How to get the most out of your oncology appointments

How to get the most out of your oncology appointments

As a patient, you’re entitled to ask your health care providers anything. In that sense, there are no bad questions.

But some questions will help you get more out of your interaction with your health care providers than others. This advice comes from my experience as a medical oncologist and a cancer survivor.

Before asking your questions, remember that you’re dealing with a human being. Doctors are not gods or saints. We try to remain professional, but just like anyone else, we prefer to deal with those who are pleasant.

You don’t have to hide your anger, but anger that’s not accompanied by constructive criticism can result in a very poor patient-health care provider relationship.

Next, you need to recognize that doctors don’t have unlimited time. Yes, we’d like to provide you with as much time and attention as you need, but the reality is that the time one health care provider has for one patient is limited. In many cases, we must prioritize our time to address the needs of patients in the most critical medical situations.

So, well-timed, organized and well-thought-out questions can make all the difference. Here are some things that you can do before you start asking questions:

  1. Ask if this is the best time to ask questions, and if not, ask when would be a better time. Doctors do appreciate this question.
  2. Prepare yourself ahead of time with an organized list of questions.

When you’re asking questions, here are some helpful things for you to communicate:

  1. “I don’t understand what you’re saying.” If you don’t understand, please say so. Also, don’t nod your head if you don’t understand. If you keep nodding, the doctor will assume that you understand and continue speaking.
  2. “Can you please explain that using simpler words?” Doctors have a tendency to use professional jargon, although we try not to. So, if you don’t understand something, ask for clarification. On the other hand, if the terminology seems too simple for you, ask for a more detailed explanation.
  3. “My understanding is X; do I understand this correctly?” It’s important to restate what you’ve heard to confirm that you understand. “Did we agree to X, then Y, then Z?” This is a good thing to do at the end of your visit.

Here are some questions or statements that are unlikely to be helpful:

  1. “Am I going to die?” Nobody knows. Although you may be tempted to ask this, instead consider asking about how long symptoms/illness might last, when the tumor might shrink, or when you can go back home or to work. Although doctors generally cannot predict overall outcomes, they may be able to estimate these more concrete aspects.
  2. “What would you do if this were your wife or your husband?” Unless you are very familiar with the personal values of the health care provider, you can get misled into a decision that you may not be happy with later on.
  3. “I don’t like (hate) clinical trials or chemotherapy.” Be careful before you say this. Doctors may remember your words so strongly that they will never bring it up in the future. If you change your mind later, you should say so; you would be surprised how much we’re influenced by what you say.
  4. Bad-mouthing other doctors versus providing constructive criticism. We are unsure of how to react, and we also wonder whether you will then bad-mouth us if you feel that we didn’t do well. Constructive criticism can be useful, but simply expressing strong emotions doesn’t help us.
  5. “I don’t know what I should ask” or asking no questions. This is like saying you have no interest in what’s happening. If you don’t know what to say, we don’t know where to start, either. If you honestly have no questions, at least state that you clearly understand the situation and the plan. If you really don’t know what to ask, consider questions like:
  • Can you write down the next step in the plan?
  • Why are we doing these tests?
  • Why am I receiving this treatment?
  • What are the side effects of this medication?
  • How effective is the treatment?
  • Please explain how the treatment will help.
  • Why do you think that this is the best treatment for me?

Remember, questions are one of the primary resources that you as a patient have to enhance your quality of care and treatment and protect yourself from poor care.

Naoto Ueno is Executive Director, Morgan Welch Inflammatory Breast Cancer Program, The University of Texas MD Anderson Cancer Center. Follow him on Twitter at @teamoncology.

Image credit: Shutterstock.com

Comments are moderated before they are published. Please read the comment policy.

  • http://www.facebook.com/profile.php?id=100000077801405 Jay B. Ham

    As an oncologist, how helpful would you find this question?
    “Am I more likely to die from my cancer or from something else?”

  • ButDoctorIHatePink

    Excellent article. i would not have thought to ask if it was a good time to ask questions. Since my oncology office went to EMR, my doctor spends a lot of time typing and I am uncertain when to ask questions, I don’t want to interrupt something important. So I let him ask me what he needs, and I answer and then stay silent while he does his data entry. If he finishes and leaves, my chance is gone.

    That’s why it is important for doctors to ask a patient if they have any questions before they leave the room. I often say no, because, as a metastatic patient, I see him every three weeks and I don’t have anything new to ask. I understand my disease well, I understand my treatment and I usually know where I am with it – I am not sure I need to explain why I don’t have questions and that shouldn’t be interpreted as a lack of interest.

    There have been times though, when I have not had questions because I truly didn’t know what to ask. When you are told that first day that you have cancer, you do not know what questions to ask or what direction to take, there is too much to think about. Sometimes, you need to educate yourself a little to even know what questions exist. That is why I like to get PET scan results, etc, in advance or at least read them at the time of the appointment. Not that my doctor doesn’t explain or tell me the crux but I find details that I don’t understand, and I want them explained.

    I think you have TV to blame for the “What would you do if it was your family member” question. I see that on shows with doctors all the time, last night in fact. It never would have occurred to me to ever ask a doctor that question as it’s quite personal, but it is becoming common because of TV.

    • southerndoc1

      ” my doctor spends a lot of time typing and I am uncertain when to ask questions . . . I answer and then stay silent while he does his data entry.”

      Wow.

      To hear a patient with metastatic disease say this, just indicates how far off track the whole system is.

  • http://www.facebook.com/ntueno Naoto T Ueno

    Thank you for your nice comments. Not having a question is ok to me. But it is extremely important for me to know that this decision was made consciously by the patients. I also welcome to revisit the question with e-mail system that we have at our hospital. If the question is complex or really important with urgency, we may further discuss this over the phone. Otherwise, I tell them to keep your questions until next visit. Sometime not answering the question is a reactive manner is important to learn how to cope with anxiety. Having an anxiety is normal but you do now want to have a patient to become pathologically anxious. At last, I also guide what kind of questions will be helpful to communicate better, Medicine is not simply about treating but it is about empowering the patients.