A doctor’s ability to provide care depends a lot on the information the patient provides
By: Bill Zolis
I’ve read that the first 30 seconds of our conversation with a doctor are the most important, and that what happens then – or doesn’t happen – pretty much determines the success or failure of the whole appointment.
I would say the first part of a “successful” medical appointment is that I feel that I fully and accurately communicated my concern to the doctor.
The second part is that the doctor listened, understood what was going on, told me what the problem was – if any – and explained to me what the next steps – again, if any – would be.
That’s asking a lot of the doctor, yes, but the first part of that successful appointment is actually not about the doctor at all. It’s about how well we communicate our concerns and describe our reasons for being concerned.
From what I’ve read, there are five big concerns that doctors have about the information patients give them when they come in for an appointment.
– Not getting to the point. It’s nice to chat, but…. doctors are busy people and have a very limited amount of time for each appointment.
– Vagueness. The patient reports things like not feeling very well, not sleeping, not having much energy… and so on. But nothing tangible.
– Too many symptoms. Then there are patients who report so many different symptoms that it’s impossible to know where to start.
– Too little information. Sometimes patients leave out or even deny certain symptoms or lifestyle issues because they are embarrassed and simply can’t talk about it.
Self-diagnosis. The patient looked up his symptoms on the Internet and is now convinced that he has a certain condition.
Handling medical information that we find on-line can be tricky, and it’s a bit of a balancing act. On the one hand, we all have a great deal of information available to us on the Internet. Most people, I think, will go straight to the Internet when they experience any kind of symptom or medical concern.
But the problem, from the doctor’s point of view, is an unfortunate thing called “Medical Student Syndrome.” I think most of us can identify with it. We read a list of symptoms for a given condition, and we start to think, “Wait a minute, I have some of those symptoms.”
But if we have one peculiar symptom that is concerning us, and we go online to look for information, we’ll probably find one or two possible conditions, each with a list of other symptoms and, well, you guessed it: we start thinking we have them all.
As a result, what can happen during those first few seconds of conversation with the doctor, is that we say, “Doctor, I think I may have such-and-so condition.” And that’s where the appointment can go off the rails. Now the doctor has to stop you, talk you out of your self-diagnosis, and start over by getting you to describe your actual symptoms.
So let’s back up and start over. It’s not about the condition you found described on the Internet that you now worry you may have, it’s about the symptom or symptoms you experienced that made you go look on the Internet in the first place.
A doctor will always look to signs and symptoms in diagnosing a condition. That’s what we need to focus on.
Signs, from the medical point of view, are things a doctor can look for and assess and possibly even measure. This could include a rash, swelling, redness, restriction of motion, abnormal test results and things like fever or vomiting. Signs are the physical manifestations of a disease or condition that can be detected through examination, tests, or other medical assessments.
Symptoms, on the other hand, are usually subjective, meaning they are experienced and reported by the patient, but not necessarily observable by a doctor. For example, symptoms can include difficulty sleeping, or feelings of nausea, pain, fatigue, or dizziness. These sensations are internal and can’t really be measured.
The signs you identify yourself and the symptoms you are experiencing are what should be telling the doctor. In fact, you may even want to write them down or make notes on your phone beforehand so that you can get straight to the point in those crucial first few moments of the consultation.
– Start with the headline: What is the reason you are seeking medical help? Get right to the point.
– Next, what are the most objective symptoms? “I haven’t been feeling well” is not very objective but, “I have been experiencing episodes of nausea all week” is objective.
– What are your definite signs of illness? Describe things such as cough, fever, diarrhea, vomiting and so on.
– What else is happening that’s out of the ordinary? Do you have swelling somewhere or restriction of motion in a limb? Do you have a rash, loss of appetite, a funny lump, dizziness or headaches? Whatever is going on that concerns you.
– Are the symptoms constant, or do they come and go? Does a particular situation or activity bring on the symptoms? Does anything you do seem to alleviate them?
– When did you first notice or experience this, how severely, and how often?
– Have you taken any measures yourself, such as over-the-counter medicines or using ice packs or heating pads?
– Are you taking any prescription medications? Don’t forget herbal medicines, supplements and over-the-counter drugs. It’s a good idea to have a list ready – or even to take the actual drug containers with their labels.
– Have you made big changes in the last little while? Did you start an exercise program, quit smoking, or try a new diet?
– Have there been life changes that could cause stress? Things changing careers, the breakup of a relationship, bereavement, parenting issues?
All of this is information we should have ready at the start of an appointment, whether it’s face-to-face in the doctor’s office or on-line in a remote consultation.
Yes, the doctor will probably interrupt fairly early in the description of signs and symptoms, but it will be to ask questions to zero in on the diagnosis – and lead to a successful appointment.
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Celebrating 25 Years of Penmore!
We just celebrated 25 incredible years at Penmore! A heartfelt thank you to all our amazing clients who have been with us on this journey. Your support has been invaluable. We were thrilled to have Mayor Steven Del Duca join us in the festivities—what a milestone! Here’s to the next chapter and many more successful years together!
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I really appreciate comments, ideas, suggestions or just observations about the blog or any other topics in benefits management. I always look forward to hearing from readers. If there’s anything you want to share, please email me at bill@penmorebenefits.com.
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