Kickas.org Forums Ankylosing Spondylitis General Discussion #1 AS Web Support Group Communication With Your Doctor

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Improving Communication with Your Doctor Can Better Your Healthcare

"How better communication leads to better results"

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I personally think that at least half the misdiagnosis and failure to treat deal with patients not telling the docs the whole picture and the Docs lack of ability to mind read.

i used to worry that it was me. my fault. something i was either not doing, or doing wrong. then i met dr B and then dr P, and realized i couldn't have communicated any better.

but rather than it being the patient or the doctor, i do think sometimes its more of how two people get on together. finding a doctor with a style that gels with ours may be the key. i think it is for me.

also, another thing i discovered that i think makes it hard for people with autoimmune and autoinflammatory diseases to get diagnosed: flaring. the doctors that didn't dx me didn't seem to believe the things i was telling them, they had to see it with their own eyes. but dr B and dr P just believed me. when i commented to them about that, they said, "why would you make these things up."

i think some of it is a matter of trust. patients trusting doctors. and doctors trusting patients. without trust, i don't think communication can be very effective. well, that's my experience anyway.

I'm not sure that it is all up to the patient to "tell all". Doctors have to be alert enough to know when to ask or probe a bit further, and that seems to be an art that is being lost. They also have to know how to ask questions to get useful answers. In the 70's when I was working in a hospital that had medical students the whole art of interviewing patients was given a lot more attention that it seems to now. I've been incredibly surprised (and worried) by how little every one of the NHS doctors I have seen in the last 6 years has actually asked me, and by how much my answers have been misinterpreted when I have finally got to see what they wrote down.

If the onus is put on the patient to tell the doctor, how do they know what is relevant? For example even questions like "is your bowel habit normal" is a stupid one - how do you know what "normal" is, particularly if you have had problems for years? If a doctor really wanted to know the answer to this question, for most people they would need to show them the Bristol stool chart and ask them to indicate which picture was closest, as well as asking specifically about frequency and discomfort, but how many doctors do this? I think the big thing for patients responsibility though is to answer truthfully and not minimise problems.

It is so so not up to the patient in all cases. Doctors fall in huge pitfalls, like blindly trusting previous diagnoses, lack of knowledge but not seeking additional information or specialist help, overtrusting own abilities, "battlefatigue" from patients with a multitude of symptoms that are hard to discover the reason for etc.

When it comes to Doctors, it's up to us all to be very aware of the fact that Doctors are you and me. In your work and your life, you make mistakes all the time. A doctor is not a superhuman, he is just the same as you and me. They make mistakes all the time. The fact you are a highly trained specialist does not guarantee you from mistakes. In fact at times it clouds your judgement. The fact that there is a culture in the medical community to deal with wrongful treatment in quiet, so "good doctors will not get their career destroyed from mistakes everyone makes"...has contributed to awful results for some patients that could have been saved, had they known all the facts and risks.

The best thing we can possibly do for our doctors, the most caring and best help they can get, is for US to doublecheck everything, grow as informed to our conditions as we possibly can, and be involved in all descitions!

Love
gilth
This above all

I think that assumptions are a big problem in the doctor-patient relationship. Doctors assume that patients are forthcoming about all symptoms and problems, where a little effort could reveal much more about the condition. On the other hand, patients often assume that doctors are much more intelligent and clever than they really are when in comes to diagnosing problems. As such, patients fail to ask for clarification or fail to provide all the details about their problems. Brings to mind the old quote: "When you assume, you make an '@ss' out of 'u' and 'me'."

--Greg

I think my doctor is suffering from the 'Battle fatigue" mentioned above. I also think I am suffering from the same condition. He referred me to another doctor. I cancelled the appointment, it is a group of Rheumatology rehabilitation and electrodiagnostic treatment .... bla,bla.
This came about when I told him the meds were not working, I did take more than prescribed, but I only did it to get through the night at work. Even at that they did not diminish the pain and cramping one bit. I was just being honest, and was not out of meds, he assumed I was abusing the the pain meds And was out. I explained to him then why I even take the meds, SO I CAN WORK. I can do without them otherwise. at the time I has a stricture, hiatal hernia, and gastritis, along with the AS. the medicine I was taking was making more problems than helping.
The reason I cancelled the appointment was for several reasons, reason 1. I had no paycheck for two months and could not pay the new patient fee, not to mention it was 150 mile round trip.
2. after my finances were somewhat in order I got the paperwork and was reading the terms and they said NO MARIJUANA.
That is a deal breaker for me, I can go 50 miles north to another state and get medical marijuana.
So next month when I see my doctor I will be honest, I disagree with the policy. So I didn't sign it. They are not the ones who need the weed to have a bowel movement.

Omg cemc, you are so en pointe. That is exactly how I feel! I majored in Communication Studies and do know that I am a great communicator. All the doctors I visited the during the 3 1/2 years just did not know how to communicate back or ask the right question it seemed...isn't that WHY I went to all these doctors? To have them ask the appropriate questions to lead to a diagnosis? It seemed I would tell them what's going on with me and their only question was "Are you allergic to anything?" as they were writing a Rx for an anti-inflammatory. I wanted to scream at each and every one of them and beg them to help me find the root of the problem! All they were worried about was getting me out of their hair and collect my $40 copay and the rest from my insurance....UGH!!!!