Misunderstandings – the importance of proactive patient participation in consultations
Asking lots of questions can feel awkward, especially in a medical setting. Many of us, patients as well as doctors, tend to assume traditional roles where the doctor leads the consultation, asks questions and does most of the talking, while the patient sits, listens and answers. 1) However, there is evidence to show that treatment outcomes are significantly improved if patients fully understand what to expect, and play an active role by asking questions. 2)
Involved patients are not yet the norm
In Europe, especially German-speaking countries, it is still unusual for patients to ask lots of open questions. 1)
According to studies on doctor-patient consultations in these countries, doctors initiate 94% of all interruptions and questions during consultations. They also control 82% of the questions asked. 3)
By contrast, American culture, for example, promotes an active question-answer dialogue. There, it is entirely normal to ask questions at any time – including in consultations with healthcare professionals. This may also explain why the shared decision-making approach, which involves the patient in the medical decision, was developed in the US rather than in Europe.
Patients who are well prepared and ask questions are not discouraged in Switzerland or Germany, but they still stand out from the norm.
When questions are unwelcome
As a general rule, it never hurts to ask. Questions and double checking are important for gathering and absorbing information. Actively asking questions not only aids the patient’s understanding, but can also help to strengthen the doctor-patient relationship.
However, there may be situations in which your questions are received negatively, despite being necessary and regardless of your good intentions. For example, if the other person is stressed: the waiting room is full and an emergency needs dealing with. Your questions may be necessary, but your counterpart may still indicate that now is not the right time.
Our tip: be firm, yet polite. Even if it is difficult, speak up if you are not feeling heard. For example, you can say: “I’m not sure you are taking my questions on board right now. My goal today is for us to decide on the best possible treatment together. It helps me to ask questions. Is it okay if I ask more questions?”
Tell them from the outset that you have prepared some questions.
Preconceptions
Like everyone, doctors too may have preconceived ideas about a situation based on previous experience.
A patient who used EverAsk to prepare for an initial consultation with a physiotherapist reported that she initially received a very critical reception to her many questions. It turned out that the practice had previously been sued by a patient who had also asked many questions at the beginning of the treatment.
Therefore, patients who asked a lot of questions were automatically treated with suspicion. At the next appointment, the patient informed the therapist in advance that she had prepared some questions and the purpose of these, which noticeably relaxed the atmosphere.
Tips for avoiding misunderstandings in doctor-patient consultations
Be aware that the other party may not understand the purpose of the questions.
Tell them from the outset that you have prepared some questions.
Explain that you will be referring to a cheat sheet on paper or smartphone to remind you of your questions.
If it appears that the doctor is annoyed or dismissive of your questions, consider why that may be: is it because of your behaviour? Or could it be that the other person simply has time constraints?
Speak up if you feel that the doctor has a negative view towards your questions or is not listening to you.
Remember: asking questions and providing information is helpful as it enables the doctor or therapist to choose the most appropriate treatment for you. It also helps you, the patient, better understand what is happening and actively comply with the treatment.
Sources
- http://www.verlag-gespraechsforschung.de/2002/pdf/medizin.pdf, S. 17 und Redder/Wiese (1994): „Medizinische Kommunikation: Diskurspraxis, Diskursethik, Diskursanalyse“
- Hibbard JH, Greene J. (2013): “What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs.” Health Aff (Millwood). 2013;32(2):207-14.
- Raspe, Normeyer (1981)