6 tips for getting your doctor to listen to you

Have you ever gone to the doctor and felt like he wasn’t listening to you? Have you tried to tell your story, only to have him interrupt with a checklist of questions: do you have chest pain, shortness of breath, fevers, cough, and so forth? Have you ever felt ignored, and left thinking that your doctor never understood why came to him in the first place?

Studies show that 80% of diagnoses can be made based on your history alone. Yet, doctors these days spend less and less time listening. “Cookbook medicine” is prevalent, with doctors resorting to checklists of yes/no questions rather than really listening to what’s going on with you. You have to make sure that your concerns are addressed—and even before that, to make sure your story is heard.

Here are 6 tips for getting your doctor to listen to you:

Tip #1: Answer the doctor’s pressing questions first. Many doctors are so accustomed to relying on a checklist of questions that they have to get these answers before they move on. Help them out and answer these questions. If the doctor want you to describe the location of your chest pain, describe it (“it’s in the middle of my chest, right here”). If she want to know what you took to make it better, tell them (“I took an aspirin. It didn’t help”).

Tip #2: Attach a narrative response at the end of these close-ended questions. If your doctor persists on asking close-ended questions, add a narrative response at the end that may not so easily fit into a yes/no answer (“it’s in the middle of my chest, right here, and it started after I really pushed myself in swimming tonight”). Pretend that you are being asked “how” or “why” instead of “yes/no”, and add your own response. Look to make sure your doctor registers this answer—does he ask you more questions to follow-up on what you said, for example?

Tip #3: Ask your own questions. If you don’t understand why a particular question is relevant to your situation, ask about it. You may be surprised to find that the doctor herself isn’t sure and is only asking the question out of habit. On the other hand, you may find out that issues you wouldn’t have thought were related might actually be very important to discuss.

Tip #4:Interrupt when interrupted. If your doctor cuts you off when you try to explain your full answer, free to interrupt. Pretend you’re having a conversation, even when it feels like you’re being interrogated. For example, if you’re asked “when did headache start,” rather than responding “10am,” go ahead and tell your story of how the pain started: “I woke up this morning and I was fine, then I started walking to work and the pain came on suddenly like a lightening bolt striking me.” This is not a new tactic; lawyers will often coach clients in advance to answer yes/no questions with a narrative so that answers can’t be taken out of context. Interrupting is a way to ensure that your entire answer is heard, not just the part that the doctor thinks he wants to hear.

Tip #5: Focus on your concerns. If you get the sense that your concerns are being brushed over, interject, “Excuse me, doctor, I have tried to answer all your questions, but I am still not certain my concerns have been addressed. Can you please help me understand why it is that I have been feeling fatigued and short of breath for the last two weeks?” and so on. You can take charge of the conversation at that point. It’s your body and your duty to advocate for yourself if you don’t feel like your story has been understood and your concerns have been addressed.

Tip #6: Make sure you are courteous and respectful to your doctor. Your doctor is a professional, and is probably trying her best to help you. Your story has to be heard and your concerns addressed, but make sure you present your points in a respectful manner. This will ensure that a solid doctor-patient relationship is present, and is critical to the partnership you need to establish.

Leana Wen is an emergency physician who blogs at The Doctor is Listening. She is the co-author of When Doctors Don’t Listen: How to Prevent Misdiagnosis and Unnecessary Tests.  She can also be reached on Twitter @drleanawen.

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  • buzzkillerjsmith

    Tip #7: Get out phone book and start looking for a new doctor when your old one fires you for not understanding the supply/demand mismatch in medicine, for asking too many questions, and for being an overall pain.

    • drgg

      Zing!!! Good one! Now you got to the heart of the matter!

  • http://www.facebook.com/profile.php?id=1599783541 Christine Mattson Carlson

    When I started getting migraines that eventually landed me in the ER because they would last 2-3 days with vomiting and no ability to function for 2 days I was referred to a neurologist. I was looking for a reason why these were happening, and to get an effective medication, after two visits the neurologist actually told me “Well, you only get them twice a month” – and would prescribe me a narcotic that would numb the pain but also make me knocked out and get rebound headaches. What an idiot!! He actually diagnosed me as having “tension headaches” which I know was definitely not a tension headache. So, I took matters into my own hands and researched my symptoms online, and I found a awesome migraine specialist in Chicago. After taking my medical history etc for ONE HOUR VISIT with her, she diagnosed me as having menstrual migraines and explained the entire process to me and why they happend, etc tec, She prescribed me Treximet which is a life saver and I can function and work without being drugged up. This neurologist guy I first saw had an award on the waiting from wall from a Chicago magazine. The last time I saw another doctor with this award, she also misdiagnosed me TWICE and I just ended up going to another specialist on my own for each problem. Needless to say, I don’t go to these two doctors anymore. In my experiences, general family practicioners don’t have a real clue and they just randomly tell you your “problem” based on a 5 min verbal assessment and say here take a pill. It’s always been better for me to find a specialist, research my symptoms online ahead of time and find someone who knows what they’re talking about and studies that particular area of medicine.

