In one of our Goalistics communities, a woman with fibromyalgia commented that her doctor used air quotes whenever he used the term fibromyalgia. Sadly, this is a great example of a disturbed doctor-patient relationship. It seems as if the doctor either isn’t up to date on medical information or he simply chooses not to believe that fibromyalgia is a real condition. The patient in this situation has three choices:
1) Tolerate his ignorance, and hope for the best
2) Ask him why he uses air quotes, see where that conversation goes, and then evaluate whether you want to continue to see him, or
3) Find a different doctor
What would you do? The passive nature of Option 1 may lead to poor care. Options 2 and 3 are more active and offer more promise. Research shows that taking an active role in your care generally leads to the best outcomes. But sometimes it feels hard to cultivate a partnership with your doctor. There are a lot of issues to consider in developing a relationship that works. One way to approach the relationship is by asking what goals you each bring into the examining room. I want to touch on three common goals:
1) Time Goals. If you are like most patients, you want more time with your doctor. Your doctor probably wants to spend less time. Not because she doesn’t care, but because she is so busy. How can you remedy this? You can’t control your doctor’s time, but you can make the time together more beneficial by getting organized before your visit. Click here to open and print our “Get Organized” form. Fill out the form a day or two before your visit. Think carefully about your goal for the visit and write it out in the space at the top of the form. Be as specific as you can. Instead of saying “I need help with my pain”, try “The pain in my knee has gotten worse and I would like to understand why. I wonder if I need another MRI.” If you have more than one goal, list it, but don’t expect to accomplish too much in the short time you will have with your doctor. If you need more time, schedule a second appointment.
If you have questions about your previous visit, about your treatment, or anything else, write them out in the second section of the form. Take notes during your visit in the third section of the form. The remaining sections include information about the history of your pain. Use this only if your doctor asks for it. You want to be prepared
for questions, but you don’t want to get sidetracked by giving information that isn’t requested. For example, if you have your medications written, you won’t waste time trying to remember them. So, do not go in and thrust this form into your doctor’s hands. Make a copy in case your doctor requests it. But use the form to organize your visit. This will help you to use the small amount of time you have more effectively.
2) Pain Medication Goals. Many physicians have fears about overprescribing pain medication. Talk to your doctor about this issue and find out what his goals are for pain medication management for you. Before this conversation, decide what your own goals are regarding pain meds. “What kind”, “how much”, “how often”, “how long” are good questions to ask yourself before meeting with your doctor. Also, what are the costs and benefits of pain medications?
3) Treatment Outcome Goals. Chronic pain treatment sometimes results in a person who is pain free. Both you and your doctor may want that to be your outcome; depending on your condition, this may not be a realistic goal. Talk to your doctor about what you can realistically expect. It can also be helpful to talk about the amount of time it may take until you notice some improvement.