Ouch! ⚠️ Pitfalls to avoid in doctor’s consultations
In a doctor-patient consultation, both sides communicate in an atmosphere of trust and openness to arrive at an effective diagnosis and treatment.
That’s the theory at least. However, the experience of both patients and doctors shows that things do not always go according to plan. Patients sometimes feel misunderstood, overwhelmed or left out of the process. Doctors too can feel slighted when the patient appears with a ready-made diagnosis fresh from the Internet and a requested treatment.
The often-forgotten role of the patient in the consultation
Patients can often be under the mistaken impression that responsibility for a good consultation and the resulting diagnosis and treatment recommendation rests solely with the doctor.
However, research on shared decision-making I shows that decisions made solely on the basis of medical expertise may not always meet the needs of the patient.
The best decisions combine the scientific knowledge of the healthcare professionals (expertise) with the patient’s awareness of their own health (patient health literacy). (See also The Expert Patient article)
There is evidence II to suggest that this input not only increases patient satisfaction, but also improves their adherence to treatment recommendations and ultimately leads to better treatment outcomes.
It therefore makes a lot of sense for patients to be given a share of responsibility in the success of their treatment. If patients fail to mention their medical history or talk about their specific life circumstances, this can lead to them not receiving the right treatment.
Turning up to a consultation unprepared can be a recipe for disasterThe first consultation pitfall concerns preparation. Patients who fail to think about how they want the consultation to go in advance miss out on an opportunity to influence it. They run the risk of forgetting important questions and information, especially if they are nervous or tense, which can deprive the doctor of crucial information.
You cannot not communicate.
Paul Watzlawick
The next pitfall concerns the atmosphere. Going into a consultation with a critical mindset and negative expectations will automatically get everything off to a bad start and is likely to make open, constructive dialogue difficult.
In the consultation itself, there are also numerous behaviours that may prevent a positive outcome. It is counterproductive, for example, if we as patients do not listen properly or constantly interrupt the doctor. Good listening also means giving them your full attention and not being distracted by formulating an answer or the next question in your own head! The strategy of staying silent and remaining passive is not conducive to success either. However, doing the opposite and weighing in too heavily with threats or accusations, for instance, is sure to ruin any positive atmosphere.
Caution with Dr GoogleSomething that does not go down at all well with medical professionals is arriving at a consultation with a ready-made solution courtesy of Dr Google. Whilst it does no harm to inform yourself ahead of the consultation, even the most extensive online research is no substitute for medical studies. (See also the EverAsk versus Dr Google article)
How good preparation can help get your consultation off on the right foot
Doing the right preparation before a consultation is key. Whether you put your thoughts down digitally or on paper, be sure to note down everything important to ensure you don’t forget anything. Especially in difficult discussions; for example, when you need to discuss emotionally stressful topics, you can always look at your notes so as not to lose your thread.
EverAsk is a digital tool that supports patients to prepare for, conduct and follow-up doctor-patient consultations. Using structured questions, it helps users create a cheat sheet for the consultation.
A little tip: to avoid annoying the doctor by constantly checking your phone, it is worth explaining that you have done some preparation (e.g. “since this is an important consultation for me, I have noted down some questions, so I’m going to keep checking my phone to make sure I’ve asked everything I wanted to know”).
In the consultation itself, EverAsk helps by leaving space for notes directly below the questions so you can write down what the doctor said. By checking off whether your questions have all been answered, you can keep track and ensure that all topics have been discussed.
Seven golden rules for a successful consultation
Compile your questions
Take time before the consultation to think about what you could ask and remember to take your questions in with you.
Set a goal for the consultation
This applies in particular to complex and difficult issues. A defined goal will help you stay focused during the consultation.
Also consider personal factors
For example, do you do shift work, are you afraid of injections? Or what do you think about life-prolonging treatments?
Be courteous and polite when talking to the doctor
Respectful interaction is key to a good consultation. Listen to the doctor and tell them everything they need to know.
Actively participate in the discussion
Ask if there’s anything you don’t understand! It can also help to repeat back what the doctor or healthcare professional has said to make sure you have understood everything correctly.
Make sure you have covered everything
Be sure to check during the consultation whether you have discussed everything you wanted to cover.
Participate in the decision making
Make sure the doctor is aware of your personal assumptions, values, positions and wishes in order to arrive at the optimal treatment for you.
References
I A patient in the clinic; a person in the world. Why shared decision making needs to center on the person rather than the medical encounter. Clayman, Marla L., Gulbrandsen, Pål, Morris, Megan A. Patient Education and Counseling, 2017, Volume 100, Issue 3
II Shared Decision-making Lowers Medical Expenditures and the Effect Is Amplified in Racially-Ethnically Concordant Relationships; Brown, Timothy T. PhD; Hurley, Vanessa B. PhD, MPH; Rodriguez, Hector P. PhD, MPH; Lee, Jadyn; Gupta, Neel; Toolsie, Grace Markarian, Sione BA; Valenzuela, Sofia; Med Care (2023)