    • ninguem

      You needed a neurologist for common menstrual migraines? Treximent is sumatriptan and naproxen. Both are generic, though I suspect the two as a combo product are under patent and really expensive.

      Sheesh, I treat those all the time in primary care, though I would use the far cheaper generic sumatriptan and naproxen.

      The city magazine “best doctor” issues are paid advertisements and little more. The big box clinics and hospitals do the best they can to gin up votes for their own people, which helps their marketing. Having worked for one such big box for a few months until I’d had all I could stand. Their marketing people came after me frequently to “make sure I voted”.

      I know some doctors who are absolute flaming idiots, who made “best doctor” in those city magazines.

  • http://www.thehappymd.com/ Dike Drummond MD

    There is a common belief that doctors are not good listeners. That is not true. If your doctor is
    - overstressed
    - burned out
    - asked to see too many patients in too little time with systems (like EMR) that just get in the way of having the time to be present with you

    … that doctor is not a good listener. And I just described a significant percentage of the physicians at work today … and tomorrow and the next day for that matter.

    This is the single largest failure of “the system” or “business as usual” in medicine. This article is a symptom of that failure IMHO.

    Dike
    Dike Drummond MD
    http://www.thehappymd.com

    • kjindal

      it is all the more annoying when OUR OWN PROFESSIONAL COLLEAGUES vilify our profession in this manner, for personal gain eg. to sell books.

      • azmd

        Especially our own professional colleagues who are not in full-time clinical practice, or have chosen lucrative specialities which allow them the luxury of spending time with their patients, because it is appropriately reimbursed.

        • http://twitter.com/beenblessednana Rhonda Radandt

          Believe me, I have seen my share of specialists and NONE of them have the ‘luxury’ of spending time with their patients. They are just as busy and its no different than we I see my PMD.

    • http://twitter.com/beenblessednana Rhonda Radandt

      It is not the patient’s fault that the doctor is
      - overstressed
      - burned out
      - asked to see too many patients (EMR)

      If that’s the case, then that doctor needs to move on to something else.

      And now that medical CARE has become a business where the patient now receives medical TREATMENT, medicine can’t be trusted since its all about money (business).

      If you’re burned out, stressed out, being pressure to see too many patients, do yourself and your patients a favor and move on to something else.

      • http://www.thehappymd.com/ Dike Drummond MD

        I agree completely that it is not the patient’s fault. And your solution is naive to an extreme.

        Not sure if you are aware of it but a survey last year showed that 60% of doctors would retire today if they “had the means”. It is not taking care of patients that leads to this level of burnout and frustration.

        In large part it is the systems in which the doctor works that are responsible. In the vast majority of cases those systems are not constructed by the doctors … but by the very business professionals that are mostly concerned with money/profitability.

        You are pointing the finger in the wrong place when you vilify the doctors who are most likely victims of that same system.

        Concierge medicine is one place where business and patient care meet and work well together. If you want to see your doctor and have plenty of time whenever you are sick … that is the way to achieve it.

        Dike

        Dike Drummond MD
        http://www.thehappymd.com

  • http://twitter.com/FerkhamPasha Ferkham pasha

    Should a patient do his/her own research?

    • http://twitter.com/beenblessednana Rhonda Radandt

      Absolutely! You should be as knowledgeable as you possibly can be. You might even save your own life as a result!

  • Andrea Peakovic

    I felt I needed more time for an upcoming appt and called to request an extended consultation because I had several questions, and out of courtesy wanted to ask in advance. I was told appointments were 5 minutes max and that’s all the time I could have with my surgeon, and they did not ever schedule “extended consults”. Is this standard or acceptable practice? Btw, I found a new surgeon.

    • http://twitter.com/beenblessednana Rhonda Radandt

      Glad you found a new surgeon. 5 minute appointments with a specialist who supposedly has the ‘luxury of spending time with their patients’ is unacceptable.

  • http://twitter.com/beenblessednana Rhonda Radandt

    Being courteous to your doctor only goes so far. When you are not being heard and you attempt to advocate for yourself and you are still not being heard or they are speaking against your current doctors eroding your faith and trust in the ones they are speaking against, courtesy goes out the window. I just had an experience with a vascular specialist who must have magic fingers because all he did was two pedal pulses and a thumb press (+1 pitting) and he told me I don’t have a problem. Then he attacked my med list and the cardiologist. I was amazed that his rapid diagnosis went from no problem to my meds being the problems. Funny, though, I’ve had the problem for 15+ yrs. and have only be on the meds for 4 months. What a joke. Then when I tried to advocate for myself, he spun on his heels and walked out of the room saying he can’t help me.