Dr. You

Your health outcomes will be best when your communication with healthcare professionals is open, honest, and as frequent as needed. (Source: Agency for Healthcare Research and Quality (AHRQ). When communication breaks down, patient outcomes suffer. If you’re uncomfortable talking with your doctor or health providers, find someone you trust to help. This section helps you understand how to communicate effectively with your healthcare team.

Patient Story – (The story is true; the patient’s and provider’s names have been changed.)

One case described in the literature involved a newly diagnosed cancer patient, Lila, who initially struggled with understanding complex treatment options and coping with the emotional trauma of the diagnosis. Lila’s doctor actively listened to the patient’s concerns, addressed her emotional needs, and tailored information to her circumstances.

By fostering trust and creating a respectful dialogue, Lila felt empowered to express her preferences and ask questions about her care plan. This collaborative approach led to the development of a treatment strategy aligned with Lila’s preferences, ultimately improving her emotional well-being and adherence to her treatment plan. By following her treatment plan, Lila eventually recovered and led a long and healthy life for the next twenty-two years.

The Cornerstone – Communicating with Your Doctor

Communicating well with your doctors, their staff, and other healthcare providers is a cornerstone of good health. Effective communication requires preparation, asking questions, actively listening, answering questions honestly, and taking time to think. Talking with your doctor isn’t always easy, but it requires effort from you and your doctor.

Finding the Right Primary Doctor

Find a primary care doctor (PCP) with whom you are comfortable. Your primary care physician (PCP) should be familiar with your health history and help you make decisions that align with your values and lifestyle. They should also coordinate with other medical specialists when needed.

If you don’t have a primary care physician (PCP) or aren’t comfortable with your current one, consider finding a new doctor. It’s worth the time to find someone you trust. A few of the key roles of PCPs are:

• Providing preventive care and teaching healthy lifestyle choices.
• Identifying and treating common medical conditions.
• Assessing the urgency of medical problems and directing patients to the most suitable care facility.
• Making referrals to medical specialists when necessary.

(Tip) You can help your primary doctor by notifying them of appointments with other healthcare professionals and any actions you’re considering.

Primary care doctors are often family practitioners, internists, or geriatricians. Family practitioners care for children and adults of all ages and may include obstetrics and minor surgery. Pediatricians care for newborns, infants, children, and adolescents. Internists care for adults of all ages who have a wide range of medical problems. Geriatricians specialize in caring for older people. Obstetricians/Gynecologists often serve as PCPs for women, particularly those of childbearing age. Nurse Practitioners (NPs) and Physician Assistants (PAs) who consult with physicians can also provide primary care, and Patient Navigators can be highly involved in patient care.

Tip: Important questions to ask the practice are:

• Who serves the lead role in helping me manage and coordinate my care, and can meet with them?
• Does your practice use patient navigators? If yes, what is their training, experience, and credentials?

Sometimes, specialists such as oncologists, cardiologists, endocrinologists, and neurologists may provide some of the services typically offered by a primary care physician (PCP). However, they are trained in a specific area of medicine and may not be the best choice to provide holistic care.

Typically, your primary care physician (PCP) should be your primary healthcare provider in non-emergency situations. Primary care is usually provided in an outpatient setting. However, if you are admitted to the hospital, your PCP may assist in or direct your care in coordination with the hospital care team. A PCP can establish a trusting, ongoing relationship with you over time. Be extra cautious if you’re admitted to a hospital in an emergency, as you’re likely to be treated by doctors who are unfamiliar with your medical history.

Health Insurance and Primary Care

Many insurance plans limit the providers you can choose from or provide financial incentives for selecting from a specific list. Ensure you know what your insurance covers before narrowing down your options. Decide what qualities you’re looking for in a doctor.

List the qualities that matter to you (gender, evening hours, hospital affiliation, language). Prioritize those qualities. Ask friends, relatives, medical specialists, and other health professionals for recommendations. Ask about their experiences (e.g., “What do you like about Dr. Smith?”).

If you have health insurance, make sure the doctor accepts your insurance and is in your provider network. Most managed care plans provide information on their doctors’ backgrounds and credentials.

(Tip) Develop a list of several doctors to choose from, as some may not be accepting new patients.

