Let It Be Heard

Clear communication with your doctor improves quality of care.

Your (fill in the blank) hurts. It's getting worse, and your partner insists you see a doctor. Before you go, you should:

1. Prepare and rehearse a concise description of your symptoms.

2. Make a prioritized list of your health concerns, e.g., worrisome pain, weight gain, and maybe that ingrown toenail.

3. Record the names and doses of all medications you take and why you take them.

The correct answer is all of the above.

To best communicate with your physician, it's productive to prepare before you get to the office, says Edward Rosenow, M.D., retired pulmonologist at Mayo Clinic.

"Call it the 'art of being a patient,'" he says. Presenting an orderly, succinct, well-thought-out description of what brings you to the doctor can mean better communication, reduced frustration all around, and ultimately, better care.

That description should anticipate what the physician will ask: When (exactly) did the pain start? Is it sharp or dull? Constant or intermittent? What makes it better or worse? Any other associated symptoms?

While doctors want to provide excellent care, there's the omnipresent time crunch. Most appointments are 15 to 20 minutes unless the patient has specifically scheduled a longer time. A 2004 survey by the Commonwealth Fund shows that just 44 percent of patients think their doctor always spends enough time with them. When time is short, it can cause breakdowns in communication and quality of care. The survey found that 31 percent of adults with a serious illness said they left the doctor's office without getting an important question answered.

That's why it's critical to discuss your most pressing health concern first. Pain first, toenails if time allows. Complete medication information is a time-saver, too. When you see the doctor, bring all your medications with you -- in their original containers -- or write down a complete list at home. Multiple medications - perhaps prescribed by several doctors -- can be hard to remember. In a study of recently discharged hospital patients published in the August 2005 Mayo Clinic Proceedings, less than half were able to list their diagnosis, the names of their medications and the purpose or major side effects of those medications.

"No one's teaching us how to be good patients," says Dr. Rosenow. But the basics aren't hard. And preparing leaves more time during the appointment for the discussion, questions, listening and learning that are needed for quality care.