How To Build Positive Relationships With Health Care Givers

You are the CEO of your health.  Your relationships with the people who care for your health, especially your doctors, are an important component of your healing.  They cannot help you if you don’t trust them and don’t feel safe enough in their care to be open and honest to the point of vulnerability about what is bothering you.

On a simplistic level, doctors do for your body what mechanics and plumbers do for your car and house, care for and maintain them in good working condition.   As a consumer, you have the right, and a personal responsibility, to terminate relationships that are not working and  shop around, negotiate, and find someone you can trust and with whom you feel safe.

However, even more than your mechanic or plumber, your doctors undergo extensive schooling, stress, and deprivation to earn and keep their credentials to keep practicing.  I really believe that most doctors do go into medicine because they have a calling, and not just to make money.  They surrender the best years of their lives to 80-hour work weeks during medical school and residency.  Many spend years digging themselves out of debt.

These days, there’s a lot of physician burnout because of how the healthcare system works, electronic health record-keeping, and pressures from Covid-19, which leads to a lack of empathy, depersonalization, cognitive biases towards patients, poor teamwork, and mistakes. 

So, how do you find a doctor you can trust and with whom you can work?  First, know the kind of dynamic you’d like to have with your doctor and what your values, priorities, expectations, and goals are for working with them.  Then, ask people for recommendations of doctors who fit your criteria.  If you have a complex or difficult condition, like long Covid, Sjogren’s (SHOW-grins), or a form of dysautonomia (dis’-oughta-know’-me-uh), you may have to ask around quite a bit.  

Use your first appointment to interview your doctor to ascertain whether you can work effectively with them.  Let them know what you want from this partnership while showing them you understand the limitations within which they must work.  Doctors typically don’t get any choice about how many patients they see or how much time they’re given to see each patient.  Doctors don’t get paid for increasingly heavy administrative tasks such as after-hours charting, consulting with other doctors, patient emails, etc.  Nor do doctors get paid for fighting with insurance companies for treatments their patients desperately need.  But, most do so anyway.

When you meet your doctor, start by stating your values, priorities, expectations and goals for the partnership.  For example, if you have Sjogren’s, you could say, “I know there’s almost no formal guidance for Sjogren’s diagnosis and care.  I know you have limited amounts of time and resources.  I’m not expecting you to have all the answers, but I am expecting _____.  I’m looking for a doctor who is willing to work with me based on my values and priorities (list them) and is willing to consider new information from credible, scientific sources.  I would like help managing _____ and my goal is _____.”  Their response will tell you what kind of relationship and care to expect, which will help you decide whether to continue working with them or to move on and find someone else.  

Be prepared for your doctor’s appointment so you get the most out of it.  Just like your mechanic and plumber, your doctor needs as much information as possible about your symptoms before running diagnostic tests.  The same symptoms can have many causes.  Describe your symptoms in detail, being specific about how they impact your life.  Your doctor, just like a mechanic or plumber, is a sort of detective working backwards from the information you share, using what they’ve learned from their training and experience to decide the likely cause or causes of your symptoms, and, therefore, what tests to run, how to manage and treat your symptoms, and, one hopes, the underlying cause(s).  Analogously, if you don’t provide your mechanic or plumber with all the information you have to help them, they almost certainly will have to spend more time and, therefore, more of your money to come up with what will probably be a more expensive, lesser solution.  Therefore, it’s most efficient and effective to give your doctor your detailed medical history, including your family history, diet, lifestyle, medications, supplements, and details about the timing, intensity, frequency, duration, and triggers of your symptoms during your appointment.  The more you prepare and the more succinct you can be while telling your medical story, the better.  Information is power.

Here’s what I bring to every doctor’s appointment:
•   health insurance cards/information,

•   a list of all of my doctors and their telephone and fax numbers (because I have doctors in different healthcare systems),

•   a list of the prescription and over-the-counter medications and supplements (brand name, ingredients, and dose) I’m currently taking, 

•   detailed information about the issue for which I am being seen: when the particular symptom started, what it felt like, how often and intensely it occurred, changes in color, temperature, pain level and type (burning, stinging, throbbing, dull, sharp, electric), and how it has impacted my life, e.g., made it difficult to sleep, eat, drive, work, write, etc.,

•   a written list of the questions I have,

•   a pen and paper to take notes,

•   something to do in case I have to wait (almost invariably, I end up waiting).

If I’m seeing a doctor for the first time, I’ll also bring a clear, typed family history, and a summary of my health story with dates of the key events and procedures. 

As with any provider of services, you’re in a partnership with your doctor, and respect and compassion are two-way streets.  To get the most out of working with your health care givers, especially doctors, you must trust and feel safe in their care and they must trust and feel safe caring for you.  Click here for a list of the local health care givers I have used and use and for more resources on communicating effectively and building trust and safety with your doctors.

 A version of this blog post is published in my local newspaper, the Davis Enterprise.  You may have to create a free account to read my article

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