In speaking to my newest client – the mother of a seven-year-old girl – she described the struggle she was having when talking with one of her daughter’s physician specialists. In short, he kept interrupting her and she found it frustrating.
She went on to explain how different these interactions were from her encounters with her pediatrician. When I asked why she thought it was different, she said, “I don’t know, I just have a great relationship with our pediatrician.”
Similarly, an older gentlemen at one of my recent talks described how he and his wife had to find a new primary care physician after thirty years with one doctor. Although their new physician was nice,he just couldn’t imagine having the same relationship with her that he’d had with the first one.
In both cases, when I asked if there was any attempt to talk to the physician about their relationship, they said that they just couldn’t see themselves doing it.
Using an agenda to talk about your relationship
You’ve no doubt read in previous newsletters that I espouse preparing for meetings with physicians by creating an agenda in which you outline the following:
- Your objective of the meeting
- The specific topics you want to discuss
- Questions you want to ask
- The action plan
- Summary review
The agenda is something you prepare in advance; it can be used in several ways. One is as a guide for your thoughts during the meeting.
Another – and one I highly recommend – is as a document that you share with your physician at the beginning of the meeting while stating, “I took some time to prepare for our meeting and put together this agenda to guide our discussion and to be sure I don’t forget anything.”
This becomes your opportunity to name the communication issues as your first agenda items.Put it in writing:
- Our relationship
- How best to communicate
- How to work as a team
It’s critical to raise the topic – and to name it – so that it can be explicitly discussed.
Then, at the time of the next appointment, here’s what that young mom could say:
“It’s very important to me that I have a good relationship with the physicians caring for my daughter. I raise this because in our last discussion, I found it difficult to get my thoughts out without being interrupted, I left feeling uncomfortable. Could we please discuss our relationship and how we can work together as a team surrounding my child?”
Here’s what the older gentleman could say:
“I put ‘our relationship’ first on our agenda for today. As you are new to my healthcare team and we are getting to know each other, I’m hopeful that I can feel the same level of comfort I had with my previous doctor. I’d like to discuss how we can we can achieve that together.”
Healthcare is changing
As a result of the evolution of many things, including demographics and healthcare reform, we are experiencing a change in the way healthcare is delivered, especially in primary care practices. These changes encompass both the relationship a physician has with patients as well as a team approach to care.
Many new developments (not the least of which is the passing in 2010 of the Patient Protection and Affordable Care Act) have challenged the paradigm of care as episodic and reactive and replaced it with an ongoing and proactive, team-based approach.
In this new model, team members who are the most well-equipped to monitor or manage different parts of care are identified, working together with other team members to the full extent of their training. For example, a trained dietician is probably the best person to teach a person with diabetes about required changes in diet, while the physician is best suited to treat the complications of diabetes.
Patients are placed at the center of the team, with all moving parts working together to achieve the best results.
Why this is important – the paradigm shift
Taken together, all of this means that you, as the healthcare consumer asking to discuss your relationship; how best to communicate; and how to work as a team; are totally aligned with how healthcare is changing.
Physician practices appreciate that the most important member of the team is the patient and that if everyone is in alignment as to what the goals are and everyone is doing their part, outcomes are better.
I understand that it can be difficult to overcome years of operating in a healthcare system that was essentially paternalistic and that discouraged patients from influencing the relationship with their physician. But that is rapidly changing.
I encourage you to take control of the things you have control over, namely, you and how you conduct yourself. Name the topic of your physician/patient relationship, state the importance of an effective one, and place it squarely at the top of your agenda for your next meeting.
Let me know what type of response you get. In my experience, the conversations are welcomed. From there, amazing things happen.