How to Form a Great Doctor-Patient Relationship
You’ve had your physical. Now it’s time to give your doctor a checkup—and find out if he’s really right for you.
When you’re in a great doctor-patient relationship, you just know it. “You feel as if you’re working as a team—you’re partners in your health care,” says Judy Cook, M.D., a longtime patient advocate and the author of To Die or Not to Die: Ten Tricks to Getting Better Medical Care ($18, amazon.com). For your part, you’re honest about your health issues, you show up for appointments on time, and you follow instructions carefully. Your doctor, in turn, sees you promptly and for as long as you need. She speaks and listens to you with respect, diagnoses your illnesses at the first clear sign, and, most important, gets you feeling better as soon as possible. “With a good doctor, you always leave the office feeling that she cares about you,” says Joseph J. Pinzone, M.D., the CEO and medical director of Amai Medical and Wellness Practice, in Santa Monica, California.
So do your experiences with your general practitioner fit this description? If not, you’re not alone. According to a 2011 study by global marketing firm Léger–The Research Intelligence Group and data-analytics software developer SSI, approximately two-thirds of patients worldwide say that they’re dissatisfied with their doctors, whether they are primary-care physicians or specialists. But many stick with them anyway, often because they assume that all physicians will treat them the same way, they’re worried about offending their doctors, or they’re overwhelmed by the idea of finding someone new, says Jenny Giblin, a medical family therapist at Upstate Golisano Children’s Hospital, in Syracuse, New York. And that’s a shame, because a good doctor, one who acts as your advocate, is essential to your well-being. “When you take control of who your doctor is, you take control of your health and you improve your quality of life,” says Giblin. Here, a strategy from experts and physicians for creating a relationship that works.
Step 1: Voicing Your Concerns
What is it about your doctor-patient dynamic that doesn’t feel right? If it’s something immediate and egregious (for example, he prescribed a medication that he forgot you’re allergic to), proceed to step 2. If it’s a common grievance, address it at your next appointment so that he has a chance to make things right. “If I’m doing something wrong, I want to know that,” says Cook. For instance, you might say, “I’m too busy to take a pill three times a day. Could you provide an alternative?” Or “What can I do to be seen on time?” If your doctor seems willing to improve matters, you might decide to stick around. After all, there’s merit in staying with someone who knows your medical history. “A conversation can help you both get over a misunderstanding,” says Cook. In some cases, it can even be the difference between perfunctory care and an outstanding, long-term connection.
Step 2: Ending the Relationship
Not satisfied with how the talk went, or do you simply know that you’re ready to leave? If you have a chronic condition that requires frequent appointments, you might want to skip to step 3 and find a new doctor before leaving the old one. However, if you’re in relatively good health, simply move on. And don’t feel guilty about it: Many general practitioners see close to 100 patients a week, so he might not even notice your absence. Says David G. Borenstein, M.D., a clinical professor of medicine at George Washington University Medical Center, in Washington, D.C., “If I hear that a patient has left, I’m disappointed but not surprised. I usually assume that their insurance changed.” So just call the office and find out the best way to obtain your records (this is your right) or have them transferred to your new physician once you find one.
If you feel that you need to tell your doctor that you’re leaving (for instance, you have a chronic condition or you’ve had a long-term relationship), call the front desk, explain the situation, and ask how the doctor prefers to handle it. He may schedule a phone call or even an in-person chat.
Step 3: Finding Someone New
Candidates abound, but zeroing in on the best one takes good, old-fashioned legwork, not to mention some sleuthing.
Ask around. While it’s tempting to speed-dial the top name that appears on a “Best Doctors” list, nothing beats firsthand knowledge from people you know well. So ask family and close friends whether they would recommend their own GPs. Consider, too, asking for recommendations from health-care providers whom you’re happy with—for instance, your dermatologist or obstetrician. They may suggest people who practice with the same philosophy. No matter whom you ask for a referral, find out the reason behind their satisfaction. Is it the doctor’s compassion? His expertise? His accessibility? Ask yourself if those qualities match what you would like to see in your physician.
Do your research. You have names. Now check credentials. Often these can be found on the doctor’s website, at ZocDoc.com (which includes verified reviews), and at Healthgrades.com (which features survey-based ratings). In particular, find out about:
- Board certification: Although all doctors must be licensed in the state where they practice, a doctor who is board certified has voluntarily undergone a rigorous process of additional testing and peer evaluation and is considered to have a higher level of expertise in his area of certification. If the doctor’s board status isn’t mentioned on the above sites, search his name at certificationmatters.org, a free site run by the American Board of Medical Specialties.
- Age: Good doctors come in all ages, but different ages may offer different advantages. For instance, you may prefer younger doctors because they tend to be more accessible, since they’re still building a roster of patients. You might prefer an older doctor who is more experienced. Or you may connect best with a doctor from your own generation.
