Few doctors consciously treat women differently than they treat men who have similar health conditions, yet women often have more difficulty convincing their physicians to really listen to their health concerns. It's tough enough when women experience inattentiveness or indifference in their careers or at home -- but when it comes to health, the issue may be one of life or death.
What can women do to assure doctor visits are productive? It's actually an issue of learning how to manage your doctor visits much like you manage other aspects of your life. A former CEO of a leading hospital told me that too many patients are like lone boatmen entering dangerous channels and declining to steer. "No one would think of doing that," he said, yet we often let impersonal medical systems and inattentive medical practitioners push and pull us about -- rather than doing the pushing and pulling necessary to help us become as well as possible.
Steering your own medical care takes self-assessment and self-training. It starts with learning how to communicate with your doctor. You need to determine whether your style and his/hers are compatible. If something about your way of communicating (whether by trait, habit, training or due to your illness) is keeping your from obtaining the answers you need, it's probably time to make some changes.
For starters, pay attention to the following:
- Do you do research before arriving at a doctor's office? Do you ever talk with other people who have been seen by this doctor? Try to learn as much as possible about the doctor or the practice before you even enter the door. And don't just go see this doctor because "he's nice" or a friend likes her. That's not enough.
- Have you noticed who is really in charge of the practice? Is it the doctor or someone on staff? Determine who the gatekeepers are and whether you can work with or around them.
- Keep a record of the names of people with whom you come in contact, whether they are doctors, nurses, attendants or receptionists. This may seem trivial, but it isn't. Use people's names and they will likely remember you and be responsive to you when you call or arrive at the office.
- The night before a visit and again in the waiting room review what you will say: What matters most to you? Start with that when you enter the doctor's office. What do you want to accomplish? Try not to waste a doctor's time. But don't allow the doctor to fail to use yours wisely.
- Bring a notepad with you and take notes on key points made and instructions. If you're uncomfortable doing this or not comfortable with listening and taking notes simultaneously, bring a companion to do so. He or she can jot down notes and remind you of which questions to ask the doctor. There's nothing wrong with this. If a doctor doesn't like it, and that makes you uncomfortable, say, "This keeps me on track and saves you time."
- Before you leave, assure you have clarity about your condition, any prescriptions, and how you and the doctor will follow up. If you're still worried about something, make sure to tell the doctor. He or she should care about your concerns.
- If the doctor appears to have formulated assumptions about you that aren't accurate and seem to get in the way of your care, be sure to correct them. Try to develop an understanding of how you present yourself in a medical office, and think about whether it facilitates or hinders your care. Make some changes in demeanor, voice, or clarity, for example.
- Regularly consider whether this is the right doctor and/or office for you. Sometimes you need to put up with brusqueness to get a good doctor -- but not with rudeness or indifference.
(If you or a woman you know has Parkinson's Disease, The Michael J. Fox Foundation website currently includes an article I wrote specifically for women about the effects of gender and illness on how well doctors listen)
Dr. Reardon also blogs at bardscove and has been a National Cancer Institute postdoctoral fellow, principal and co-principal investigator on medical research grants, and on the faculty of Preventive Medicine at USC.