Expert: Shilpa P. Saxena, MD, a board-certified family-practice physician, is the founder and director of the SevaMed Institute in Tampa, Fla. Their motto is “Patients Powered by Knowledge.”
Most medical consultations have unnervingly high stakes. The anxiety you feel as you sit in the consulting room can be enough to make you queasy.
You want answers from your doctor that will clarify your situation, but will you understand what your practitioner says? And if you don’t, will you be able to ask the right questions? If you decide to do research ahead of time, how will your doctor respond to the information that you — the non-MD — gathered on your own? How do you make the most of the limited time most doctors have to see you?
Finally, what if you’re told your condition is chronic, incurable — there’s nothing to be done? Should you get a second opinion?
According to Shilpa Saxena, MD, becoming a more empowered patient begins with understanding the kind of care you want — and seeking out the practitioner who can best meet your particular needs.
Challenges to Overcome
- Wrong-doctor syndrome. Saxena believes that most of the problems we encounter in the consulting room result from a mismatch between our desires and our doctor’s orientation and expertise. (For example, an emergency-room doctor can splint your broken arm but might not be the best one to consult about your physical-therapy plan.)
- Expecting the worst. “Many people assume that everything they are going to hear from their doctor will be difficult, painful, or negative in some other way,” says Saxena. But if you have a practitioner who is well suited to your needs, you will get a good deal of helpful and encouraging information — even when the news is less than ideal.
- Diploma intimidation. All those framed certificates and diplomas on the wall are supposed to reassure you that your doctor knows what she or he is doing. But they can also make you feel unqualified to even ask questions.
- Time poverty. Physician visits have gotten shorter and more rushed over the past decade. This can leave you feeling like you don’t have enough time to explain your condition, much less get all the detailed information you want from your doc.
- Fear of judgment. You may worry that if you come prepared with information that you’ve gleaned on your own — or if you ask too many questions about your condition and treatment options — your doctor will dismiss you as difficult.
Strategies for Success
- Explore your options. “We’re usually pretty careful when we choose advisers for investments, car care, or whatever,” says Saxena. “But when it comes to a doctor, we may simply pick the one with an office closest to our work.”
- Know your needs. Would you do best with a doctor who has more time for consultation? One with a holistic perspective? One who is a good advocate with various specialists to help you manage a chronic condition? “Finding the right doctor in the first place enables and supports your empowerment,” she notes.
- Forge a partnership. Saxena encourages patients to approach their doctors as partners, rather than authorities. If you’ve chosen a skillful provider who’s a good match, he or she is more likely to feel comfortable with input from you. This includes information you’ve gathered online, which he or she should be able to corroborate or correct. “Naturally, a doctor who doesn’t believe in the holistic approach may resist you if you ask for it,” she says. “But if your healthcare provider is never interested in your contribution, rethink who you’re working with.”
- Inform yourself. Saxena recommends gathering information about your condition or complaint before talking with your doctor so that you can have a thoughtful exchange and ask proactive questions about your treatment options. But be selective about your sources — not all information is created equal. See “Sharing Internet Health Information With Your Doctor,” below, for how to find reliable health information online.
- Cultivate calm. “When you’re in a state of high anxiety,” says Saxena, “your ability to remember things like medical suggestions and procedures is greatly diminished.” Arrive a little early, so you aren’t rushing, she advises, “and do some simple deep-breathing exercises while you wait for your appointment.”
- Write a succinct timeline. Saxena recommends writing out a one-page timeline that details the relevant factors and symptoms prompting your visit. She says providing a written account of how you’ve been feeling, along with symptoms in the chronological order they appeared, “will save 10 minutes of medical-history-taking.”
- Take along a companion. Saxena suggests asking a friend or relative along to any appointment that might involve an exchange of detailed information. “Having a second set of ears is a smart idea,” she says, “and a good doctor will appreciate it, as long as there’s no disruption of the primary relationship between you and that doctor.” Ask your companion to take notes like a court reporter — a lot of detail and no opinions. This will prove most helpful to you later on.
- Ask four questions about any treatment. When a doctor suggests a particular treatment, whether it’s a drug or a diet plan, Saxena recommends asking four questions: How many times have you done or prescribed this? How often does it work? What are the most serious side effects I might expect? How soon will I likely see positive results?
- Don’t take no for an answer. If a doctor tells you there’s nothing that can be done for a condition, says Saxena, that’s a good time to seek other opinions. “I’m the sort of physician who believes that there is always something more that can help, even if we’re talking about palliative care for stage 4 cancer,” she says. “Ask your doctor if there is someone he or she could recommend who might have a different angle on your condition, or who practices a different form of healing.” Or if your doc’s not helpful, do some research on your own. Ask friends, family, and experts for further suggestions.
The Empowered Patient: How to Get the Right Diagnosis, Buy the Cheapest Drugs, Beat Your Insurance Company, and Get the Best Medical Care Every Time by Elizabeth Cohen
A comprehensive guide to the whole range of issues in the “patient empowerment” movement, by CNN’s senior medical correspondent.
A list of suggestions for how to make a medical appointment more productive — what records and medication information to take, how to document your specialist’s input, and so on.
This article from WebMD offers tips for overcoming the natural reticence we feel when sharing every last detail of a condition with a doctor.
A concise exploration of the challenges many doctors have with online medical information, plus suggestions for choosing reliable sources.