As of Friday, October 11, 2013
DEAR DOCTOR K: I like my doctor and I trust his judgment, but I don’t feel he really listens to me or explains things. What can I do, besides look for another doctor?
DEAR READER: Like every doctor, I am a patient as well as a doctor. I think I can see things from both perspectives. Let me respond first as a patient.
If you like and trust your doctor, I’d recommend that you put him to the test before looking for another. At your next visit, gently but firmly make certain things clear:
Suppose he says something you don’t understand. Tell him you’re sorry, but you don’t understand. Ask him to explain it again.
Suppose he recommends a particular diagnostic test or treatment. If you’re concerned about the risk, the cost or something else, tell him that, and explain why. If he mentions risks, be sure he tells you how likely the risks are. (Don’t expect a precise answer, but ask for a rough estimate: one in 10, one in 100, one in 1,000?)
Suppose, after hearing the answer, you don’t like the doctor’s recommended test or treatment. Then ask him if there are any other options that you both should consider.
Suppose you’re dealing with a potentially serious illness, or a test or treatment that has serious risks — a diagnosis of cancer, or a major operation, for example. If you’re not sure you agree with the option your doctor has suggested, you can always seek a second opinion. This is not something to do lightly: At least initially, you won’t have the same level of trust for another physician, since you won’t know him or her as well as you know your doctor.
Suppose, despite your gentle prodding, it becomes clear your doctor just isn’t interested in having you involved in making decisions about your medical care. It happens. In that case, I’d start looking for another doctor.
Now let me respond as a doctor. One of the hardest things for us is finding the time to do everything we need to do during a patient visit, given the time we have. That includes time for listening and explaining. You can help your doctor by making your time with him as efficient as possible.
If you have a chronic illness, remember the questions your doctor asks you at most visits. Be ready to answer the same questions at this visit. For example, if you have diabetes, think about whether you have symptoms that could indicate heart problems, such as chest pain or feeling as though you might pass out.
If you tend to forget what the doctor said at the visit, consider bringing someone with you — a spouse, adult child or friend. That person can help make sure certain questions get asked. He or she can also take notes while you speak with your doctor. The time you spend with your doctor is precious to both of you: come prepared to make the most of your visit.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.