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    Old 09-11-2004, 06:25 AM   #1
    atsim
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    Tips for Handling the Patient Doctor Relationship

    I see so many posts here of people struggling to get answers from their doctors, being afraid of calling their docs, not being able to get timely appointments, pain management or physical therapy when needed...I thought it might be good to start a thread of tips for handling this relationship...

    I have learned many things by managing my own health and caring for my parents. I learned that it is up to me to be educated and my own advocate. And that being nice goes a long way and then getting assertive and persistant is the only way.

    Here are a few things to consider...Other people please list your tips.

    Shop for your doctor, decide what is important to you...and ask questions like...
    Can I call you anytime if I have problems?
    Are you or a partner accessable 24/7?
    How long will I have to wait to get a call back?
    How do you typically manage post operative pain?
    Can we decide together what pain medicine will work best for me?
    How frequently do you do this type of operation?

    I set up an additional appointment to have time to ask these questions before my surgery. If you doc won't do that for you, that's your first indicator of what it will be like...

    All doctor's offices have gatekeepers, these are the office personnel and the nurses. You need to get to know these people, by name and make them your allies. I have found that being honest and saying things like...I'm really concerned about this...I could really use your help to talk with the doctor...I'm scared...are words that encourage a positive response.

    Remember you are the CUSTOMER, they get paid well to take care of you... if you're not satisfied, say so and there is nothing wrong with switching in mid stream. You need energy to heal not to battle the doctor or his/her office...

     
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    Old 09-11-2004, 10:41 AM   #2
    CrazyCatLady
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    Re: Tips for Handling the Patient Doctor Relationship

    Those are all really good suggestions, but they don't really work for people like myself who are on Medicaid. I get whatever doctor will take Medicaid and there are few here.

    What if you can't afford to be choosy?

    I feel that the main problem I have is that the office that my OS is in is saturated with patients. I wish there was some way I could get away from that, but like I said, I can't afford to be choosy.

    It makes me upset to think that the doctors know I'm on Medicaid and that they might not treat me as well because they know that. I can't be sure, but sometimes it feels that way.

    I also type medical charts and I do notice a difference in the quality of care that people with different insurances get.
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    Old 09-11-2004, 08:42 PM   #3
    KarynLR
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    Re: Tips for Handling the Patient Doctor Relationship

    Great topic, atsim, a lot has already been said.

    --I think it is very important to trust your intuition with doctors. I know sometimes we tend to put that aside, but if you feel something is wrong or lacking, it usually is. I unfortunately, didn't listen to my intuition when I saw a bad doctor, and a necessary correction led me to my good doctor. Some other things I have learned:

    --I adore my dermatologist, and he has referred me to many specialists over the years, including my genius OS. I think this is a good way to find a well-respected doctor, and while I love most of the people he's sent me to, I cannot stand the internist he recommended. So, asking a friend or trusted health professional for a referral is okay, but if you don't like the doctor, don't see them! You will not make the person feel bad by not taking their advice. Similarly, I don't like to tell people about my old doctor. It is not my duty to "protect" people from him, and partially out of respect and potential malpractice, I wish to not tell them his name. Yes if I am asked outright I will share my bad experience, but I feel if someone else has a good relationship with him, who am I to make them doubt it? People will ask, "Who was your podiatrist?" And I say, "I don't feel comfortable sharing," and they say, "But what if he's mine?!" So I ask them who their podiatrist was--and answer accordingly.

    --Do not be afraid to ask for what you need--even though I sometimes am. I think that we feel, "He is the doctor; I am below them", but you aren't--and the doctor should never make you feel like that! It is also a good idea to bring a friend or relative to important visits. Sometimes you get so caught up in the moment you forget a question, or don't get it answered completely, so a friend could jot down the notes, or remind you if you forgot something. It is also nice to have an extra set of ears for help with decisions too. You are processing a lot of information at these visits, and you're hurting and in pain, and this is a hard time to make really important decisions. Having someone who's able to say, "Remember, he said this too," is a good thing. They may even ask your doctor things you haven't thought of! My aunt, who accompanies my grandma to many of her medical visits, has just been a wonderful asset in terms of this, even more than my mom. She will say to my surgeon, "And what will that do?" "When will we make that decision?" Etc.

    --Kindess gets you a long way. Showing up on time for your appointments, even though the doctor is not always on time himself, being courteous to the staff--it matters. The OS's office is a crazy place, and these people are your friends! They are ticket to getting emergency appointments and a call into the pharmacy today. On that note, never let one of them blow you off. Sometimes, they feel they need to be the gatekeeper for the physician and go a little overboard. If that's the case, ask politely to speak to the office manager, your doctor's assistant, or a nurse. Never let them tell what is or is not important; most do not know and should not be giving out that information over the phone.

    --Be knowledgeable about your problem. Know where it hurts, when it hurts, what makes it hurt more, etc. Know what treatments and drugs you've already used. The doctor does respect this, and you get more out of your visits. Also, make sure you understand what the doctor is saying. Sometimes my derm likes to use his big medical jargon, and I have no idea what he's trying to say, and I tell him that. Do not keep nodding your head because you think you'll look stupid if you admit to confusion.

