When patients leave the hospital, they are often sent surveys about their hospital experience. Several of the questions in those surveys ask about the communication they received from their doctors, nurses, and other members of the health care team. Basically, those questions ask, if those members of the health care team communicated with you in a way you can understand. I completely understand the question. Sometimes in healthcare we fall into medical jargon—technical terms, and acronyms that mean absolutely nothing to the average person. Just to give you an example, in 2000, I had an ACDF. Even breaking out the acronym for most people probably doesn’t help much. Anterior cervical discectomy and fusion. But if I told you I had to have neck surgery and the doctor made the incision on the front of my neck and then with plates and screws and connected several of the bones in my neck together, I am pretty sure you know exactly what happened. The problem is that explanation is much longer than 4 letters or 4 words, and sometimes those of us in healthcare forget to break it out and those surveys remind us that we have to make sure we are not drowning people in medical jargon.
The thing those surveys can’t ask though is if the communication is going both ways. Two-way communication is so important in healthcare. Doctors can speak in plain language and ask if you understand, but if you answer “yes” to the question, “Do you understand?”, when you really don’t, the communication doesn’t exist. In addition, doctors, as brilliant and good as they are, aren’t psychics. Unless you tell them your concerns, talk to them about symptoms, and ask questions, they won’t be able to help you.
In a recent poll, physicians were asked the most common questions they wished their patients would ask them. They wish people would ask about preventative care, and personal wellness. Doctors wish people would ask about their medications and why they are being prescribed. They wish they would ask if antibiotics were necessary instead of asking for antibiotics. They wish we would ask about our fears and not be embarrassed to ask about gynecological, urological, sexual questions, or to ask about odors or discharge—even when we don’t know the medical terms for such things. The wish we would ask about our health risks related to our family history. And, they wish we would ask about long-term effects of chronic health conditions. Doctors want us to ask questions so we really understand, and if they aren’t answering our questions, they want us to keep asking until they do. Doctors want their patients to understand their healthcare and their recommended treatments. People who understand the whys of their healthcare are more likely to follow treatment plans successfully. People who ask questions and have good communication and a good relationship with their doctor are more likely to catch things early when they are the most treatable and avoid many health issues completely.
The biggest piece of that communication is building a relationship with your doctor. That means finding a regular primary health care provider and visiting them routinely. Every time you visit the doctor, you should ask when you need to come back—and then follow that schedule. Emergency rooms and urgent care clinics are very necessary, but they are not the place to develop a relationship with a doctor that will allow you to discuss things like preventative care, managing chronic conditions, or the many other things that need regular attention to keep someone healthy.
The Agency for Healthcare Research and Quality (AHRQ) several years ago put out a commercial that used to make this point so clearly. A man was at a big, box technology store and was asking tons and tons of questions about a cell phone so he made the right decision about which phone to purchase. Later that same man was at his doctor’s office and was given a serious diagnosis, and the doctor finished with “do you have any questions?” and the man was silent. Unfortunately, that happens far too often, people don’t know what to ask, or they don’t want to sound dumb or ask a question that is potentially embarrassing. They ask more questions about a purchase than they do about their own health, even if it can affect their life in a very negative way. Please don’t be that person, develop a relationship with your doctor and ask questions. If you get nervous when you are with your doctor and forget, write down your questions before your appointment. Please help your doctor help you by communicating with them and having a relationship with them.
