Want a Better Doctor? Be a Better Patient!
Who likes going to the doctor? No one, especially if you have something we all dread, symptoms: a sudden chest pain, a screaming headache, a nagging backache. Though the symptoms will vary, your goal is always the same. You want your physician to figure our what’s wrong. And you want to get well. Fast.
And that’s why Dr. Jerome Groopman’s classic, “How Doctors Think” (Houghton-Mifflin Co.), is so valuable for all of us who want to live a healthier, happier lifestyle. It teaches us to be a better patient. It recognizes that doctors are far from perfect. They make mistakes — as many as 15 percent of all diagnoses are inaccurate, according to one study he quotes — and the majority of errors they make are not technical screw-ups, but rather errors in thinking.
Doctors are under great pressure to perform, and perform quickly. They jump to conclusions they are comfortable with. They ignore facts that don’t fit. They have egos and emotions that can cloud their judgment and lead them astray. In short, they’re just like us.
So how can you avoid those problems and hugely improve the quality of your medical care? Here are some highlights from Groopman’s book. Read them, believe them, and use them.
— BE A PARTNER. To lower your risk of a wrong diagnosis, Groopman says, you can’t be passive or shy or intimidated. You must be involved. “Patients and their loved ones can be true partners with physicians when they know how their doctors think and why doctors sometimes fail to think.” Doctors who fail to think? Uh-oh. It can happen. Just knowing that will make you a wiser, better patient.
— TRUST YOUR INSTINCTS. If you sense your doctor is rushing through your exam, or isn’t listening to your story, or just plain doesn’t like you, pay attention. “Research shows that patients do pick up on a doctor’s negativity, but few understand how that affects their care, and they rarely change doctors.” Groopman’s advice? Change doctors!
— DON’T BE PIGEON-HOLED. Doctors think in stereotypes, just like the rest of us. The hysterical housewife, the overworked executive, the kooky hypochondriac. If you think your doctor isn’t paying enough attention to who you really are and what you’re saying, call him on it (humor helps).
— BE INFORMED. It’s OK, even desirable, to learn everything you can about your case “and respectfully question each and every assumption about the diagnosis and treatment.” You do this not because you don’t trust the doctor, or hospital, Groopman writes, “but because God did not make people omniscient.”
— ASK QUESTIONS. “What we say to a physician and how we say it sculpts his thinking. That includes not only our answers, but our questions.” You can positively influence your doctor’s thinking by asking smart questions: “What else could it be?” “Is there anything that doesn’t fit?” “Is it possible I have more than one problem?” If your doctor doesn’t have time for your questions, and isn’t capable of giving clear answers, say goodbye.
— SLOW DOWN THE PROCESS. Studies have shown that physicians, on average, give their patients only 18 seconds to tell their story before they interrupt. Yikes. You spend more time ordering at Starbucks. If your doctor is distracted — interrupted by staff, looking at the clock or a computer — speak up. Be polite but firm. “The inescapable truth is that good thinking takes time. Working in haste and cutting corners are the quickest routes to cognitive errors.”
— BEWARE OF CORRUPT PRACTICES. It’s well known but still shocking: Some doctors get financial incentives or kickbacks to prescribe certain drugs or do suspect surgeries. (“Spinal fusion may be the radical mastectomy of our time,” Groopman writes.) Ask hard questions, and pursue second opinions. And please distrust any doctor who tries to turn the natural aging process into a disorder.
Every year, tens of thousands of people die from medical errors. You don’t want to be one of them. It’s a life-saving cliche: The best defense is a good offense. Find a doctor you trust and respect and can partner with. Be involved. Ask questions. Take a friend with you to take notes and listen. And read “How Doctors Think” before your next appointment.
ENERGY EXPRESS-O! THE ART OF MEDICINE
My doctor is wonderful. Once when I couldn’t afford an operation, he touched up the X-rays. — Joey Bishop