It’s time for more in the Speaking Up series.  In doctor-patient interactions, what types of things hinder patients from speaking up?

Shock – There’s a fair amount of shock involved with hearing the unexpected from a doctor.  If I go to see my physician about symptoms, I’m expecting to hear what I need to do to recover.  I’m not expecting a life-changing diagnosis.

The doctor is dealing with just one more case of a disease that he’s seen in many other patients.  He knows what the disease is, what the patient’s prognosis is, and has a good idea of the best way to approach treatment.  Why don’t patients speak up or ask for this information?  One reason:  we might be trying to cope with what we’ve just heard.

It’s a bit like being slugged in the stomach.  Initially, all you can do is try to catch your breath.  While the patient is trying to figure out what’s going on, the doctor walks out the door as he hands the patient a prescription with instructions to return for follow-up in two months.  By the time the patient has recovered enough to ask questions, the opportunity is gone.

Other times the doctor might overwhelm the patient with information before we’re ready to hear it.  If A, then BThis disease gets this treatment.  If B doesn’t work, we’ll try C or D.  The patient, however, is hearing words that aren’t even in his vocabulary.  If A?  What’s A?  I can’t have A!  Don’t talk about B & C & D when I’m stuck on A!

Over at Bedside Manner, there’s a post about The Balance of Power Between Patient and Doctor:

“Some patients like to receive a lot of information about their condition and prefer to be a leader or equal partner in making decisions about their health. Others would rather just have the doctor sift through the information and tell them what to do.”

The article goes on to suggest that instead of ignoring this situation, doctors should ask patients how much they want to know.

No doctor has ever asked me how much I want to know.  Even if someone did ask, I don’t know how I’d respond initially.  For me, there was too much shock in the beginning for me to have any questions.  It wasn’t until I was on my way out the door that I realized I had no idea what the diagnosis meant, how long I needed to take the prescription, or when I’d feel better.

I would have found it very helpful to hear, “This is a lot to take in right now, and you’ll probably have some questions.  Write them down and we’ll discuss them at your next appointment.”  Another thing that I would have found helpful:  resources.  A short brochure with basic information would have been nice, including a list of reliable websites and good books on the subject.  People who don’t like to read could be pointed to specific YouTube links for appropriate information.

When I was diagnosed, I walked out the door with way more questions than information.

  • What do I have?
  • Are you sure?
  • What is it?
  • Any chance there’s a mistake?
  • Why did this happen to me?
  • What are my treatment options?
  • What criteria do you use in choosing one treatment over another?
  • What if I decide against treatment?
  • Where can I learn more about this disease?
  • When will I feel better?
  • Do you know others who are dealing with this that I could talk to?
  • How often will I need to return for follow-up?
  • Is there anything else I can do in addition to swallowing all these pills?
  • Any idea how much I should budget for treatment?…

I, obviously, am in the “give me all the details” camp, but the shock of receiving a diagnosis kept me from speaking up.

Do you think that doctors should ask patients how much information they want?
Would you want your doctor to ask?

Other posts in this series:

  • Speak Up  
  • Hindrances 
  • More on Speaking Up