We’ve discussed the fact that doctors don’t always display the best communication skills. As a group, doctors haven’t developed a reputation as skilled communicators. As proof of that reputation, research shows that the vast majority of doctors don’t use Teach Back to verify if you understood what they said. (See prior post for description of Teach Back)
Sadly, we don’t really have expectations that our doctors, who teach us about life and death issues, will communicate as well as someone teaching our children in elementary school. We’ve seen many stories of parents of school-age children going to great lengths when they feel their child is being taught by a second-rate teacher. We don’t see the same outrage when doctors communicate poorly. What we usually see is confusion and frustration.
But what about your own communication skills? Don’t cast stones unless you’re willing to accept projectiles coming your way. When you go to the doctor, are you ready to process and understand the information to the best of your ability? You have a responsibility to be at your best and brightest during the office visit because you may be talking about serious health matters. And even if you’re not talking about life and death issues on a particular visit, you are paying for a service.
When you go to the barber or beauty salon, you probably make sure your hair is in good condition so the hair person can start with something good and make it better. Likewise, when going to the doctor, you should strive to be at your best mentally so you can skillfully communicate. Unfortunately, there are many times when you may go to the doctor and are not giving it your best. And you may or may not be aware that you’re underperforming. Listening, responding to questions and asking questions takes effort and focus.
Assuming you can normally communicate skillfully, what are some of the barriers that may blunt your abilities? Here are some of the most common. Medication is at the top of the list. It’s at the top of the list because the number of medications that can cause what’s called “foggy thinking” is very high. It’s also at the top of the list because many people take these very common medications without knowing they can cause mental changes. Sometimes those changes occur over time and they can look like ordinary mental decline. But take the medication away, and many times, the person becomes their “old self.”
I won’t include a list of medications because it runs into the hundreds. The popular book Worst Pills, Best Pills provides a nice summary for your review. You can also look on the web and if you want to display your intellect you can ask Google if your medication causes “cognitive impairment.” You could also ask your pharmacist.
One of the other problems related to foggy thinking and medications is that sometimes it’s very difficult to determine if one of your medications is combining with another medication to cause mental problems. Each medication when taken alone may not typically cause problems.
Many things can hinder your clear thinking during an office visit. Anything that causes you to lose your focus during an office visit can sidetrack your thinking. It may be something as simple as embarrassment for being undressed with your backside showing in a stranger’s office. It may be the financial stress you are expecting because you don’t have insurance and know you may be paying a large sum to maintain your health or cure a disease. For instance, can you imagine the stress and shock you’d feel if your doctor informs you that your biopsy that looked like normal tissue to the naked eye was actually cancerous?Common reasons for foggy thinking besides medications are fear, stress, fatigue, normal mental decline with age, embarrassment, pain, and illness.
Bringing a companion with you to your office visit is a common solution for the times when you may not be at your best during a doctor’s visit. They can write things down. They can ask appropriate questions. They can be there to support your emotional needs. Another option for some of you is to hire a professional patient advocate. Look up “patient advocates” on the web and you’ll find experts who can help you, for a fee, with almost any health care predicament.
Prepare for your office visits and you’ll be on your way to better health.
My next post will be about how you may be inappropriately blamed for problems that occurred because of your doctor’s inadequate communication.