| I had a rewarding experience last week when one of | | | | What about when you last went to see your |
| my patients asked me a range of excellent questions | | | | accountant or your lawyer? Did you think through |
| about their condition. I had just diagnosed them as | | | | what issues might come up beforehand and plan |
| having an anxiety disorder. This patient was clearly | | | | some possible questions? Did you think of several |
| concerned about possible medication side effects, | | | | potential scenarios that might occur, and try and |
| having had difficulties with these in the past, and | | | | work out what your response would be to those? |
| wanted to know in detail about the type of | | | | Now compare this with the last time you went to |
| psychotherapy that would be most likely to help | | | | see your doctor. Did you check out various different |
| them. I recommended that they read about the | | | | hospitals if you needed surgery? Did you read up on |
| illness on the handouts that I printed out for them, | | | | a variety of possible medications if you needed drug |
| and on a number of websites I suggested, before | | | | therapy? Did you confirm your diagnosis by reading |
| coming back to see me again to decide on a course | | | | about your disorder and all possible treatment |
| of treatment. It was pleasing to have a good open | | | | modalities? Did your doctor tell you what he or she |
| discussion about their best therapeutic options, to not | | | | thought was wrong, and then offer information to |
| need to simply prescribe and undertake a treatment | | | | help you make a decision on what to do next? |
| program immediately, and to be able to take the | | | | The Agency for Healthcare Research and Quality has |
| time for the patient to do their own research, and | | | | been running an excellent public campaign called |
| then come back and make a joint decision on the | | | | "Questions are the Answers". This campaign |
| best therapy together. This is the way medicine, in | | | | encourages patients to create their own list of |
| non-emergency situations, should be practiced. | | | | questions whenever they visit the doctor, or need to |
| Unfortunately this is not the usual way that | | | | have any sort of medical procedure. The campaign |
| physicians practice, partly because it takes more time | | | | consists of both print and internet resources, as well |
| to communicate and arrive at a mutually agreed | | | | as television advertisements. The Agency has |
| treatment plan, but also because most patients still | | | | created all sorts of lists of questions which I would |
| do not really plan in advance what questions they | | | | encourage any patient to use, and has sorted them |
| should ask. This leads to doctors still having to | | | | by a number of differing situations and encounters |
| second guess what patients want to know when | | | | that commonly occur in the health field. Examples of |
| they give them an opinion, and of course they | | | | some of the core questions are "What is this test |
| therefore often omit telling patients key information | | | | for?", "How many times have you done this?", "Are |
| of particular importance to that individual. | | | | there any alternatives to surgery?" and "How do you |
| Most doctors like patients to ask appropriate relevant | | | | spell the name of that drug?" These may all sound |
| questions about their health condition. Two way | | | | like very simple questions but it is astonishing how |
| information flow is a key component in any | | | | often patients, when confronted with a potentially life |
| doctor-patient relationship. It is just as essential that | | | | changing or serious diagnosis, have very few |
| patients ask questions of doctors about their | | | | questions at the time of the doctor's consultation. Of |
| diagnosis and treatment, as it is for doctors to ask | | | | course people often think of questions afterwards, |
| patients questions to help them decide what tests | | | | and will then hopefully read up on their condition and |
| are necessary, and what treatments are best. | | | | arrange another appointment to ask their doctor |
| Think about the last time you bought a major | | | | about these issues, but not all do, leading to people |
| consumer item, such as a television, computer or an | | | | receiving all sorts of medications and surgeries for |
| expensive piece of furniture, or even something | | | | reasons that they simply do not understand. |
| cheaper, such as a cell phone or new clothing. What | | | | So do help your doctor, and plan your questions as |
| research did you do? Did you go online and compare | | | | much in advance as much as you can. Most doctors |
| all sorts of products? Did you go to various stores | | | | will be appreciative of your questions, and will be |
| and compare prices, availability and replacement | | | | happy to answer them so that your treatment can |
| guarantees? How much time did you spend on your | | | | progress with your full understanding. |
| research before making your purchase? | | | | |