After a patient of mine had an arthroscopic partial knee replacement, he found that his pain was worse than ever. He went back to his orthopedist, who ordered an X-ray and assured him that everything was fine. But when the patient returned to the surgeon and said that he was still in severe pain, he was stunned to hear the doctor respond, “That’s not possible.” So the patient sought a second opinion and after undergoing a total knee replacement was told that his pain had come from a stress fracture in the femur, a rare complication of the first operation.
No one likes to be blown off, but when you’re concerned about your health, more than feelings are at stake. Here are five steps you can take in a doctor’s office to make sure that the physician is really listening to you.
Doctors get distracted when you give them a lot of superfluous information. (“I was on my way to the supermarket because we were all out of eggs, and my husband said he wanted an omelet that morning ….”) Lead off with your main problem: for example, “I’m here today because I’ve had abdominal pain for the past week.” Doctors call it your “chief complaint” and it helps them ask the right questions.
Regular office visits, as opposed to new-patient visits and annual physicals, are usually scheduled for 5 to 30 minutes. So it’s often difficult for doctors to discuss multiple medical issues without getting behind and keeping other patients waiting. Try to address one problem at a time and characterize it thoroughly. If there are several issues you want to address, tell the receptionist in advance that you might need a longer time. Or at your appointment ask your doctor if he or she has time to delve into another problem. If not, schedule another visit.
When rock singer Bret Michaels suffered a subarachnoid hemorrhage, he reportedly characterized the experience as feeling as if he’d been “hit in the head with a baseball bat over and over again,” which probably led doctors to focus on the thunderclap headache that is characteristic of the hemorrhage. Be prepared to describe to your doctor how long you’ve had the problem, how often it occurs, how long it lasts, and how severe it is.
The patient who always uses superlatives to explain symptoms risks being labeled as histrionic. Doctors listen more to someone they know to be level-headed when he or she says that the pain is “the worst of my life” than someone who always describes symptoms as most severe.
Let your doctor know if you feel that something important has been ignored. Nothing gets doctors’ attention more quickly than a direct statement such as, “I feel like I’m not getting my point across to you, doc.” They might be distracted by worries about a patient in the emergency room waiting to be seen or a patient they saw earlier in the day with a terminal illness. But most of them would rather hear what you’re thinking than have you leave the office angry or frustrated.