Saturday, November 17, 2012

Does your doctor listen to what you say?

 A few years ago, my primary care provider (PCP) wanted me to have a particular preventive test, which I declined. Several days later, I received a phone call from a receptionist wanting to set a date for the test. Clearly there was a disconnect between what I wanted and what my PCP heard me say.

This is more common than one would think. In fact, a new study says that in order to provide appropriate treatment, the doctor should consider the patients wishes.

Unfortunately, there can be a large gap in what a patient says and what a doctor believes. One study found that doctors believed that 71 percent of breast cancer patients rated keeping their breast as a top priority, but the actual number was just 7 percent. Another study found that patients with dementia placed far less value in being kept alive with severe mental decline than doctors. A third study showed that 40% fewer men preferred surgery for benign prostate disease after they learned about the risks of sexual dysfunction. BMJ News Release 11/8/12 

There a host of reasons for this disconnect, with too brief an office visit for a full discussion and/or the provider forgot to make a note of it in the chart, being among the top. While this can result in an irritating phone call, such as I received, it can also be a very costly error with patients receiving, or not receiving the care they want or need.

There are some steps you can take to make sure your provider knows what you want. Consider the following:

• Put it in writing-Whether it’s advanced directives or your concern about specific treatments, put it in writing and ask that this be kept in your chart. While e-mails are great, depending on whether your provider uses this method, giving them a printed copy can reinforce the message.

Use an advocate for medical appointments. They can aid in better communication and understanding. 

• Have the provider repeat back to what you said, so you can be sure that he or she heard what you said.

If you find that there has been more than one instances where the provider isn’t listening, and you’ve brought this to their attention, consider changing providers.

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