What's up, doc? Doc should ask you, too
"Don't be afraid to speak up," advises Dr. Leana Wen, co-author of "When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests" (Thomas Dunne Books, $26). "It's up to us to advocate for better care for ourselves." Credit: Handout
You leave your doctor's office without a diagnosis but with a litany of time-consuming and expensive diagnostic tests you must undergo. Worse, you don't think the doctor actually understood the symptoms you were describing, but you didn't say anything because, after all, you are only the patient.
Does this sound familiar?
"Don't be afraid to speak up," advises Dr. Leana Wen, co-author of "When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests" (Thomas Dunne Books, $26). "It's up to us to advocate for better care for ourselves."
Wen believes too many doctors are practicing "cookbook medicine," where conclusions are drawn based on a checklist aimed at eliciting one- or two-word answers. The doctor then heads to a prefabricated pathway of what Wen terms overtesting and underdiagnosing instead of making the patient a partner in the process.
"It should very much be a give-and-take," Wen says. "It should not just be the doctor saying, 'This is what we should do.'"
Wen says if a doctor cuts you off when you try to go beyond the one-word answers, do not be cowed. When the doctor interrupts you, feel free to politely interrupt the doctor. And do not be afraid to mention a possible diagnosis that concerns you. While your doctor should have your family history in your chart, do not assume he or she has looked it over recently. If cancer or heart disease runs in your family and you're worried you may have some of those symptoms, share your fears with the doctor.
Seniors, especially, may have a hard time correcting or interrupting the doctor. "It does seem to be that the older generation has a more difficult time speaking up," Wen says. Older adults remember a time when they built a relationship with a family doctor, not a primary-care physician. "But that relationship was built on a trust that may not be there today," Wen says. "And it's based on listening skills that also may not be there today."
Wen has been honing her doctoring skills — and listening skills — as an emergency room physician at Massachusetts General Hospital and Brigham & Women's Hospital in Boston. She was on duty at the Massachusetts General emergency room last month during the Boston Marathon bombings. She and her fellow ER doctors treated about 30 of the victims, an experience she recounts at bit.ly/wenbostonblog.
To help patients take control of their health care, Wen offers advice on her website, drleanawen.com. Click the book jacket for more tips.
