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When your doctor won’t listen

04 May
O. M. Lanstrum, Physician, Helena, Montana. (1911)

O. M. Lanstrum, Physician, Helena, Montana. (1911) (Photo credit: Butte-Silver Bow Public Library)

Many patients go to the doctor with complaints only to feel they have never been heard.  You know when there is something wrong.  You know all the struggles in your life. You are your best advocate, unless you are fortunate to have someone help you out.  The question is what do you do “When your doctor won’t listen?” The main challenges in healthcare today include limited appointment time along with many patients who are misdiagnosed or undiagnosed.  Don’t let this be you. Always be proactive in your healthcare.

Know your doctor has a time limit.  Plan for 10 minutes or less.  Anything more is a bonus! Prepare questions ahead of time and stay with that topic.  Ask only medical questions. Leave other questions for someone else to answer in the office. When you are not sure, ask a nurse what questions you should ask.  That conserves the limited amount of time you have with your doctor.  Ask the doctor what they mean when using medical terminology.  Write down the terminology and take notes.  Tape record your medical appointments. (Read: Being A Smart Patient by: Dr. Oz).  If your doctor interrupts you, kindly ask your doctor to listen to your symptoms or to hear the entire question.  Always ask your doctor “What to expect next?”.  If they send you for tests ask your doctor “What do you expect the outcome to be? What information would the tests provide?”

You can do this by the following: First, when you visit your doctor take a list of the most important points you need to make. Think of all the questions you want to ask and write those questions out.  Do your research before going to the doctor if you are well enough. Don’t wait till you are nearly dead before visiting the doctor…your doctor may not recognize how ill you really are. This is a huge problem…because most patients do not go until they are extremely ill, than they are not taken seriously!  Sad fact, and no one will ever understand this because you have always been like that and you have likely been since a young child.

Dan J. Donohue, Physician and Surgeon, Glendiv...

Dan J. Donohue, Physician and Surgeon, Glendive, Montana. (1911) (Photo credit: Butte-Silver Bow Public Library)

Let them know what you are thinking, but emphasize and stick with how you feel.  Do not let anyone minimize how you are feeling, unless you truly feel you are simply anxious and need reassurance.  If you are dealing with a sense of worry and nothing else medically, a little reassurance can be comforting.

Make sure if you get progressively worse go to the emergency room. If they don’t listen or take you seriously return to the emergency room until they get it right.  If it’s an emergency … it needs to be handled as one.  Usually the basic tests are done and you are sent on your way unless it’s the obvious trauma patients or heart attack.  Even these problems can be subtle and missed on routine examinations.

If you feel your doctor is not listening to you make an appointment to interview the doctor.  Find out what they are thinking and how they think you should be treated. If they don’t have time for you that is a red flag.  Get a second-opinion or another doctor.  Do not provide your next doctor with all the details the first, second, third, forth, fifth physicians have provided.  You probably are not getting another opinion at all.  You may simply be getting feedback and labeling that occurs repeatedly in the healthcare system. This is still happening with the HIPAA regulations.  Don’t let HIPAA fool you.  It’s not a fool-proof system.  One doctor backs the next.  If you are looking for another opinion, they need to come up with their own tests and start from scratch.  You may need to have a new radiologist re-read your MRI, CAT scans, X-rays. Remember these tests are only as accurate as the person on that specific day.  Errors are frequent.

Doctor-patient relationships do not always work out.  If the chemistry is not there, you will never have a good relationship and what is more important than your life!  Of course when things don’t work out “you” will be considered the problem.  Few doctor’s will admit they are wrong. You will be at fault for not effectively communicating your needs.  How do you do this?  How do you ask the proper questions?  Sometimes it is necessary to get outside advice.  When is this?

You may have simply met an empass with this doctor and no longer have a working relationship.  If you don’t agree “fire them!”.  Your LIFE could be on the line.

Most patients don’t discuss what they suspect…because they don’t know what to suspect!  I believe this is true with nearly every patient.  I didn’t know, I wasn’t the doctor and I expected them to tell me what the symptoms meant.  Many times symptoms are not as serious as some patients believe.  More times than not, many patients will never see a doctor unless they have serious symptoms.  These patients are overlooked because physicians routinely will not think outside the box.

The patient is not at fault, but most healthcare professionals will believe it is the patient’s mistake not to communicate effectively.  This is not something that comes easy or naturally.  How do you know what to say or how to say it?  You need to be comfortable asking questions.  When you do not agree or feel your doctor is not listening get another opinion or find a new doctor.  You may not have a good working relationship.  It’s time to move on.