Consult Reference Resources to Check Credentials

• The Directory of Physicians in the United States and the Official American Board of Medical Specialties Directory of Board-Certified Medical Specialists are available at many libraries.
• MedlinePlus (www.nlm.nih.gov/medlineplus/directories.html) has a comprehensive list of directories.
• You can also find doctors through the American Medical Association’s website (www.ama-assn.org; click on “Doctor Finder”)
• Doctors participating in Medicare are listed at (http://www.medicare.gov). Click “Search Tools” and then “Find a Doctor”.
• WebMD also provides a list of doctors (www.webmd.com; click “Find a Doctor”).

(Tip) Contact your local or State medical society to verify if there are any complaints against the doctors you are considering.

Choosing a Primary Care Doctor

• Learn more about the doctors you are considering.
• Narrow your list to a few doctors and contact their offices to inquire about their education, qualifications, office policies, and payment procedures.
• Pay attention to the office staff.
• Request a meeting to talk to the doctor.
• Ask what you will be charged for the visit and check if your insurance will cover the cost.

After an initial appointment, ask yourself whether this doctor is someone with whom you could work well. If you’re not satisfied, schedule a visit with one of your other candidates.

When learning about a doctor, consider asking questions like:

• Do you have many patients like me?
• How do you feel about involving my family in care decisions?
• May I contact you or your staff by phone or email with questions? Do you charge for telephone or email time?
• What are your thoughts about complementary or alternative treatments?

When deciding which doctor to choose, ask yourself:

• Did the doctor give me a chance to ask questions?
• Was the doctor really listening to me?
• Could I understand what the doctor was saying? Was I comfortable asking them to say it again?

The First Appointment

Once you’ve chosen a doctor, make an appointment. This visit will likely include obtaining a medical history and conducting a physical examination.

• Bring your medical records or have them sent from your former doctor.
• Bring a list of your current medicines or bring the medicines in a bag.
• If you haven’t met the doctor, ask for extra time during this visit to ask any questions.
• When you arrive at your appointment, introduce yourself and let the staff know by what name you like to be called (e.g., “Hello, my name is Mrs. Jones”).
• Ask how the office runs.
• Learn which days are busiest and when the best times to call are.
• Ask about procedures for emergencies or when you need a doctor if the office is closed.
• Share your medical history, including any illnesses, surgeries, medical conditions, and other doctors you consult.
• You may request to receive a copy of the medical history form prior to your visit, allowing you to complete it at home. If you have problems understanding how to fill out the forms, ask for help.
• Provide your new doctor with the names and addresses of all your previous doctors. Your doctor will ask you to sign a medical release form, which gives them permission to request your medical records.

How to Talk to Your Doctor

A good relationship is based on you and your doctor openly sharing information and working together to make the best decisions about your health. Open communication with a trusted doctor increases your confidence in your treatment and its outcome.

Doctors are busy, and visits may be short. Prepare by writing down all questions that are important to you in advance and bring a pen and paper to take notes. Here are some questions you might want to ask:

• What do you think might be wrong with me? How do you know?
• What are the common causes of this problem?
• Will I need any tests? Which tests might I need? What does each test involve? How do I prepare for each test? Will my insurance cover the costs of the tests?
• What are my treatment choices? What are the benefits and risks of each treatment? What are the side effects? What are the likely outcomes of each treatment? What is the most common treatment for my condition? What are the next steps if treatment fails?
• What kind of medication(s) must I take? For how long? What does the drug do? Will there be any side effects? What should I do if I have side effects?
• Can I take a generic version of the drug?
• Will the medicine interact with any medications I am already taking?
• Should I avoid any specific foods or activities while taking this medication?
• Will I need to see a specialist?
• Should I get a second opinion?
• Do I need a follow-up visit?

Additional preparation includes:

• Bring a list of the symptoms you’re experiencing.
• Bring a list of all the medicines you take, including doses, frequency, vitamins, and supplements.
• Arrive early enough to complete the necessary forms.
• Have your insurance card ready.
• Bring your medical records or have them sent in advance if you’re seeing the doctor for the first time.
• Dress and present yourself as a successful, confident person.