    --Never let the doctor put you off. You must be persistant and assertive in your quest. If you say, "I'm in pain" and they brush it off, do not let it go. They are not the ones living with this! You can say, "Well, it doesn't seem normal" or "I didn't expect this kind of pain", whatever, but get a confirmation that they acknowledge this, and get a solution to the problem. Never be afraid to call their office. Remember that an office visit is always better than an over the phone answer. I had a few questions for my surgeon after the initial consultation, and the receptionist said, "Honestly, your best bet is an appointment; you'll get better answers, especially since you and the doctor are just deciding your treatment plan." She got me in a week and a half later, and he was more than happy to see me. He was actually happy that I'd come back with a list of questions!

    --Don't confuse a doctor who isn't a chit chatter as a bad doctor, and vice versa--a super chatty one as a good doctor. Yes, it is important to have good bedside manner, but your doctor is not your best friend and your confidante. They should be polite though: hello, shake your hand, ask how you are doing, explain things in your terms. I am led astray by schmoozers. My derm is a schmoozer, but a wonderful doc in terms of his medical knowledge. My OS is friendly, but doesn't talk with me for 15 minutes before we start talking about my foot--and he is still a wonderful doctor.

    I hope these help everyone!

     
    Old 09-14-2004, 10:15 AM   #4
    EMG
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    Re: Tips for Handling the Patient Doctor Relationship

    Great info to get a good DR. You have 6 seconds to make an impression on someone (& visa versa). I take Brownies! A $2 mix goes a long way to get attention. I tape my business card on top of the plastic bag. then even if the person I need to deal with does not know me they rem. my name! like the billing clerk, or surgery sheduler. Esp. helpful for the medicare lady that doesnt have much choice in where she can go. Kill 'em with kindness & food!

    Last edited by EMG; 09-14-2004 at 10:16 AM. Reason: spelling

     
    Old 09-14-2004, 12:53 PM   #5
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    Re: Tips for Handling the Patient Doctor Relationship

    You are right, kill them with kindness. I was in out of my podiatrist office for over a year. I was told by his nurse that I was her favorite patient because I had a positive attitude unlike the other patients who swore they were dying when their feet just hurt. I also became a liason between my insurance and the Dr. office, keeping on top of referrals and approvals so things would go smoothly. Communication was essential. I also educated myself about my foot issues so I could ask intelligent questions and knew what he was talking about. As it is important for us to find a good doctor, we need to be good patients as well. Our successful recoveries are a joint (excuse the pun) effort.
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    Old 09-14-2004, 01:30 PM   #6
    atsim
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    Re: Tips for Handling the Patient Doctor Relationship

    Everyone has such great suggestions...I chose the doctor to do my surgery based on relationship first. I knew she was board certified DPM and she had done many great toe fusions, but it was the collegial feeling I got when talking to her that made the difference.

    I went to the leading foot and ankle OS in my area for my second opinion and frankly asked her if there was a reason to use an OS for this surgery. She was honest and direct and then told me my DPM had an excellent reputation and cared deeply for her patients. The OS actually said she personally did better with the technical aspect of the work than the aftercare.

    I struggled with pain meds the first week and excessive swelling. She called me a couple times a day (weekends included) while I was struggling and met me at her office on Saturday to cut off the cast when my toes turned purple from lack of circulation. I have felt like I had a partner in this challenging situation.

    I think your gut is your best guide...

     
    Old 09-14-2004, 04:58 PM   #7
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    Re: Tips for Handling the Patient Doctor Relationship

    EKO,
    You are so right about killing them with kindness. If it's one thing I can't stand is people who think that they are going to die because they have had ankle or foot surgery. I know it's a serious surgery and believe me the pain has definately been there (after 2 ankle surgeries), but it's not like I have cancer and I can't work or I am truly dying. This is just a short setback that in a couple of years I'll forget all (or almost all) about it. Of course we all hurt differently but when I would go in and see my OS I would smile to the receptionist and ask her how she was doing. I would then look around the crowded room and see everyone acting as if they were dying. Don't get me wrong, I feel for the people that have to suffer but some of these people were about 20 years younger than me and they were talking like this was the end of the world.
    When my OS would walk into the room I would smile and when he asked me how I was I would say fine. He was just asking a simple greeting:"How are you?" as if he were meeting me on the street. We would then talk about the ankle. If I had questions, he would happily answer them.

    Yes, being in a cast for months was not my idea of fun and still having pain and having to live in tennis shoes is not fun either but it all has to do with attitude. I don't want people talking about me that I'm always complaining about my ankle. I work in a medical facility in quality assurance and one of the nurses at my facility asked me how I could always smile and be so upbeat when I just had my 2nd ankle surgery 4 months ago. I asked her what was I suppose to do? I'm not going to go around and feel sorry for myself.

    I think that's what helps when you go to the OS or DPM. They like someone who isn't so depressed or angry at their situation. They would rather talk to someone who has done their homework and can talk to them rather intelligently and who is pretty upbeat considering the circumstances.

