What do patients want from their doctors?

I would like my doctor to listen without a prescription pad in hand.

“confident, empathetic, humane, personal, forthright, respectful and thorough”

That’s my internist! Also my gynecologic oncologist and my cardiologist. I guess I’ve been lucky, but I’ve also been assertive enough to dump previous internists who didn’t listen, were impossible to reach, insisted on following their own agendas that had nothing to do with me, barely spoke then sailed out of the exam room before giving me a chance to ask questions, etc.

I also do what I can to make my office visits go well: I bring an updated list of medications, maintain a log of symptoms to help determine whether changes in treatment are working, bring a written list of issues ranked by priority so even if one of them take more time than expected, the issues we don’t get to are the least important, and take notes so I know what I’m supposed to do after I leave.

A good doctor/patient relationship has to involve some give-and-take. I think I’ve been lucky to have physicians who respect my intelligence and ability to understand my treatments and conditions. I also understand that they are busy people, that they have my best interests at heart, and that they do not always know the answers right away.

The best relationships are partnerships in which responsibility is divided between doctor and patient. It is up to my doctor to diagnose, treat, etc., and it is up to me to communicate clearly and effectively with my doctor, follow my plan of treatment and do my best to live healthily.

I’m going through what is turning out to be the very long process of being diagnosed with some congenital cardiac funny business. I find I truly appreciate the lengths that some of my doctors go to to help me understand exactly what is going on when I undergo an unfamiliar procedure or get new test results back.

When appropriate, a sense of humour doesn’t hurt either.

My patients want it addressed at the one visit so they don’t have to pay another $25 copay to return. I have tried to explain that I can only process so much information at one time and it seems they don’t listen. They want it all and they want it today. Even if they only called an hour ago for a sore throat and we worked them in, they then ask, “Can I get my pap smear and mammogram today too?” Oh and they need refills on all their medicines, even the ones that require complicated lab evaluations and then if they get them they do NOT come back for their previously scheduled appointment. Very frustrating.

“Indeed, it’s better to focus on a few issues well, rather than superficially covering an entire list.”

And even better to make sure all the patients concerns are addressed thoroughly.

If I make an appointment specifically to ask questions, hire a babysitter so there can’t possibly be any interruptions, and drive an hour to see my doctor, I don’t want to be rushed out the door in ten minutes. Doctors should have a pretty good idea what concerns a person with a specific diagnosis will have, so some basic education and tips on where to find reliable information could cut down on a lot of future questions.

@K – sounds like you need to find a different PCP. When I call my doctor’s office, I tell the receptionist why I want an appointment; if it’s urgent I’ll be seen the same day. If it’s not urgent, I might need to wait 3-6 days for an appointment with the doctor; I’ve always been able to see the ARNP on the same day I phone. If you always have to wait six weeks to see your doctor and he doesn’t answer your questions when you finally get in, it might be time to find a new doc.

@Family Physician & Stargirl65: I’d prefer to double-book appointments and pay a second co-pay than have to make the drive a second time.
I have a typed list of issues I want to address, which I give to the nurse when I arrive. My doctor always covers everything on my list, even though I have repeatedly said that I can make another appointment if we run out of time. Usually we stay within the time scheduled, but one time it took half an hour, and one time it took over an hour. I would gladly have paid extra for the extra time spent, but apparently insurance doesn’t allow that.

“I’ve always been able to see the ARNP on the same day I phone.”

Seeing the ARNP or the PA does nothing for the doctor-patient relationship. Most of the time I have to repeat everything again with the doctor wasting valuable time.

The last urgent issue I had I was shuffled off to the PA. When I had complications with my condition, my PCP was not up to speed and was unable to direct my care (and unavailable for an appointment.) Some relationship.

I have two clinics to chose from…they both operate under the same model of care.

Monica said “…I gotta say, I’m tired of the whining of physicians.” That’s funny, I didn’t really hear much whining in the comments above.
She also states: “If you don’t like it, you can go do something else.” This is true, and clearly many physicians are doing just that – or retiring early – or finding alternative career paths. But why would you want to state the obvious? Perhaps you feel there is no value in analyzing our health care system, including the many players (hospital administrators, taxpayers, physicians, nurses, patients , etc.) and their concerns. Well then, perhaps you should go read something else. For anyone who is trying to find solutions, though, it should be interesting to hear from providers of health care to see their concerns.

It is very hard to do adequate medical care when it is broken up into visits of 15 minutes or less, especially when a patient has problems that are even slightly complex. There are some tricks that make it easier to do barely adequate care under these circumstances, but the tyranny of the 15 minute visit is bad for patients, and for doctors.
What I don’t understand is why so many of us physicians act like the 15 minute visit resulted from an act of God, and must be accepted as inevitable.
In fact, the 15 minute visit is a product of the current system for paying physicians. And this system has largely been driven by how Medicare pays physicians, which in turn has been controlled by the opaque RBRVS Update Committee (RUC).
On Health Care Renewal, we most recently summarized the pernicious role of the RUC here:
http://hcrenewal.blogspot.com/2009/6/letter-from-RUC-and-my-reply.html

” Doctors are frustrated because they are having a hard time HELPING THEIR PATIENTS get better care while in the constraints of the system. ”

Doctors helped create the system. They sign up with these third party payment contracts, which to be honest have paid them exceedingly well over the last few decades. If they feel squeezed now then they only have themselves to blame. If you don’t want to be paid in 15 minute increments, then don’t sign the contracts that pays you like that. The choice is yours.

And Monica is right – stop whining. A lot of people who don’t make near as much as you work just as hard. And they don’t have the lobbying power you do.