Monday, January 19, 2009

Listen Up, Doc! - Tip #3

Time to get back to my tips for going to the doctor, taken from my book, Despite Lupus, due out this Spring. Check out my first Listen Up, Doc! post, Tip #1 (Ask Questions) or Tip #2 (Take Someone Along) if you'd like a refresher. Here's Tip# 3, titled "Recap and Review":

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Recap and Review

My doctor uses a funny little recording device at the end of each appointment to document everything that’s been discussed. While I now understand how sensible, even vital, it is to have a recount of the finer points of an appointment, I’d never seen a professional use a tape recorder before. In the beginning, it just seemed so melodramatic and over-the-top. Whenever he would launch into his full-bore recap of an appointment, I would avoid making eye contact and do my best to suppress my laughter. Who knows why it was so funny back then, watching him speak into a little recorder about all of the terrible things that were happening to my body. Maybe it was the novelty, but I imagine the routine allowed me just a few minutes to refocus my thoughts, not toward myself, but on him. Here was this intelligent, experienced, highly-respected physician in whom I had put my complete faith, hope, and trust, struggling to speak normally into this teeny, tiny little recorder. He’d start speaking, then stop, rewind, rephrase his words, and start over again. He’d repeat and stumble over words, often tripping over the easiest phrases. I would have the same trouble, of course; the daunting task of recording’s one voice never seems to be an easy one.

At the end of each recording session, Dr R. enumerates the action items that are to be taken between now and the next appointment. Whether I need to start (or stop) a prescription, get an X-ray, see another doctor, or watch for symptoms to change or arise, it’s all recapped at this time. It’s the perfect way to summarize what has happened, what needs to happen, and in some cases, what should happen. The conclusion of the recording session is the definitive moment when we can look each other in the eye and confirm that, yes, with absolute certainty, doctor and patient are in agreement. In fact, it’s like a temporary reversal of roles, where I get to be the teacher and him, the student. He gives the oral report, and then I grade him on it. It is Dr. R’s moment in the spotlight, the few minutes where he tries to succinctly recount everything we’ve discussed while I sit back, “testing” his recall. In most cases, he records the details accurately. In the rare event that he misses something, I signal for him to stop, I correct his mistake (or ask for clarification), and then he continues on. I used to only half-listen as he repeated the happenings of our appointment, but I soon realized that this simple, albeit amusing, routine exercise is as much for my benefit as it is for his.

I overheard a phone conversation between him and an evidently frustrated, confused patient once. She was denying that he’d prescribed a medication to her and he said according to the dictation, he had. Didn’t she remember him mentioning it at that time? He expects his patients to listen intently, correcting his mistakes and double-checking his work, and I’m happy to oblige.

Even if your doctor doesn’t utilize a Dictaphone, it’s still possible to get a summary at the end of every visit. Simply ask your doctor to review the highlights or repeat the action items to which you (or he) have been assigned. If you prefer and are so inclined, you can even recount the details to him. That will ensure that you have your facts straight.

Don’t be too hard on yourself if you find that you’ve missed major points of the appointment. I never realized how disoriented I was during my sickest appointments until recently. I made an appointment to see someone other than my primary doctor in my perinatologist’s office, thinking I was seeing someone new. At the start of the appointment with her, I immediately launched into my entire medical history as it related to Lupus and pregnancy. Halfway through my story, she pointed out that I didn’t need to rehash my past history. She had actually seen me before. In fact, she’d performed an outpatient surgery and had followed up with me several times afterward. Those previous appointments had taken place during the early stages of a bad flare and in the midst of a miscarriage, so I definitely wasn’t as alert as I could have been. Thankfully, she understood my haziness and wasn’t offended!

It’s understandable if you’re not as coherent as you’d like to be during your appointments. Just be honest with yourself, and realize you may need to prepare or take extra steps to ensure that you’re getting the most out of your visit with the doctor. You should benefit from every appointment, both parties working in unison to ensure a successful outcome and a healthier, happier you!

2 comments:

MaxJerz said...

Another excellent tip I've heard is to bring your own tape recorder, and record the entire appointment. That way, once you get home and are in a clearer frame of mind, you can listen to the recording to remind yourself exactly what your doctor said.

Be well,
MJ

Sara Gorman said...

Fabulous suggestion! I almost did that at a recent meeting I had with a prospective publishing company. I ended up not needing to do so, but I thought it would be a good way to make sure I didn't miss anything.

Thanks for sharing!