Getting your doctor to listen

Jul 5, 2013

Have you ever been to the doctor and felt like you weren't able to tell your physician everything you wanted to? It's a common complaint and one that is hard to overcome. Dr. Leana Wen is a physician and the co-author of the book, "When Doctors Don't Listen: How to Avoid Misdiagnoses and Unnecessary Tests." Lorraine Rapp and Linda Lowen, hosts of WRVO's health and wellness show "Take Care" spoke to Dr. Wen about this issue.


Lorraine Rapp: What do you think that patients can do differently to try to get a better outcome? When you're in the situation, it's not always as easy as you would hope it would be to advocate for yourself. So what is your advice to patients?

Dr. Wen: When you're the patient, you already don't feel well, even if you just have a cold, you're already feeling rundown and tired, and not feeling like that's the time to advocate for yourself. And also, there is this mentality between patients and doctors, that the doctor is almost like your parent, that if the doctor says, "take this medicine," you say "sure." So that's why I emphasize it's so important to practice your patient advocacy in advance, and to know the pressures on doctors. Not saying that the health care system is perfect, but to say that we understand that there are certain limitations of our health care system. So here's how to work around it, and here's how I can practice ahead of time to be my best advocate.

Linda Lowen: In your book, you refer to "cookbook medicine." What do you mean by that, and why is that a problem in reaching a diagnosis?

Dr. Wen: A lot of patients think that if their doctor asks them a lot of questions, that that's a good thing. So you have chest pain, and the doctor says, "oh, when did it start? How bad is this chest pain?" And then, ends up doing a lot of tests, which patients also think, well, maybe this is a good thing that I'm getting all these tests done. But actually, be careful when you feel like you're being led down these pathways. Because, you should be treated like an individual. Just because you have chest pain, doesn't mean that you should be treated the same way as everyone else who comes in with that same symptom. You should look for these warning signs of being put down these pathways that are actually cookbook recipes, rather than that's tailored to your individual illness.

Linda Lowen: In your book, you concretely take us through what patients can be doing to better advocate for themselves. First... is tell your whole story. Why is this so important?

Dr. Wen: We know that 80 percent of diagnoses can be made just based on your history alone. That means your story is the key to your diagnosis. And actually that's better than any test or combination of tests that are out there. And yet so many patients believe that they should tell their symptoms and not their story. And so they'll tell their doctor something like, "Oh, I have chest pain, headache and nausea." But what if the patient, instead said, "I experienced sharp chest pains when I was walking. I stopped, I took a nitroglycerin pill and that gave me a headache. Then I became nauseous and I had to sit down." I mean, that would tell the doctor a lot more than just stating the symptoms alone. We know that doctors interrupt patients in less than 10 seconds. If you only have 10 seconds to tell that compelling story, you really have to practice it and get the high-impact part of the story out in advance.

Lorraine Rapp: Dr. Wen, do you think the threat of medical malpractice just hangs over doctors now more than ever and that's why they feel so compelled to follow along those lists and check things off, just to make sure they're covering themselves?

Dr. Wen: I certainly understand that this is something that people fear. However, I don't think this is a good place to be, where doctors are so afraid of our patients, that we don't trust our patients to partner. And that's why I emphasize that the best way for patients to get good medical care is for patients to say to their doctor, "Look, I'm the expert when it comes to my body, you're the expert when it comes to medicine. So let's work together to partner, to get the best medical care for me.

More of this interview can be heard on "Take Care," WRVO's health and wellness show, Sunday at 6:30 p.m..  Support for this story comes from the Health Foundation for Western and Central New York.