Your Doctor Said WHAT?
“Is your doctor really listening? How to tell.”
Doctor-Patient Communication  
By Dr. Terrie Wurzbacher
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You're nervous. Your palms are sweating. You're looking at the floor. You're fidgeting. You may be glancing at your doctor out of the corner of your eye. You don't dare look directly at him. You're telling him what's been bothering you but you don't really know if he's listening. If he's listening, is he understanding?

Remember that talking is NOT communicating. You may think he's listening to you talk and he may just be. But does he know what you're saying? You know that you don't understand most of what your doctor says to you. There are so many different disconnects affecting your communication - upbringing, geography, education level, nerves, etc. There are many phrases that are specific to different areas of the country that the likelihood of a misunderstanding is high. Education and geographical differences are common causes of communication problems.
How can you tell if your doctor's listening? Don't look at the floor! Look him straight in the eye. Just because he may seem to pay attention to his computer doesn't necessarily mean he's not listening to you. In fact, it might be easier to talk about those "awkward" things when he's not looking at you.

Don't be timid. Explain your symptoms in an organized, short and concise manner. Then listen to your doctor to see what he asks you. Does it make sense to you? If not, ask him a return question "Doctor, I'm not sure I understand. I told you that I have had headaches every night now for a month and you want to know if I'm having problems with my bowels? Did I hear you right and if so, can you explain the relationship to me so I can give you a better answer?" By asking for clarification, you'll make sure you give a right answer and you'll get him to explain things better.

It's all about interaction. If you don't understand a statement or a question, ask about it. If you don't say anything, the doctor has absolutely no idea that you're lost. Interrupt if you don't understand. Don't wait for an opening. It won't come. You have to insert (and assert) yourself. You have to gauge his comprehension by his responses to you.

The doctor should be discussing your condition with you. Paraphrase what he says and repeat it back to him. Ask him to say your symptoms back to you.  This might help avoid some confusion. If you tell your doctor you're afraid you have "the sugar", who knows what the result will be. His opinion may become the reason for the appointment  and it will be radically different from your reason for being there. If you ask him to repeat back to you, you'll be able to tell from his words. For instance, he might say "Mr. Jones, I understand you're having difficulties eating sugar in your diet. I'm going to send you to a nutritionist to get you some help." You look bewildered. You say "that's not what I'm talking about. I'm worried that I have what my mother had, you know, 'the sugar'. She had to take shots every day and I sure don't want that to happen to me." The doctor should finally realize you're talking about diabetes.

Don't let the doctor put words in your mouth or twist your words. This may happen when you don't answer quickly or seem uncertain about how to answer. Don't "just" agree with a suggestion he has. Take your time and describe the pain or pressure the best way you can. Then ask him to repeat it. Tell him you're not sure you are getting your point across or making any sense. Say "doctor, I'm not sure if I just confused things even more with those answers. Can you tell me what you've heard so I can make sure you've got it right? I'm really sorry." This is a good way to recruit his help without seeming threatening or accusatory.

Take control of the conversation and when there is interaction between the two of you, you'll also be taking charge of your own health care.

Dr. Wurzbacher is a retired Navy Emergency Medicine Physician who recognized about early in her career that she wasn't good at communication and more importantly that she was probably missing much of what her patients were trying to tell her.Teaching young doctors and ancillary staff the personal aspects of medicine has become  a passion of hers. "Your Doctor Said What" is intended to help patients not only understand why many doctors seem like aliens but also how to empower themselves to deal with them. Check her out at http://www.yourdoctorsaidwhat.com and http://www.yourdoctorsaidwhatblog.com .



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