You may not have had a chance to give this very deep thought, as of late. But, it’s worth a moment. Your physician is someone with whom you have a close relationship. I would even say, “intimate”… in some cases, “deeply intimate”. You may find that you have to share information with your physician that you have shared with no one else. You may have to share the things of which guilt, shame and pain are made. This is often necessary in order for your provider to begin planning your care.! !
Perhaps you do not realize how much trust you must afford this person when the issue is occasional headaches or a sore throat. But the stakes become a little higher when it comes to questions concerning things like mental disease, sexual health, cancer scares or permanent and invasive procedures. By the time many of these issues arise, you may already have a physician to whom you will go; but, how did you choose him or her?!!
Years ago, we went to someone who came recommended by a trusted neighbor or friend. There was a time when we inherited our family’s doctor who may have been around for generations… literally. That person was likely to have delivered our grandmother, mother and her siblings and then provided care for all of their children. It’s also possible that that physician did all of those things, while taking care of various and sundry items, like sprained ankles, hypertension, colds and ulcers. Maybe that person even operated.! !
But things have changed. Gone are the days of Marcus Welby, MD. Small, once nuclear, communities have imploded, as younger members of society leave home to spread their wings. Medicine has changed drastically, so that medical disciplines are now highly specialized… thoroughly compartmentalized. In today’s society, strangers often live alongside one another;
the internet affords us anonymity and efficiency at the cost of intimacy; and the personal touch that accompanies human interaction is all but lost. ! !
In today’s world, it’s quite possible that you won’t have a relative or neighbor who can vouch for the good Dr. Jones, anymore. It’s very likely that you and your neighbors may have to refer to a panel of providers under an insurance plan in order to find a practitioner. You may find that you have to consult a directory to see who is credentialed and approved to see you. As you scroll through the list of names, how do you know who is compassionate? Or who is patient? Who will take the time to talk to you? Or even make eye contact?! !
It’s almost like being in a diner and having lots of choices, but not knowing how good everything might be… or even if things are good at all.! !
Many Americans are not privy to this last option. For those who are uninsured and relegated to indigent care clinics or government-run facilities, they are likely not to have a choice. Period. When they call to schedule an appointment, they will be assigned to a provider. Take it or leave it.! !
So what can you do to increase the likelihood that you will get a strong clinician and have a productive and respectful relationship?!
(1) ASK SOMEONE YOU KNOW.!
This is still the best way to find a physician with whom you feel comfortable. Ask a friend, neighbor or co-worker who they like (or don’t like) and why.!
(2) ASK THE STAFF!!
If you have the opportunity to see a physician in a group practice, ask the staff (off the record, of course), which provider they use; or to which provider they refer family members. If they indicate that they do not use any of the providers in that practice, there is a strong possibility that they have witnessed some things that made them uneasy. You might want to look elsewhere. Generally, office staff can tell you who the strong clinicians are; who has good bedside manner; and who most patients prefer. But the ultimate question becomes “… would they see that person?”. I would ask it.
(3) GIVE YOUR NEW DOC A CHANCE.!
At the end of the day, no matter who recommends a particular provider, ultimately, you will have to try them out. Try to keep an open mind, as well as open communication with your new physician. Discuss with this person whether or not you have significant anxieties about medical professionals in general or about your health and whatever problem brought you in for a
visit. Remember that your provider is not a mind-reader and will not know exactly what you need and want until you begin this dialogue.!
! Also, remember that intimacy is not established within one visit, nor is trust. It might be a bit awkward, at first, as any new relationship can be. However, if this provider shakes your hand when meeting you, looks you in the eye and listens to your concerns, you are probably off to a great start. A strong partnership can be built on this basic foundation.
(4) MAKE SMALL TALK AT YOUR FIRST VISIT.!
While your doc is examining you, inquire about his children or about her hobbies. Share what yours are. If you have a sense of humor, crack a joke. (No dirty ones.) And observe your physician’s response. What type of reactions are you getting? What body language and facial expressions do you notice? These seemingly mundane conversations can reveal a great deal about your physician’s personality and how he or she will regard you as a patient.!
(5) IF YOU HAVE BOUNDARIES, ESTABLISH THEM EARLY; SET STANDARDS FOR YOUR CARE AND COMMUNICATE THOSE.!
This is often an important, yet unrecognized component of any doctor-patient relationship. We often see the impact of the absence of communication in the field of Women’s Health. Every now and again, we will encounter a patient who has been the victim of sexual assault, and remains traumatized. In these cases, there is a strong chance that what she endured might significantly impact how she responds to gynecological exams. If she lets her provider know, up front, that this encounter is frightening and potentially traumatic for her, the two can have a constructive discussion. Together, they can plan how her exam is to be carried out, so that her concerns and autonomy are still respected and her dignity preserved.!
(6) REMEMBER THAT YOUR PROVIDERS ARE HUMAN.!
Once you have established a relationship with a provider that you trust and who you believe has your best interest at heart, please remember that they will have occasional bad days. It is more than reasonable to expect that they should always be professional; however, you may encounter them from time to time, and notice that they are not themselves… not as friendly… not as open… maybe just detached.!
If their behavior concerns you, say so respectfully. Give them an opportunity to explain their behavior or attitude, and to alter it, if needed. Your feedback may lead to a better experience for other patients, as well as for yourself in the future.
(7) “DON’T HARASS THE ANIMALS!”
If you are in a relationship with a provider for a long enough time, and if that relationship is honest, you will, at some point, encounter conflict. This might be a difference of opinion, or that you dislike something that you have observed or experienced within their practice.
Certainly, advocate for yourself. State what you find unacceptable and ask for resolution.
But, whatever you do, do it calmly and respectfully. Do not yell, curse at or threaten your provider or their staff. Not only will such behavior erode the substance of your doctor-patient relationship, but it is simply unkind.
During times that I have seen patients become completely inappropriate with a physician or staff members, the sign that is often seen at the zoo would come to mind. You’ve probably seen it too:
“Don’t annoy, torment, pester, plague, molest, worry, badger, harry, harass, heckle, persecute, irk, bullyrag, vex, disquiet, grate, beset, bother, tease, nettle, tantalize or ruffle the animals.”
If we are asked not to do that to animals, why would we do it to other human beings?
(8) REMEMBER THAT YOU ARE A CONSUMER.
Ultimately, if things just don’t appear to be working out, and you feel that you cannot communicate with your provider; or that he or she is not advocating for you; and you have addressed these concerns, you may find that the most constructive thing to do is to end the relationship.
Remaining in a situation in which you feel unable to trust your doctor, for whatever reason, will only further undermine your relationship. You will come to question every recommendation that is made, and not follow most. This, ultimately, is detrimental to your health.
In this situation, remember that you can always find a new provider. Finding the ideal one may take time, but it can be done. Look for someone who realizes that medicine is a profession of service. Your provider should feel that it is a privilege to practice medicine and for you to entrust him or her with so much. If your provider does not appreciate the sanctity of the relationship that you have, then you would fare much better by finding a more suitable alternative.
The next time that you are in the position of having to choose a new provider, consider, first, what you are looking for in that relationship and from that provider. Do you want a good listener, someone who freely shares information; or just someone who will attend quickly to your needs?
Once you have determined this, take the necessary steps to start building the type of doctor patient relationship that you feel will serve you best for many years to come.