Brenda Della Casa had been seeing her primary care physician for two years
and had brushed off her concerns about getting rushed care - until she had a
health scare she couldn’t ignore. She told her doctor she was experiencing
terrible back pain and stomachaches. Her doctor checked her, said she was fine,
and sent her on her way.
Five days later, Della Casa, an author and dating coach in Chicago, was
traveling and had pains so severe she could barely move. When she received a
“Communication is an inexact science,” says Bob Arnold, MD, professor of medicine at the University of Pittsburgh School of Medicine and director of its Institute for Doctor-Patient Communication. “Communication between doctors and patients is especially hard because the stakes are high and there are strong emotions on both sides.”
Some doctors are better than others at broaching touchy topics. Here are six things some doctors leave unsaid -- and what to do about it.
1. “You need to do something about that.”
Doctors are often reluctant to bring up a topic that might cause offense, even when there are pressing medical reasons to discuss it. A patient’s weight problem is one topic doctors sometimes shy away from. Others include whether the patient is depressed, smokes, abuses drugs or alcohol, has marital or sexual problems, or is experiencing financial hardship.
What to do: If your doctor fails to broach a topic that might be relevant to your health, bring it up yourself.
“Patients often think, ‘I will tell the doctor about this only if he or she asks me,’” says Richard M. Frankel, PhD, professor of medicine at Indiana University School of Medicine in Indianapolis. “They should be thinking, ‘Am I telling the doctor everything that I ought to be telling him or her?”
2. “You don’t need that drug.”
Direct-to-consumer pharmaceutical ads can be pretty effective at convincing patients that they need a particular medication (drugs to treat depression, diabetes, or erectile dysfunction are among the most heavily advertised) -- and even doctors can be swayed by these ads, notes David H. Newman, MD, director of clinical research in the emergency department at Mount Sinai Medical Center in New York and the author of Hippocrates’ Shadow. And when asked for a prescription, some doctors find it hard to say no--even when the patient doesn’t really need that particular drug.
Why is that? Ultimately, medical practices are businesses, and doctors sometimes fear that turning down a request for a drug could leave the “customer” feeling disappointed. “Doctors are terrible at saying ‘no,’” Newman says.
What to do: Newman says there’s nothing wrong with asking the doctor if medication might be helpful. But it’s a mistake to push a doctor to write you a prescription. “It can be dangerous to ask for things,” Newman says.
3. “I don’t know what’s going on.”
For all the advances in medical care, many ailments remain hard to diagnose and treat.