How to Talk to Doctors
Disclaimer: I am not and have never been a qualified medical professional, so this is informal, unqualified advice. If you have heart pains, shortness of breath, or feel unsafe in yourself or towards others, go straight to a medical professional and stop reading now.
In a past life, I once turned up to a new job to find two shoulders sitting on my new desk.
Thankfully this wasn't entirely unexpected, given I was an office manager for an orthopaedic surgeon. I quite enjoyed it as a job actually. The doctor I worked for was a middle aged Iraqi man who'd left after the first Gulf War. He'd just set up his own practice in New Zealand, and he worked twice as much as any of the other specialists in our building, which meant a lot of work for me. I picked up a variety of different skills [1] but by far the most useful has been learning how to talk to doctors.
It can be incredibly frustrating to try and get medical help, especially for invisible illnesses. But you can smooth the communication between you and your doctor in a way that allows you to express what's troubling you and gets them the information they need. As a medical receptionist, part of my job was to communicate information from a patient to a doctor and vice versa, and I also literally spent years reading doctors reports, referrals, medical test results, case manager files etc. so I'm in a unique position to be able to help here.
Caveats: I am not a doctor, and also these tips may not be effective if your doctor just plain sucks. Doctors are unfortunately susceptible to all the usual conscious and unconscious biases, and can be very bad at dealing with certain kinds of illnesses. Sometimes even the best communication will not get you a useful result. It's not your fault if it doesn't happen.
As I write this, I am literally applying an ice pack to my foot because I accidentally dropped a dinner plate on it, because I am graceful and elegant like the antelope.
[2]
I'm planning to go see a doctor tomorrow and hopefully get some x-rays, so I'll use this injury as an example for this post.
First things first: describe your injury or condition. This doesn't actually have to be that long, because we'll cover the other more detailed stuff later on. A succinct one or two sentences or so is plenty. "I've noticed my [x] is causing me trouble since [y] and I was wondering if something's wrong with it."
In my case, "I dropped a dinner plate on my left big toe and second toe last night, and now they're swollen and hurt."
In the case of visible wounds or injuries, don't panic. Your doctor works with these every day. To paraphrase the classic film Street Fighter, "The day you dropped a plate on your foot was the most important day of the past few weeks. But for your doctor, it was Thursday."
The doctor will probably want to see your injury, if it's something visible in a convenient spot. So you can show the doctor what it looks like, or if there is anything even noticeable about it. They might want to touch it too. At this point, try to be specific about when you started to see or feel something was wrong, and if it changed at any point. "Within minutes of the injury, my toenail started turning black as you can see here. The big toenail looks like it's at an angle compared to the other foot, but I'm unsure if it was like that before the accident."
I mentioned "it hurts" earlier. You'll have to elaborate on this. Since pain is super subjective, describing it is crucial to helping your doctor diagnose and treat you.
Here are some aspects of pain that you should consider:
- What does it feel like? Is it sharp, achey, dull, burning, prickly, stabbing, irritating, tender, pounding?
- When does it happen? Is it constant or do you only feel it when you move a certain way or do a certain thing? Is it worse first thing in the morning or at the end of the day, or does it remain the same?
- What helps with it? Which painkillers work, does elevating it or cold baths or massage or holding it a certain way help?
- What makes it worse? Any particular activities or situations, foods, temperatures, etc.
- Where is it? Is it everywhere, or is it localised to one spot? Has that changed?
It's a constant throbbing ache in the top right of my left foot and first two toes which hurts more when I touch it. It gets worse when I try to bend the toes, but ice packs and paracetamol have helped a lot. It's been about the same for the past few hours since I injured it.It's hugely useful to doctors to be able to tell them when something started, or at least when you noticed it becoming an issue. Depending on how long ago it was, you can get away with less specificity e.g. Yesterday, 2 weeks ago, around 3-4 months back?, last year, from about 5 years ago, when I was a kid in primary school... Fall back on "As long as I can remember" as a last resort. Other useful time-related things are:
- how often it happens - is there a pattern?
- how often you notice it and whether it becomes an issue then
- when any changes happened
The next thing they'll want to know is if it's affecting your day to day life. Many things aren't seen as proper "disorders" worth treating unless they're having noticeable negative effects. Some particular effects worth mentioning are:
- Does it affect your sleep? Does it prevent you from falling asleep or staying asleep or getting good quality sleep? This is a really big one, and definitely worth mentioning if it's the case.
- Is it preventing you from eating? This is another big one - whether it's affecting your mouth, or whether it stops you from keeping food down. Or for that matter, any other part of your digestive system - these are some of your most important bodily functions
- Does it affect everyday activities? For example my toe is making me limp, so I have to be careful of how I walk. Other things might be typing, sitting, concentrating, reaching up or down, driving, standing or getting up, wiping while on the toilet (seriously, this one is important!).
- Does it prevent you from doing certain activities? Have you had to give up a hobby because of your injury? Have you noticed a decline in your work performance, or have you had to take days off?
Keeping a diary is useful, or else if it's something you feel comfortable with sharing, you can ask people who spend a lot of time around you if they've noticed anything. I once used my online auction activity as evidence - every few months I'd make a whole lot of impulse purchases related around a new hobby, which formed a reliable pattern over the course of several years. Taking a support person when seeing a specialist can be useful like this as well - they can jog your memory, or fill in any blanks that you might have ("Oh yeah, like that time when..."). Your support person may even have noticed some things you haven't, which is even more useful information for your doctor.
Try not to tell them you’ve Googled it - see if they come to the conclusion first with all the information you've given. Doctors have a knee jerk reaction to WebMD, which is understandable given that everything is apparently cancer. You can mention “I read about it and what they describe sounds similar to my experiences”, but try to link it with the specific examples you've given above, which are less subjective. For example, "they mention irrational dread, and I've had trouble sleeping the past 3 nights because..."
They’re looking for, I guess, external evidence that something needs to be treated or investigated further rather than what you think or feel about it. So the more of that you supply in terms of experiences where it has been an issue, or times when people have told you it’s an issue, they’ll be more confident in diagnosing and treating you.
Getting emotional can help at times, but for the most part it doesn’t. If you can stick to the above communication style while crying or what have you, that can work, but they’re going to have trouble if you’re incoherent.
Try not to argue with the doctor. Having a good relationship with them, particularly your specialist, goes a huge way. Be polite even if they're being frustrating. The power imbalance sucks and if it gets really bad, remember you have the option of finding another practitioner. But hopefully, if you're managing a chronic condition or making regular visits, you can build trust over time with one doctor. They'll be willing to let you try things and have a better understanding of your needs, and you'll need to rely on less of this post to be listened to.
Break a leg!