Ask what the medical terms mean.  Write down the medical terms.  Take notes during your appointment, don’t wait till later…you won’t remember it!

Patient-physician relationships are not a personality contest.  If you have that gut feeling that they are not listening and do not care, follow your intuition and move on to another doctor.  If you have a good doctor they will listen to you and help you.  The doctor has enough power to withhold treatment simply because their opinion is different than yours.  You know yourself.  Don’t try to prove anything.  Proving you are right could be years to decades later, and that doctor will not even remember who you are or what they did wrong.  That is if you live and they may be dead or simply not care.  If they don’t care now, they won’t care years later.  You are not on trial, but might feel like you are.  You should never feel this way.  If you do, move on to another doctor.

Patient Recognition Month Poster

Patient Recognition Month Poster (Photo credit: Army Medicine)

All we hear about are the malpractice insurance and the medical malpractice cases.  Most lawyers will not even touch a medical malpractice unless it is so obvious and they are nearly guaranteed to win the case.  If it takes much research, lawyers don’t want to touch it.  The reality is few physicians are held accountable for their mistakes as compared to those who are permanently disabled or die as a result of mistakes.

Mistakes are not verbalized openly.  Anyone who brings up the mistakes are subject to release from their positions in healthcare. Some institutions are finding that if they admit mistakes families do not pursue legal action.  Ideally, all healthcare institutions should do that to avoid causing further damage to the individual and their families.  They can all suffer for a lifetime trying to figure out why things are different and why their loved one suffers.  Suffering should never be the answer.

Physicians have exceptional attorneys representing them and they will find whatever they can to blame the patient.  The patient will be at fault because of: their age, pre-existing medical conditions, “never complained” even if the patient did, and a million different excuses.  The physician’s story will always be credible over a patient.

If you have a good doctor they will not mind if you tape your visits. They will listen and help you.  Many people have memory difficulties and almost all patients are so stressed they do not even remember what the doctor said during the visit.  Taping your visit will help you understand exactly what had been said so you can take control of your health.

Make a list of most important symptoms and points

  1. Make a list of most important symptoms and points

    Write down all the questions you have

  2. Write down all the questions you have
  3. Have the office staff make a copy of your symptoms to be put into your chart
  4. Fax into the office your symptoms on paper.  Leave a paper trail and keep everything in your own personal file at home.
  5. You need to be in control of your health and ultimately your life!

Good communication from your doctor includes the following:

  1. Speaks in understandable terms or explanations.
  2. Respects the patient.
  3. They know you are sick or injured and should never take advantage of these vulnerabilities.
  4. Does not stereotype patients.
  5. Does not interrupt patients.
  6. Effectively manage patients’ expectations by planning and helping the patient understand possible outcomes.

    Dr. Patient

    Dr. Patient (Photo credit: Wikipedia)

Here are two examples of expressing your concerns with your physician:

“Dr. Soanso, I have had these symptoms for the past 2 weeks and I’m getting worse.  I am not coming here to waste your time or my time.  I need your help now.  I am not able to work with these problems.  Please take these symptoms seriously and help get me back on the right track.  A friend had suggested it might be celiac disease.  I’d appreciate if you would explain why you do not think this is the problem?  Why are you not doing any tests to find the problem? What do you think the problem is?  Why do you think I am just stressed or anxious?”

“Dr. Soanso, I suffered a closed head injury one month ago. I still have symptoms.  The CAT scan was normal according to the radiologist. I am vomiting constantly, with confusion and severe worsening headaches. Please have another look at the CAT scan.  I heard many findings can be missed. I can’t live like this.  What do you think about MRI of the brain? A friend suffered years of disability because a missed subarachnoid hemorrhage that could have been prevented. They missed a blood clot after a head injury.  I do not want that to happen. I will not take medications for headaches until a blood clot has been totally ruled out.  I have concerns, but I am not making up my symptoms. Help me get back on the right track.”

 

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14 responses to “When your doctor won’t listen

  1. cindyhfrench

    May 4, 2012 at 7:25 am

    t his is really good solid information even if you don’t have a brain injury! And having had to find out the hard way that there were radiologists and neuroradiologists-good and bad has been a frightening experience! Us Baby Boomers grew up in the time where it was not done to question and doctor! I do now-but then I have had enough bad medicine practiced on me.