    I will probably always have some sort of pain, but I'm telling you I'm not letting it get me down. And my OS guaranteed me that there will not be a 3rd surgery next year!!
    Karen

     
    Old 09-16-2004, 07:43 PM   #8
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    Re: Tips for Handling the Patient Doctor Relationship

    I agree, a positive outlook is important. I really do try to go in with a positive attitude, and I am always at the OS's office with a smile. Their support staff is wonderful, and always offers a little sympathy, which makes all the patients feel better. The cast room and waiting room were wonderful-- sure, it doesn't offer a lot of privacy for talks with your doctor, but it made a lot of us smile and laugh.

    I do think that it is very easy to get down after major foot surgery. I am 21 and it has affected so many areas of my life. I had been just getting into the gym when I started having problems, and gained a few pounds the first summer of this. I cannot walk or stand for long, and this has kept me from a lot of activities. The hard times for me were 2 and 3 weeks post op, in incredible pain, feeling bad for myself. I would feel worse when I thought about my aunt's brother-in-law, who was dying (he just died a week ago, actually) of cancer at the time--I will not die from this! But my aunt always told myself to give me 20 minutes a day to journal, cry, or feel bad. When the 20 minutes was up, I'd read a book, watch TV, call a friend, distract myself. This is a big deal. You may not ever be back to 100% of where you were, and you might always have a little pain. My physical therapist tells me all the time that people have my problem in their neck or shoulder, and while it is bothersome, after treatment, it's better--but you put all your weight on your foot everyday, so it is very trying for the patient with foot problems. Just keep that in mind. My surgeon said to me post op, "Yes, this is your foot; you won't die from this. But it is still a major setback in your life that will continue to affect you for a long time to come."

    That being said, a positive attitude is such an asset. You don't have to be Miss Mary Sunshine--trust me, at at least the first post-op visit, you won't be-- but you will get better responses.

     
    Old 09-17-2004, 07:58 AM   #9
    StephanieVD
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    Re: Tips for Handling the Patient Doctor Relationship

    I have had bad luck with bedside manner, and seemingly those surgeries with those doctors, even if they are the best don't go so well. I have to disagree with some of the posts, about people and their pain. Because some people have very different pain tolerances, and deal with pain in different ways (not saying that complaining is good). Plus I have ended up with a serious (possible amputation) from an ankle surgery. I guess I am saying just don't be so quick to jusge others. Positive attitudes are definitely helpful, same with family support. Ask your questions regardless of your os. My last ankle os (I have had many) was awesome pre-op and as soon as I was post-op he didn't care.. cuz I guess he "fixed" the problem. Ask around.. if bedside manner is important to you, ask about that and then skill. They are totally different. Just my 2 cents!

     
    Old 09-17-2004, 03:33 PM   #10
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    Re: Tips for Handling the Patient Doctor Relationship

    Stephanie,
    I hope you didn't misunderstand my post. I have great sympathy for people in your situation and Karyn's and Ellen's and everyone else. I am not one to judge people. I know that everyone's pain is different also. You all have gone through a tremendous amount of pain and suffering.

    I was just talking about the ones that do complain over and over. I'm not suggesting that they aren't in any pain, I'm sure they are. But all the other patients in the waiting room are also there for a reason and we are all in pain. But some of the people in the waiting room seem like they're compalining just to be heard. The doctor's and nurses pick up on that. They don't have the positive attitude that some other patients have.

    Remember that for most of us, this will get better. Some people, like yourself have added problems. But I look at it this way: I can walk, I can still have fun and life is still good. It's just a setback. I still have another 50 years of living (God willing) and having a small setback that has lasted a couple of years isn't so bad (for me anyway. I'm not trying to speak for anyone else).

    I like Karyn's suggestion. She said to just take about 20 minutes a day for yourself to cry or scream or whatever.

    Education is also the key. When the doctor starts talking about a certain part of the foot or a type of surgery, the doctors like to hear that a patient knows what the doctor is (sort of) talking about.

    Good luck Stephanie. You have been through so much and I wish you the best.

     
    Old 09-17-2004, 06:07 PM   #11
    StephanieVD
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    Re: Tips for Handling the Patient Doctor Relationship

    No, I totally understood what you were saying, and I wasn't upset. But some people aren't as lucky and I admit, yea, I complain to my doctor. But I would also say I am upbeat and happy as can be. I know there are people out there who complain just to complain and there are people who like the added attention too. I hope you didn't misunderstand my post either. I was just saying, I don't like to be quick to judge, because I know I feel people judge me when I just say my ankle hurts and think I complain all the time. I too know this will end and I will be happy. Heck I am happy now. lol. Even if the worst thing is that I lose my lower leg there are always people worse, even when I am upset and it doesn't seem like it. I live in Florida and so many people have it worse who are dealing with the hurricane. I hope you heal up quick. And I hope you didn't misunderstand my post.. I wasn't trying to make accusations, I just don't think its my place to judge.. I'll let the doctors do that. lol. Back to the original topic, a positive attitude is definitely the best way to start a good dr/patient relationship... voice your concerns and problems though, mention your pain.. or it won't get better any faster, lol. Oh yea, and always ask how your dr is doing.. just a light way to make em a little more personable possibly.

     
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