- Published articles: Academic papers aren’t usually part of a doctor’s job description, unless he also holds a university post. Nor do they mean that a doctor will have great people or diagnostic skills. But recent articles do mean that he’s up-to-date in treatments concerning his area of expertise, which may be important if you have a chronic condition, such as diabetes or an autoimmune disorder. (Of course, a strong research background is less relevant if you’re simply looking for someone to treat a sore throat every once in a while.) You can often find a doctor’s scientific articles on his website. If not, type his name into pubmed.gov, a database of summaries and papers on medical topics.
Interview the top contender. Call the front desk and ask for an informational chat in the office. (If the physician doesn’t provide one, you may want to move on to one who does. Or, if you don’t mind, leave the assessment for your first visit.) Pay attention to how he speaks to you. Can you have a conversation, or does it feel as if he’s talking at you? Do you feel comfortable asking questions? Anita Varkey, M.D., an internist and a clinical associate professor of medicine at Loyola University Health System, in Chicago, also suggests asking if the doctor has a network of established specialists to whom he refers patients and at what hospital he has admitting privileges. (When you get home, you can research that hospital’s reputation at Healthgrades.com.) It’s also worth asking who would fill in for him when he’s away. If commuting is difficult, find out what services are available at the office. You might prefer a practice where blood tests and X-rays are done in-house so you won’t have to travel to another facility for them. Before you leave, ask the front desk about typical wait times and how quickly you might get an appointment if you’re sick.
Step 4: Keeping the Relationship Strong
These guidelines will not only prevent misunderstandings but also help your doctor do his best work.
Be realistic about the time you’ll need. If you have a long list of problems to discuss, schedule an appointment that’s longer than the standard 15 minutes.
Come to visits prepared. Write down what you would like to address so you won’t forget. Bring a list of all the medications you take (including over-the-counter ones); also note the dosage and how often you take them.
Clearly describe the reason why you’re there. Unless you’re having a regular checkup, you need to be as specific as possible about the issue you’re there for, mentioning the time sequence of when you noticed the problem and what you did to alleviate it on your own. “Treat it like a business meeting with an agenda,” says Joseph J. Pinzone, M.D. After all, a doctor-patient relationship is a two-way street. If you respect his time and efforts, he’ll probably do the same for you.
5 Common Signs That You Need a Change
1. Your doctor doesn’t tailor recommendations to your life. Your GP should take the time to understand your day-to-day routine and prescribe treatments that fit it, says Pinzone. For example, if you say you can’t afford to join a gym, she should suggest a workout DVD, not a daily yoga class.
2. He’s always running late. The average wait time to a see a physician is 21 minutes, according to a 2012 survey by Vitals.com, which provides information on doctors. If your doctor regularly keeps you waiting for longer and that aggravates you, consider switching. There’s probably a problem with the office’s scheduling policy (for example, not setting aside time for emergencies), which won’t be remedied easily.
3. She rushes you. Does your doctor breeze through a physical or fail to ask if you have questions? These time-saving tactics can hurt your health. A 2013 study published in the Journal of the American Medical Association found that almost 50 percent of diagnostic errors in a primary-care office resulted from exams conducted improperly.
4. The office is disorganized. For instance, they can’t find a record of your test results. Or the doctor neglects to return phone calls. This behavior not only is annoying but also makes you vulnerable to substandard treatment.
5. She’s arrogant. Your doctor should offer knowledgeable guidance but also ask if you have concerns about your treatment. She should take your doubts seriously, and you should never feel stupid about asking questions. Feelings of disrespect can “prevent you from getting the care that you need,” says Pinzone.
Ask Your Specialist
To assess the other doctors in your life, the advice given on whether to leave your doctor still applies. But a few specific questions can offer more insight into their working style.
Question: Is your focus on medical dermatology or cosmetic dermatology?
Why you should ask it: One in five Americans will be diagnosed with skin cancer. A medical dermatologist may be more focused on doing a thorough full-body skin exam.
Question 1: What percentage of your deliveries last year were by Caesarean section?
Why you should ask it: Since complications are more likely with a C-section than with a vaginal birth, a doctor shouldn’t be too quick to operate. The national rate is one in three. If your doctor’s rate is higher, ask him about his decision-making process.
Question 2: What do you think of estrogen-replacement therapy to treat menopausal symptoms?
Why you should ask it: There’s no one-size-fits-all approach. Estrogen can be harmful to some and helpful to others. If your doctor’s response is “This is complicated,” it’s a good bet that he delivers truly personalized medicine.
Question: What is your treatment approach?
Why you should ask it: Many psychiatrists are more focused on the pharmacological aspects of the specialty. If you want someone to talk through problems with, make sure that the doctor is trained in, and builds his practice around, a behavioral-based therapy.