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Talking With Your Doctor |
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 Know
what you should expect from your doctor
When you are living with a serious illness, your relationship with
your doctor becomes especially important. You should feel secure in
that relationship, and you should know what you can expect. If you
have many doctors, then you should identify one as your primary
doctor. This is the doctor you call for emergencies, medication
changes, new or changing symptoms, and even to clarify what other
doctors may have told you. This doctor may be any of the doctors that
you have. If you expect one of your specialists to fill this role,
you should explicitly ask the doctor if he will do so. Many specialists
expect to limit themselves to advising patients, family practitioners,
general practitioners, and internists.
Other specialists, however, are prepared to be the primary doctor
who will see you through the frequent changes, complications, and
treatments of a chronic, severe disease. Sometimes a nurse, nurse
practitioner, or physician 's assistant will be your "primary doctor."
Throughout this book, and throughout health care, these professionals
function very much like doctors and we'll use the term "doctor" for
all.
Often expectations are personal. Only you can decide if a doctor has
a sufficiently pleasing personality, comforting bedside manner, and
respect for you and your time to establish or continue your relationship.
In fact, writing down what characteristics are important to you can
help you choose a doctor. But other expectations are universal; your
doctor should be competent, dependable, and have a professional demeanor.
Your doctor should also have reliable coverage "after hours."
Competence can be judged in several ways. You can ask if the doctor
is "board-certified" in his specialty or look for him in medical specialty
directories found in many public libraries. Doctors who are "board
certified" have had additional training and passed an examination
in their fields of medicine. You can ask how much experience your
doctor has in caring for patients who lived and died with your disease.
And you can ask how those deaths went. In addition, you should consider
your previous experiences with the doctor, as well as opinions of
friends or other doctors who referred you to him.
Dependability includes many different things. Your phone calls should
be returned in a timely fashion by someone who can reasonably be expected
to answer your questions. Dependability also means that getting information
about yourself and your situation should be easy. Test results should
be relayed to you promptly and in a professional manner. That may
mean a phone call or mailed note, but not an eternal wait. Ask your
doctor how you can expect to get this kind of information and how
long it usually takes for different tests to be completed. If you
are told, "We only call you if the results are abnormal," then you
may be in for days of uncertainty that fades but doesn't completely
disappear. If the "no news is good news " approach does not satisfy
you, ask how arrangements can be made to notify you when results become
available. Or, ask when you should call for the results, or give them
a self-addressed envelope to provide a reminder.
Your doctor should be professional in all aspects of your relationship.
That doesn't preclude a genuine friendship. It does mean that your
medical information and personal concerns are kept confidential by
the doctor and staff. It means that your care is not shaped by the
doctor's self-interest. Your doctor should be able to handle emergencies
at any hour and should be comfortable working in various settings:
hospital, nursing home, home, and emergency room. Your doctor should
also accommodate reasonable requests to stay in touch with your family.
For example, a particular family member could be called before the
patient leaves the office or after any examination. |
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Adapted from The
Handbook for Mortals: Guidance for People Facing Serious Illness,
by Joanne Lynn and Joan Harrold, copyright by Joanne Lynn, used by
permission of Oxford University Press.
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