Wednesday 1 April 2015

How to talk to doctors when they don't listen.

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By Camille Peri
WebMD Feature

Doctors don't always have a reputation for being the best listeners. Studies have shown that when patients start to talk, doctors tend to cut them off, usually after about 17 seconds. 

That can be frustrating, but does it really affect your care? If the doctor is skilled, how important is it that he or she listens to you? Very important, experts say. 

Without good communication, a doctor may give you the wrong diagnosis or order tests you don't need. And the less you and your doctor talk about your care or make decisions together, the less likely you are to understand or follow through on your treatment. Whether good dialogue makes you less confused or more invested in your own care, it matters.

"It's important that your doctor values and respects you as a patient by listening to you," says Martine Ehrenclou, author of The Take-Charge Patient: How You Can Get the Best Medical Care. "Your relationship with your doctor is really the cornerstone of good health care."

You might not be able to change some things that affect your doctor's attention span, such as the shorter and shorter visit times that are common. But you can take steps to make sure your concerns are heard in the time you have.

Why Your Doctor Might Not Hear You

Why do people think doctors don't listen? "Because often they don't," says Zackary Berger, MD, PhD, author of Talking to Your Doctor: A Patient's Guide to Communication in the Exam Room and Beyond.

"I think most doctors want to do a good job," he says. "But they lack the incentives. Doctors are paid for doing procedures, not for talking, explaining, or empathizing. Our payment system is out of whack." 

Other reasons doctors might not listen include:

  • They're rushed. A typical primary care doctor has about 15 minutes per patient. Some hospital doctors may have only 11 minutes with a patient. So your doctor likely has one eye on you and one on the time. Shorter visits also mean your doctor may be more likely to hand you a prescription than discuss, say, lifestyle changes that could improve your health.
  • They have a different agenda. You may come to an appointment armed with a laundry list of health complaints. But, with limited time, your doctor's goal is to zero in on your main concern. If you try to bring up others, the doctor may cut you off.
  • They're distracted by electronic devices. Doctors are often the first to admit that updating electronic health records on a laptop or answering instant messages on a mobile phone is distracting during an office visit. With an electric chart of information laid out before them, doctors -- and patients -- can also be tempted to skip talking.
  • Some doctors might be biased. A 2004 study of primary care doctors showed that white doctors tend to talk more and listen less to African-American patients. Doctors may also have set ideas about some patients that keep them from listening. For instance, if a person returns often with the same complaint or doesn't follow through on treatment, the doctor may be more inclined to shut him out.


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