Getting the most out of a visit to the doctor

Mary Hawkins has a lot to say about doctor-patient relationships. She says it in a new book called Health Talk: How to Communicate with Your Doctor.

Hawkins is a former health columnist with the Ottawa Citizen. She also teaches communications skills at Algonquin Community College and the University of Ottawa.

She talked with Marilyn Smith at Fifty-Plus.Net.

Q: What made you write this book?


Health care is changing. Many of the services that were provided by the health care system are now being delisted. So people need to learn to communicate and negotiate their health care treatment.

Many people either don’t feel assertive enough or don’t have the skills to be assertive, to challenge their doctor, or negotiate treatment with doctors.

They don’t have the confidence to challenge a doctor who might be abrupt with them. They leave feeling upset, hurt, and they either never go back, or they go looking for another doctor.

So I thought—it’s a two-way street here. The doctor-patient relationship is just another relationship we have in our lives. It’s one where people need to play a more prominent ro. And remember, we have information the doctor doesn’t have—we live with our bodies.

Q:Why do patients find it hard to communicate with their doctors?


The inability to communicate with doctors has always been there, partly because of the hierarchical view we have of the medical profession.

That’s changing, partly because of all the health information that’s out there on the Internet and in the media.

And the changes in the health care system require us to take more of a role in our own health care treatment. In order to do that, you have to communicate. You need to be able to participate in decision-making. And you need to be able to say to the doctor, look, I don’t like the way you’re speaking to me.

Q: Would you say that to a doctor?


We are all different personalities, so obviously, you have to take into consideration the different personality types. I think if you’re dealing with someone who’s very abrupt and very rude to you, then the best strategy is to use a polite, firm, and direct tone with the doctor.

Q: When does that come up—a doctor being rude to patients?


I’ve often heard patients say their doctors dismiss them in terms of time length—‘okay, we don’t have time to talk about this anymore, you’ll have to make another appointment’. Particularly in the emergency ward, you’ll get doctors taking patients to task for coming for minor things. And perhaps the patient needs to be spoken to firmly about that.

I’ve heard many women describe how doctors have spoken to them in a very dismissive manner.

I don’t want to give the impression that all doctors speak abruptly, because they don’t. There are many doctors who are very cordial, but because of time constraints, they may sound like they’re pushing you out the door.

Maybe they are in fact. Part of the reason may be that you’re not going to the doctor prepared. One of the ways to be prepared is to sit down before you go and note your complaints, in point form. And if you don’t feel confident to say to the doctor, this is how I feel, then give the doctor the list.

That’s written communication. The doctor can read it, and go over it with you.

If you handed it to the doctor as soon you go in, that’s dealt with right away, rather than dealing with things that don’t pertain directly to why you’re there.

If you wait to the last minute to say ‘this is why I’m here’, the doctor has to push you out the door, because there’s a whole line-up of patients.

Q: What can older people, seniors do to improve communications with their doctors?


Many seniors will say that what they say is not taken seriously, that they’re regarded as not having as much information as the doctor has.

I say the doctor may have a lot of medical information you don’t have, but you have information about your body. You live with your body, you know how you respond to certain things, or at least most of us do.

You should really reflect on how you feel when, for example, you have stomach pain. Is it burning, gut wrenching? Is it surface or deep pain? Does it feel like a muscular pain, does it feel like it’s twisting, or does it feel like the bone is jabbing into your side?

Come up with metaphors that give further explanation to your doctor.

Listening skills are very crucial. And that’s why it’s good to have someone with you. A couple can finish each other’s sentences. In one scenario in my book, the husband describes the wife’s cough for the doctor.

Q: How can grown children help their aging parents deal with doctors?


You may be driving them to the doctor, watching out for them, making sure they get their medications. So the adult child needs to negotiate with the parent, get information from the parent as to how they feel, ask questions.

You need to draw out information so that when you go to the doctor with them, if the parent is not conveying the information, then you can convey it. Or you can help your parent write down how they feel. Treat the situation as you would want to be treated.

Q: What’s the reaction of the medical profession to the advice you give in your book?


Medical people who have read it—I’ve had very good feedback from them. And they themselves have admitted to me that they do not always communicate very effectively with the patient. And they agree that the patient needs to play a larger role in this.

Health Talk:How to Communicate with Your Doctor

by Mary F. Hawkins is published by Macmillan Canada.