Without doubt, communication is crucial to good health care. When people
take an active role in their care, research shows they fare better -- in
satisfaction and in how well treatments work. A passive patient is less likely
to get well.
Yet patients often don't speak up for themselves, says Dr. Paul Haidet,
staff physician at the DeBakey VA Medical Center, in Houston.
Hannah Kalil is 83 years old, and lives by herself in upstate New York. She
has aides who help with her caregiving throughout the day. But the
responsibility of managing her finances, health care -- both mental and
physical -- and long-term living situation falls to one person: her daughter --
and my mother -- Eleanor.
It's almost a full-time job. Making sure my grandmother is happy and not
feeling lonely means daily visits. Her never-ending stream of medical issues
means weekly -- if not...
Haidet learned this lesson first hand with a new patient complaining of a
cough. A 50-year-old Boston dockworker with no serious illness in his past, the
patient said the cough had been hanging on for three weeks. Haidet noted the
details, performed a physical exam, and diagnosed an upper respiratory tract
"The guy had a cold," Haidet tells WebMD. He recommended cough syrup
and was about to leave, but something gave him pause. The patient "just had
this weird look on his face," Haidet recalls.
Haidet learned that the man's best friend had recently died of lung cancer and
when his friend was diagnosed, he had a very similar cough. As a longtime
pack-a-day smoker, the patient was afraid his number was finally up.
The Ideal Doctor-Patient Relationship
Chest X-rays eventually showed the patient had no tumors, but Haidet was
astonished by the difference between what he thought the visit was about and
what the real reason was. He had assumed the man wanted him to treat his cold,
but he really wanted to be assured that he didn't have lung cancer.
Haidet, who now runs part of a program at Baylor College of Medicine that
helps people communicate with their doctors, feels sure that the patient
"would have kept going to doctors until somebody unlocked that story and
addressed the real issue for that visit."
The ideal doctor-patient relationship, says Haidet, is like a meeting of two
"experts." The doctor comes to the meeting with medical expertise.
"The patient is entering with contextual knowledge, what these symptoms
mean in the broader context of my life, and what kinds of therapies that
broader context is going to support," he says.
So, how do you manage an "expert" meeting of the minds with your
The ABCs: How to Talk to Your Doctor
The Baylor program hosts "How to Talk to Your Doctor" workshops in
the Houston area. The workshops are intended for those who need advice the
most, such as seniors -- who tend to be passive in the doctor-patient
relationship -- people who speak little English, and cancer patients.
"We've tried to boil it down to a simple mnemonic: ABC," Haidet
A: Ask Questions
Jessie Gruman, PhD, has more experience talking to doctors than most would
ever want, having been treated for three different cancers at various times in