How to Talk to Your Doctor, Especially if you Disagree. How to Choose a New Doctor. #8
It’s a shame to leave the appointment feeling confused or ignored. And how do you bring it up if you think the doctor is simply wrong? I give tips in this video to get the right diagnosis and be heard. Some of the ideas are from the book I mention and some are from my own experience. (It’s a good book. Check it out.)
video content timeline
Patient story who was originally misdiagnosed but later got the right diagnosis [0:00]
My objective today is to help you get a better experience when you see the doctor [3:17]
Book: How Doctors Think by Jerome Groopman [3:48]
Doctors’ diagnoses are correct 85% to 90% of the time, according to the book [4:19]
You might disagree with the doctor or think something remains inadequately addressed. Ask these questions [4:47]
“Is there anything that doesn’t fit?” [6:11]
“Could I have more than one problem?” [6:58]
“What else could this be?” [8:16]
“What’s the worst this could be?” [9:20]
“What body parts are near my pain [or itching, or whatever symptom you have]?” The importance of anatomy knowledge [9:42]
“What’s your clinical reasoning for your conclusion?” [13:20]
“I disagree. I think it’s ______. What’s your clinical reasoning for thinking it’s not that?” [13:54]
I’m a big fan of second opinions. And of you taking responsibility for your health [14:50]
Ask these questions when you interview a potential new doctor [16:22]
How long have you been in practice? [16:56]
How many surgeries of this kind have you done? [17:04]
Do you tend toward immediate action with lots of tests or do you tend toward a conservative, watch-and-wait approach? [18:05]
How do you make yourself available? Email, phone, telemedicine, house calls, same-day appointments? When I come back, will I be scheduled with you or a nurse practitioner or physician assistant? [21:00]
The difference between seeing a nurse practitioner versus a medical doctor [22:15]
“But I’m satisfied with so-and-so.” Your satisfaction might not be all it’s cracked up to be [26:18]
Do these things to improve your visit [28:12]
Bring your medications
Say your deepest concern first thing in the appointment
Be direct, be candid, be truthful
resources
Book: How Doctors Think by Jerome Groopman
This paper finds that highly satisfied patients die more, are admitted to the hospital more, spend more money overall on healthcare, spend more on medications, and go to the emergency room less. The Cost of Satisfaction: A National Study of Patient Satisfaction, Health Care Utilization, Expenditures, and Mortality. Joshua J. Fenton et al. Arch Intern Med. 2012;172(5):405-411.