office feeling like you think you heard everything but then, later on, realized your doctor’s recommendations and next steps are about as clear as mud?
How to Have Clear Communication with Your Doctor
Communication is two way. And it requires that both parties be able not only to listen, but to actually hear what’s being said. As well as clearly convey what they want to express. That sounds great on paper. But the parties involved here are human, and communication breakdowns can occur in spite of the best of intentions.
Patients have a lot on their minds when they meet with their doctor. Juan, for example, may have been focused on something that his doctor said earlier in the conversation, so he wasn’t able to completely listen to what followed. Also, his doctor was discussing numerous topics, and maybe throwing in some medical terminology here and there, and Juan may have had trouble following the flow and taking in everything she said. And if Juan was feeling anxious or fearful in any way, his emotions could have made it harder for him to listen to her.
Physicians also have a lot on their minds. Juan’s doctor may have been a little distracted that day, causing her to move from one topic to the next without being as thorough as Juan needed her to be. She may have had some time pressures — as doctors often have these days — and slipped into using some verbal “shorthand” along the way. Or she may have been “thinking out loud” at times, giving voice to her own thoughts but not necessarily intending to make any changes in his regimen at this point.
With clearer communication, Juan might have walked away from this conversation with not only assurance of his physician’s thoroughness, but also a clear treatment direction for the near future. Instead, he and his doctor were like two ships passing in the night, a missed connection that left him feeling like his best option was to make another appointment to complete the conversation.
Use the Paraphrase Technique
What happened between Juan and his physician — and what might be happening between you and your doctor — could have been prevented through the use of the paraphrase technique.
When you paraphrase, you are basically repeating back to the other person what you think you heard them say. Not word for word, but the “essence.” Using the paraphrase technique with your doctor is a way for you to test your understanding of what your doctor said, to get clarification, before you leave the office. Paraphrasing is a great way to make sure you and your doctor are in sync, that what he/she wants you to know is indeed being received on your end. Paraphrasing enhances communication, and effective communication builds relationships.
Here’s how to use the paraphrase technique to improve your communication with your doctor:
Let your doctor know you need some clarification. Say something like, “I just want to make sure I understand what you are saying/recommending,” or “I wasn’t sure what you meant but it sounded like…” This signals to your doctor that you value his/her words and want to make sure you have complete understanding.
Restate what you think you heard. Repeat back the gist of what your doctor just said. Again, not word for word, but the key points. An example: “It sounds like you are thinking of changing my medication pretty soon,” or “What I heard is that you think I am doing well but there is something else you want to start monitoring.” If the doctor has said anything that you are unclear about, let him/her know you need more clarification.
Follow your paraphrase with a check-in. Make sure you heard what your doctor intended, and give him/her a chance to clarify further. It’s as simple as: “Is that what you meant?” or “Am I understanding you correctly?”
You may need to repeat this process. For example, if you and your doctor aren’t quite in sync, he/she may need to give you further explanation and you may, in turn, need to do some more paraphrasing. “Now I think I understand. But I just want to make sure. So you’re saying…” It can’t hurt to cross every “t” and dot every “i.” After all, this is your health we are talking about.
Make sure you clarify next steps. What, when, why, how. Give your doctor a quick overall summary of the conversation with a focus on what comes next. If you and your doctor can commit to a timeframe for any next steps, then so much the better.
Consider taking a pad and pen to your appointment. This will help you to keep track of what your doctor is saying, help you to avoid getting distracted. You can quickly review your notes at the end of the session. If nothing else, write down your doctor’s recommendations and quickly review them together.
Don’t Be Afraid to Speak Up
The paraphrase technique may seem a little uncomfortable if you are used to listening while your doctor does all of the talking. But look at it this way: By getting clarification before you leave, you are actually saving time, for you and for your doctor. You’re avoiding the second-guessing and confusion that leads to unnecessary follow-up appointments. As well as follow-up phone conversations (and phone tag) or email.
And the benefits? How about: Less chance of misunderstanding that can lead to error. Less stress. More efficient use of your time. More efficient use of your doctor’s time. And who knows? Your doctor might even appreciate that you helped him/her not to leave any loose ends behind.
Here’s what Juan did at his next appointment: As his doctor discussed his latest test results, he took a more active role in the conversation. Periodically, he paraphrased what she was saying, and checked in with her to make sure he was understanding what she intended to convey. He jotted down her recommendations and reviewed them with her. At the end of the appointment, his doctor smiled and said, “You are on your top of your game today, Juan. I feel like we totally in sync.”
Listen. Paraphrase. Check in. Repeat the process as needed. Partnering with your doctor means making sure you are talking on the same wavelength. That’s where paraphrasing helps. So give it a try the next time you meet with your doctor!
This article was originally posted on patient social networking sites from Alliance Health. Here is the link: http://www.depressionconnect.com/depression-articles/275-clarifying-meaning-and-intention-with-your-physician?category=choosing+wisely