Lack of Communication

In an effort to make this blog more intellectual (and less a recounting of everything I do during the day), I thought I'd start responding to articles and news that are medically pertinent. The first one I want to talk about is a actually a blog entry by a Dr. Brent Ridge, who happens to be a geriatrician at Sinai. Here is the link to the blog itself, but in case it gets taken down at some point, I am including the text here (it's not too long):

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Do you ever leave the doctor's office feeling a little unsatisfied with the visit? Are you ever frustrated by a conversation you've just had with the doctor? Do you ever think the doctor was outright rude? You're not alone. In this blog, I thought I'd try to convey the doctor's perspective. Being a caregiver for a sick relative or loved one is a difficult and often thankless and unrewarding job. More and more, physicians are feeling the same way.

To our discredit, doctors do have the habit of doing more talking than listening. Unfortunately, this has only become worse as managed care has strictly curtailed the amount of time each patient has with his/her doctor. While doctors do try to spend as much time with their patients, this time pressure constantly forces doctors to ignore the patient's own emotional health. Truthfully, if the doctor actually spends any amount of time at all addressing issues of the caregiver's sanity and emotional well-being, you should count yourself as very lucky.

However, I can't place the blame for the lack of communication solely on the doctor. Let's face it-- we are all human. Patients (and their caregivers) are not perfect, and also contribute to the lack of communication. In one survey doctors rated 15% of their patients as "difficult." Disagreements involve everything from expecting an instant cure to demanding prescriptions.

Patient and caregiver qualities described as "frustrating" by doctors:

• Do not trust or agree with the doctor. (You need to at least give your doctor the benefit of the doubt. After all, you are there for his/her advice.)
• Present too many problems for one visit. (I understand you are trying to make the most out of your visit; however, please remember, there are 15 more patients waiting right behind you.)
  
• Do not follow instructions (Again, you asking for your doctor's advice. What's the point if you don't follow his/her advice and instructions?)
  
• Are demanding or controlling. (Doctors are there to work with you to stay healthy--- not work for you.)
  
• Present themselves as overly helpless (You have to give your doctor some guidance in order for him/her to help you)
  
• Make a melodrama out of every symptom (Yes, it is important to let your doctor know every symptom. However, over dramatizing each one can be counterproductive. If you do so, your doctor will not be able to gauge which symptom is more relevant in determining your illness)

Despite the common saying that the "squeaky wheel gets the grease", that's not how it tends to work with the doctor. Studies have shown that patients or families who make too many demands on the physician's time ultimately get less attention.

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I thought this was an interesting point that Dr. Ridge makes. We often hear reports of how doctors don't listen to their patients, about how doctors don't make decisions with the patient in mind, and how in general a visit to a doctor is an unpleasant experience. Dr. Ridge remnds us that the visit is really a two-way conversation between two people, each who has his or her own thoughts, ideas, prejudices, and expectations. It's only by really opening this dialogue that you are able to really have an effective doctor's visit. This, unfortunately, often gets lost, especially when physicians are under pressure to see as many patients as possible.