How to Talk to Doctors When They Don't Listen

From the WebMD Archives

Doctors don't always have a reputation for being the best listeners. Studies have shown that when patients start to talk, doctors tend to cut them off, usually after about 17 seconds. 

That can be frustrating, but does it really affect your care? If the doctor is skilled, how important is it that he or she listens to you? Very important, experts say. 

Without good communication, a doctor may give you the wrong diagnosis or order tests you don't need. And the less you and your doctor talk about your care or make decisions together, the less likely you are to understand or follow through on your treatment. Whether good dialogue makes you less confused or more invested in your own care, it matters.

"It's important that your doctor values and respects you as a patient by listening to you," says Martine Ehrenclou, author of The Take-Charge Patient: How You Can Get the Best Medical Care. "Your relationship with your doctor is really the cornerstone of good health care."

You might not be able to change some things that affect your doctor's attention span, such as the shorter and shorter visit times that are common. But you can take steps to make sure your concerns are heard in the time you have.

Why Your Doctor Might Not Hear You

Why do people think doctors don't listen? "Because often they don't," says Zackary Berger, MD, PhD, author of Talking to Your Doctor: A Patient's Guide to Communication in the Exam Room and Beyond.

"I think most doctors want to do a good job," he says. "But they lack the incentives. Doctors are paid for doing procedures, not for talking, explaining, or empathizing. Our payment system is out of whack." 

Other reasons doctors might not listen include:

  • They're rushed. A typical primary care doctor has about 15 minutes per patient. Some hospital doctors may have only 11 minutes with a patient. So your doctor likely has one eye on you and one on the time. Shorter visits also mean your doctor may be more likely to hand you a prescription than discuss, say, lifestyle changes that could improve your health.
  • They have a different agenda. You may come to an appointment armed with a laundry list of health complaints. But, with limited time, your doctor's goal is to zero in on your main concern. If you try to bring up others, the doctor may cut you off.
  • They're distracted by electronic devices. Doctors are often the first to admit that updating electronic health records on a laptop or answering instant messages on a mobile phone is distracting during an office visit. With an electric chart of information laid out before them, doctors -- and patients -- can also be tempted to skip talking.
  • Some doctors might be biased. A 2004 study of primary care doctors showed that white doctors tend to talk more and listen less to African-American patients. Doctors may also have set ideas about some patients that keep them from listening. For instance, if a person returns often with the same complaint or doesn't follow through on treatment, the doctor may be more inclined to shut him out.

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How to Talk to Your Doc

Prioritize. Decide on the three main things you want to know when you leave the doctor visit and focus on those concerns.

Tell a story. Don't just list symptoms. Tell your doctor what's going on and why it concerns you. 

Let's say you have shoulder pain. "A doctor is less likely to pay attention if you come in and say, 'My shoulder hurts and I want an MRI,' than if you explain, 'My sister had cancer that [spread] to her bone and shoulder. Now I'm really worried about a pain in my shoulder,'" says Berger, who's also an assistant professor at Johns Hopkins School of Medicine in Baltimore. 

Practice telling your story so that you include the most relevant information.

Ask a question. This pulls the doctor into a discussion. After you explain your health concern, for instance, ask the doctor what she thinks. 

Asking questions also inserts you into decision-making: "Could side effects from a medication cause my symptoms?" or "How much will this treatment help me?" puts you in the center of the conversation.

Put interruptions in context. If your doctor interrupts, it doesn't always mean she's not listening. "It depends on why the doctor is interrupting," says Sherrie Kaplan, MPH, PhD, co-director of the Health Policy Research Institute at the University of California School of Medicine in Irvine. "It could be …the doctor knows where you're going with it and isn't cutting you off." 

It might be annoying, but if you're still getting the information you need, it may not be a problem.

Ways to Ask Him to Listen

If you feel like your doctor isn't hearing what you're saying, be firm but pleasant with him, Ehrenclou says.

You could tell him things like:

  • "I know you're very busy and short on time, but it took a lot for me to get here. So if we could have a brief discussion in which we're listening to each other, I'd appreciate it."
  • "It seems like you're distracted. Shall I wait to go on until you can listen to me?"
  • "You seem very busy today. What's the best way to get in touch when you have a little more time?"

Any of these statements might be enough to make the doctor tune in. If not, you might suggest setting up another visit. Also, always find out the best way to reach the doctor in case you have other questions.

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When It's Time to Walk Away

Doctors can be under a lot of pressure to see too many people in too little time. But if yours doesn't let you ask questions, share in decision-making, or participate in your care, it's time to look for a doctor who does.

WebMD Feature Reviewed by Melinda Ratini, DO, MS on March 01, 2015

Sources

SOURCES:

Zackary Berger, MD, PhD, author, Talking to Your Doctor: A Patient's Guide to Communication in the Exam Room and Beyond, Rowman & Littlefield, 2013; assistant professor of medicine, Johns Hopkins School of Medicine, Baltimore, Md.

Center for Studying Health System Change: "Electronic Medical Records and Communication with Patients and Other Clinicians: Are We Talking Less?"

Dyche, L. Journal of General Internal Medicine, March 2005.

Martine Ehrenclou, MA, patient advocate and author, The Take-Charge Patient: How You Can Get The Best Medical Care, Lemon Grove Press, 2012.  

Kaiser Health News: "15-Minute Visit Takes a Toll on the Doctor-Patient Relationship."

Sherrie H. Kaplan, MPH, PhD, co-director, Health Policy Research Institute, University of California School of Medicine, Irvine.

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