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Communicating with Your Primary Care Physician

Your grandmother probably remembers how the doctor used to make house calls, or how she could go into the office and talk to him (and in those days, it probably was a him) without an appointment. But the pace of modern medical care has changed that dynamic.

Today, it’s normal for primary care providers to be pressed to see as many patients as possible in a day and for patients to bounce between practitioners in a group practice. Patients have their own busy schedules, too, and they want to get in and out of the office quickly.

In light of this, having a strong relationship with your primary care provider (whether you see a physician, certified nurse practitioner or physician’s assistant) is crucial to getting the most out of each visit. When it comes to doctor-patient communication, women have an advantage, says Debra Roter, Dr.P.H., a professor at the Johns Hopkins Bloomberg School of Public Health who has studied doctor-patient interactions and communication dynamics for more than 40 years.

“Women tend to talk more in medical visits; they ask more questions, they’re more likely to talk about aspects of their daily lives, their lifestyles, their feelings and emotions,” Roter says. All of these things are part of what she calls patient-centered communication, and they help doctors tailor advice and treatment.

Whether you’re already a great communicator or you feel like you want your doctor to understand you better, Roter offers four key elements to maximize your visit.

1. Set an Agenda

Many doctors’ visits last only 15–20 minutes, so it’s important to prioritize your concerns by setting an agenda, Roter says. According to her research, the length of an appointment matters less than its quality. Before the visit begins, create a list of topics that you want to address. Introduce them at the start of your visit.

“The way in which time is used really makes a critical difference,” she says. “Your outline doesn’t need to be complex; it can simply be that you have medical problems, fears or worries that you want to discuss.”

2. Be Honest

Roter urges patients to be honest about worries and concerns. She calls this telling the “real deal.”

“It’s important to share things about your lifestyle, social obligations and relationships at home and at work,” she says. “Sometimes patients are fearful that the doctor isn’t interested or that it isn’t relevant.” But providing detailed information helps a doctor get the full picture of your overall well-being and assess lifestyle factors that might contribute to your health.

Also, don’t be afraid to bring up pain or a feeling that’s bothering you, even if it’s embarrassing. Your doctor’s job is to help you feel better, and he or she is required to protect your privacy.

3. Ask Questions

Medical visits can be overwhelming and sometimes even the most well-meaning doctor can present too much information too quickly and in complex terms. It’s OK to ask questions, and Roter stresses that you should feel comfortable asking as many of them as you need to understand your doctor’s advice.

“Sometimes people are reluctant to ask questions. Ask your doctor to clarify what they’re saying in plain language if they’re talking in medical-speak,” she says. “It’s perfectly fine to say, ‘Sorry, I’m just not following you. Can you explain that in another way?’”

Next, repeat the information back to your doctor. This will help you absorb it, and it will also help the doctor know whether you understood. And if you didn’t understand everything? That’s perfectly natural, too. Often, a doctor will need to repeat information in a different way so that it’s clearer.

Be sure your doctor has understood what you told him or her. For example, if you talk about a concern — such as a lump in your breast — and your doctor brushes it off, don’t be afraid to revisit the issue.

“We know from studies that physicians tend to reassure patients a lot, and patients sometimes feel that this reassurance is premature,” Roter says. “It’s fine to say, ‘I’m not sure you really heard how concerned I am about this.’”

If you emphasize your concerns, your doctor can explain his or her reason for reassuring you and revisit the issue more deeply.

4. Work Collaboratively

Finally, it’s important to work together with your doctor for the best outcome. If your doctor recommends a treatment, share your worries about possible side effects or questions about other options, Roter suggests.

This is a way to actively partner with your doctor to make treatment decisions that are most likely to work for you. It’s a win for you and a win for your doctor, so don’t be afraid to ask him or her to help you understand your options.

“A critical part of the conversation is saying to the doctor, ‘I understand that all treatments have risks and benefits. Can you help me compare these to other treatments?’”

Most of all, try to control your anxiety by expecting a good outcome before the appointment starts.

“If you enter the room expecting that the doctor is going to help you, then it sets the tone. The best doctors are trained in mindfulness, for instance, which tells them to take a minute to focus on the new patient and really see the person in front of them. And I think patients need to do this, too,” Roter says.

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