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.
Things to Consider
Select the number (on a scale of 1 - 3) that best describes your situation for each item or issue. You can total your scores if you wish to get a big picture of the situation. Lower scores indicate less manageable situations -- situations requiring additional support beyond the primary caregiver -- and higher scores indicate situations that may be more readily managed.
The care receiver is usually:
_____ (1) Confined to the bed
_____ (2) Homebound, but not bed bound
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