Talking to Your Doctor: Deciding When, How – and If – to Speak Up.

Jan was frustrated with her physician and she decided that, as a patient, she had a right to let him know. First, she waited in his office for an hour beyond the scheduled time of her appointment. Second, he had told her he would call her to let her know the results of a test, and he hadn’t. And third… well, it was just time he did a better job.


And so, when she was finally in the examination room with her doctor, she let him know exactly what was on her mind. Starting with her third complaint: “You need to start doing a better job if you want to keep me as a patient.”


Later that afternoon, Jan realized she might have been a little harsh with her doctor. Yes, he had left her sitting in his waiting room for way too long, though that did not generally happen with him. And her test results had come out fine. But still…


“I really gave it to my doctor today,” Jan said to her husband that night. “But that’s what patients have to do these days. If you don’t demand to be treated with respect, you won’t be.”


After Jan had left his office, her physician talked about the experience with Jan with one of his colleagues in the practice:


“It’s hard to be a physician these days,” he said. “I feel like patients don’t understand my side and don’t respect what I’m trying to do for them. They read these blogs on the Internet that tell them to stand up for their patient rights. So be it. But they set standards I can’t possibly meet.”


It’s not easy to be a patient these days. Cost controls seem to get tighter and tighter, restricting the choices available to patients. Physicians are spending less time with each patient as a result of reimbursement guidelines. Medical practices may be understaffed, and less responsive.


It’s not easy to be a physician these days. For the same reasons.


I think that few people would disagree with the current thinking that patients benefit from taking responsibility for their own healthcare. Even doctors agree. Among other things, taking more responsibility means making the best use of the time you have with your doctor. Doing your own research on your condition and its treatment so you can ask your doctor questions. Keeping all of your doctors in the loop on medications.   Making sure you stay on top of test results.


But the next time your doctor disappoints you, here’s a question: Would it be advisable to take a step back and consider your perspective before you act? In other words, is your frustration or anger at your doctor based on an ideal world and the real world in the current healthcare environment?


And another question: How can you express your expectations and concerns to your doctor in a way that promotes teamwork?


Let’s tackle the first question. Your perspective?


Take a look at your expectations. Sure, you have a right to be frustrated with your doctor. But take a look at the expectations that led to your frustration. Ask yourself if your expectations are realistic, as well as if they are correct. For example, did your doctor say he/she would call you with the results on Tuesday or that the results would be available that day? Two different messages, right?


Ask yourself: Is this an annoyance or a potential catastrophe? When you’re having a bad day, any and everything that doesn’t go as expected can feel much bigger than it is. Being inconvenienced by your doctor is one thing. An error that places your health at risk is another. Take the moment to be clear with yourself on the gravity of the situation before you take action with your doctor.


As they say, choose your battles. I am not saying that you are at war with your doctor. But I am saying that in any relationship, we learn when to raise the alarm and when to shrug our shoulders and let it go by. In the long run, keeping the peace can trump proving yourself right.


Now for the second question. What’s the best way to say what’s on your mind? Here are some ideas to consider:


Breathe before you speak. When your emotions are peaking, it’s hard not to act out of your feelings. As a result, you may say something you later regret. While you don’t want to swallow your frustration and not say what’s on your mind, you also don’t want to spit out a lot of anger that is way out of proportion to the situation (or about everything else that has made you mad that week). It can help to take a deep breathe. Calm yourself down. Maintain your perspective.


Get a sense of what your doctor’s day or week has been like. Everybody hits rough spots when their good intentions don’t quite make it to fruition. Like you, your doctor may have a lot of days like that. The two of you may even be having a really bad day on the same day. So ask a simple question: “Seems like you’re especially busy today. How’s it going?” Or, “I’ve had a frustrating week. How about you?” Starting out be being conversational – instead of with an accusation – can help you to dial down your frustration and avoid causing your doctor to become defensive.


Be specific about your concern. It’s only human nature to want to talk in absolutes when you we have strong feelings. But “you never” or “you always” isn’t productive. Instead, discuss the specific concern you have in a non-accusatory manner. Instead of “You made me wait too long today,” say something like “Wow, I sat for an hour in your waiting room.” Instead of “You didn’t call me with the test results like you promised,” try “I was hoping to hear about my test results when they came in.” Your doctor may appreciate the feedback. Or you may get no response. But at least you provided space rather than backing him/her into a corner.


See if there is a way to work together. You might ask: “Is there is anything that could be done to avoid this happening in the future?”  Or, “Could we find a way to communicate a little better?” You might come to an understanding. Or your doctor may say it’s his/her way or the highway. And then the direction is up to you. But it can’t hurt to ask.


If the problem you have with your doctor doesn’t seem to be solvable:


Consider the big picture. If your doctor is doing a good job of taking care of you, if you trust his/her competence, then these may be reasons to shrug your shoulders and decide the quirks and the annoyances are just that. And not worth making an issue out of. Nobody’s perfect.


If you can’t live with the disconnect, it may be time to move on. Just to be clear: I am not suggesting you continue to go to a physician who is difficult to work with, who has poor practice management, or shows questionable judgment that might place your health at risk. If this is the case, and you don’t see the potential for positive change, then it’s time to consider moving to a new physician.


Your relationship with your physicians is an important aspect of your healthcare. Keep the line of communication open. Use your own good judgment, tempered with compassion. And always: Take responsibility for getting the best possible healthcare.