Is Your Doctor Asking the Right Questions?
Wed, December 1, 2010 at 03:00AM When you go to your doctor, as part of the opening niceties she/he will ask something like: “How are you doing?” And you’ll probably answer “O.K.” before getting to the reason for the visit. It would be much better if the “How are you doing?” came after the doctor was aware of the problem (disease, your response to treatment, etc), when the answer “O.K.” would be obviously inadequate, and you’d be able to give a more nuanced reply. Jane Brody, writing in the New York Times, makes a good analysis of the gaps in doctor/patient communications.
The situation can be exemplified by someone with a chronic disease – let’s say arthritis (which Ms Brody faces and masters). Management of the disease by the doctor is not always appropriate for the patient’s actual disabilities; these aren’t taken into account because the doctor hasn’t enquired about them, and the patient hasn’t been given an opportunity to list/detail them. Patients need to be assertive if they feel their treatment isn’t matching their particular symptoms – or they need to hear why that’s not the case.
The term ‘quality-of-life’ is often over-used or misused, but there’s a place for it in the management of chronic conditions. Indeed, some crusading physicians and sociologists would like to have formal assessments by patient’s of their quality-of-life, which would serve as a basis for discussions on disease management with their doctors. An article in the Mayo Clinic Proceedings in 2007 recognized the problem and made a good case for such self-report evaluations. Whether they can be more generally adapted by doctors who, short of time, often can’t get beyond “How are things going?” remains to be seen.
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