     
    • brain injury self rehabilitation (BISR)

      May 6, 2012 at 5:48 pm

      It’s sad that when one is ill and most vulnerable they cannot advocate for themselves, hence they are at the mercy of poor healthcare. At least there are some excellent professionals, but hope and prayer is all you have to get one when you’re not well. You know how difficult it is, and you live with the permanent disabilities as a result of crappy care with every breathe. I hope others begin advocating for their friends and relatives when they are not well.

       
      • cindyhfrench

        May 6, 2012 at 6:08 pm

        I do try and bring my husband with me-unless I don’t want him with me-but that is rare. Most of the time he needs to be there to hear everything I say and the doctor says and they can confirm with him that this is how she sounds, or feels or coughs or acts? And he can remind me if I don’t get all the directions and instructions right as he is likely to do-because he loves me, I know. It was very good when my sister went with me to the infectious diseases doc after Christmas. I wonder if I would be where I am now without her intervention…
        now it seems that my lot is just not to pick up some new infection, bacteria, virus, fungus-when I go outside of my bubble. I thought I was so careful yesterday- by 11pm I had pink eye! Glad I had eye drops! Didn’t keep me from Church this morning though! and what a wonderful message.
        Gave myself my IGG infusion this afternoon while wking on computer, paying bills, dealing with ins.-it never stops! I am so thankful I have the insurance now to pay for it, but my insurance agent has said I need to contact the national foundation now so that by the time I need it 4 yrs-medicare doesn’t pay for it-so neither does supplemental, hopefully the foundation will pick me up. The doc says I have to have this the rest of my life! just like a diabetic needs insulin!

         
      • brain injury self rehabilitation (BISR)

        May 6, 2012 at 6:35 pm

        It’s extremely difficult when you have no/poor immune system. What a hard balancing act to remain healthy, in your own right. Great advice to start looking to the national foundation to help with your medications that your supplement and medicare will not pick up. It’s a never-ending task trying to take care of your health, when one is already drained. It’s more than a full-time job. Remember the days when life was so simple…leave for work and return? Now, it’s a fight every day to remain alive and in the best of health possible. Keep me posted.

         
  2. thetickthatbitme

    May 4, 2012 at 12:08 pm

    Thanks for linking to my site!

     
  3. Lydia H

    May 6, 2012 at 11:36 pm

    Heck, a month after my TBI, I couldn’t have put that paragraph together corehently. lol. It was more like. “Head hurts, throwing up, dizzy. Did I say my head hurts? Yeah, the car accident.”

    It was a good post with great information. I think a lot of TBI patients need a friend or family member with them when they see the doctor. Friends and family can point out differences and symptoms the injured person may not see.

     
    • brain injury self rehabilitation (BISR)

      May 7, 2012 at 7:47 am

      You’ve summed it up well, how difficult it is trying to communicate after a brain injury. Because of this inability to put appropriate words together most general practitioners that do not understand brain injury will refer to psychotherapy rather than pursue the much needed physiological workup and appropriate therapies that could enhance one’s well-being with prompt treatment. I also find it very difficult for the general population to communicate when they are struggling with any unexplained illnesses. It’s really surprising that this communication barrier exists, when it shouldn’t with healthcare professionals.

       
      • Lydia H

        May 7, 2012 at 12:38 pm

        I think you mentioned a large part of the communication barrier. The clinicians just don’t have the time to listen. The “elevated” position of the doctor also adds into the problem. The doctor is the expert. It can be hard for someone to stand up to an expert. Or they think the expert knows….
        I was lucky that my PCP took the time to listen. She also knew me before the accident and the change in my function was huge.

         
      • brain injury self rehabilitation (BISR)

        May 7, 2012 at 4:16 pm

        Thanks for helping to clarify the communication issues. It is definitely not having time to listen. You also make a great point about standing up to an “expert”.

         
  4. heidirmoore

    May 7, 2012 at 12:00 am

    This is fantastic information. As I read it, I thought, where was this when I needed it? I have bookmarked this page, and I know I will refer to it many times. I wish there was a place we could refer your page for people with chronic illness. Your info is terrific!!!

     
    • brain injury self rehabilitation (BISR)

      May 7, 2012 at 7:55 am

      Thank you. I really don’t know how to put this information anywhere else. If you know, feel free to share it. I’m still trying to figure out this website. It really doesn’t come easy, but my thoughts of what I want to put out there are not difficult.

       
      • cindyhfrench

        May 7, 2012 at 9:57 am

        Hooray, do you feel validated! i do for you!

         
      • brain injury self rehabilitation (BISR)

        May 7, 2012 at 4:07 pm

        Yes, I do. I finally feel someone is getting the message I am trying to convey. If this touches just a few, it’s all worth it.

         

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