Speaking Up During the Appointment

Don’t be put off by big words or a doctor’s impatient manner. If you don’t understand, ask the doctor to explain it again using different words. Don’t leave the office without understanding everything the doctor told you. If you have any concerns you’d like to discuss that the doctor hasn’t mentioned, please bring them up. Consult your doctor to determine the tests you may need, based on your age (e.g., mammogram, colonoscopy). Don’t be embarrassed to bring up sensitive topics.

Don’t Withhold Information

Speaking up also means sharing all your knowledge about your body and health with your doctor, including any symptoms and health issues you may be experiencing. Be sure to mention all the medications, vitamins, and herbs you are taking, as well as any other healthcare providers you are consulting for your physical and mental health.

Bring Someone With You

Sometimes, people like to bring a friend or family member to a doctor’s appointment for support. A companion might help you relax, remind you of questions, and assist you in recalling what the doctor said.

Follow Up with Questions

If you feel nervous or rushed, you might forget to ask a question. Don’t hesitate to call the doctor’s office later with any follow-up questions or concerns.

Alternative & Complementary Medicine (CAM)

Some medical professionals have begun to integrate these two approaches to medicine into their practices. They typically make it known that they integrate what they consider the best of traditional and complementary and alternative medicine (CAM) approaches into their practice. There are also doctors who are opposed to complementary or alternative medicine.

One of the challenges with CAM therapies is that there has been a limited amount of clinical research into the effectiveness of many treatments. If you want to consider how CAM therapies might help, you need to ask what type of medicine the doctors practice. Just as important, ensure that the doctors or healthcare providers you choose have extensive experience in treating your condition. If you have a good relationship with your current doctor, you may want to discuss your interest in possible CAM treatments with them

You can accomplish that with the following steps:

1. Tell your doctor about your interest.
2. Ask if they would be willing to explore options with you. If your doctor is open to considering complementary and alternative medicine (CAM) treatments, learn as much as you can about therapies that are suitable for your specific medical condition.

Tip: Be cautious when using authoritative and trustworthy sources during your research. Many CAM books, websites, and businesses focus on selling something that may not be credible or have proven outcomes.

One reason why many doctors don’t recommend complementary and alternative medicine (CAM) to their patients is that evidence is lacking to prove its effectiveness. Conduct thorough research to identify CAM therapies that have been published in peer-reviewed journals. Without that evidence, your doctor is unlikely to support your care, and your insurance company is unlikely to cover the treatment.

3. Once you have found a therapy that you believe will help you and have reviewed the evidence to support it, record the source or copy the information to take to your next appointment.
4. During your appointment, discuss your findings with your doctor and summarize the key points you have learned. Do not hand your research to your doctor unless they ask for it. Together, the two of you can determine the next steps.

Using this approach will strengthen patient-doctor communication and your partnership, creating a mutually beneficial situation where both parties learn something new about potential ways to improve their health.

Mental Health

Finding the right mental health provider is crucial for effective treatment. It’s essential to choose someone with whom you feel comfortable and can discuss openly. Consider factors such as age, religion, or cultural background that may help you feel more at ease. Don’t hesitate to limit your choices based on your comfort level. Recent efforts have increased access to mental health services in local communities. Remember, a strong doctor-patient relationship is fundamental to good care.

Finding a Mental Health Professional

Begin your search with these steps:

• Consult your primary care physician, as many illnesses can mimic mental health symptoms.
• Seek recommendations from trusted sources, such as ministers, friends, or relatives.
• Contact your health insurance provider for a list of covered local professionals.
• Understand your insurance benefits, including coverage and out-of-pocket costs.
• Make a call for help or ask a trusted person to assist you.
• Schedule an appointment, even if there’s a long wait.
• Attend your appointment, bringing a friend for support if needed.
• Prepare questions in advance to ensure you obtain the necessary information.
• Determine your needs, including medication, therapy, or other treatment options.

If you’re not comfortable with the provider, consider seeking an alternative option.

Psychiatrists or medical doctors can provide medication management of your condition. Therapists, social workers, or psychologists offer talk therapy and cognitive skills development. Many people work with multiple providers to address different aspects of their mental health care. Choose a provider based on your specific needs:

Payment Considerations

Verify that the provider accepts your insurance plan and review it to understand your coverage and co-payments. For those without insurance, inquire about fees and sliding scale options.

Collaborate, communicate, and coordinate with your chosen provider to ensure the best possible outcome.