Being the Right Patient

The doctor who just performed my reverse shoulder replacement is new to me. He is in the same practice as the excellent surgeon that did my other shoulder replacement and the myriad other shoulder surgeries and injections I’ve had the last few years. But my regular surgeon was going to be out on leave for a while, so I was referred to Dr. NewGuy.

Making sure to do my research

I did all the stuff you do when considering a new doctor (especially one doing major surgery). I read all the online reviews, read his bio on the clinic’s website, even polled my neighbors to see if any of them had gone to see him. By the time my initial appointment rolled around, I felt I knew him fairly well as a physician and a person.

Of course, he walked in totally blind to that first appointment. And being the “active participant in my healthcare” that I am, I’m fairly certain he was a bit taken aback. While he no doubt looked over my patient history at the clinic, I doubt seriously that he looked me up online to get a feel for my personality and background. The good news is that we quickly found our equilibrium and, over the course of my surgery and recovery, have had good conversations about treatment choices and outcomes that take into account both his medical expertise and my preferences.

This experience reminded me about some advice I once heard (and believe) about marriage. It was something along the lines that a good marriage means not only finding the right partner, it’s also being the right partner.

I think medical relationships are like that. You need to not only find the right doctor, you need to be the right patient. There is a lot of advice about this but, to me, it comes down to two essential parts (which also seem to work in marriage and other successful relationships). The first is open, honest communication. The second is holding up your responsibilities in the relationship or, more simply put, doing what you say you will.

I’ve talked to other people who have stated things like, “My doctor didn’t even ask me about X.” Then they’re surprised when I asked them if they told their doctor that was a concern. Somehow they expect that a medical degree includes a minor in mindreading. (I think veterinarian degrees do, but not so much people doctors.)

Having good communication

From a communication standpoint, it’s not only important that the doctor discuss your treatment with you, it’s critical that you let them know your concerns.

If I am going in to a regular checkup, I always take a list. I not only include my current needs/concerns, I make notes about my health appointments and procedures with other doctors since the last visit. And I don’t just read the list, I hand the list to my doctor so s/he knows the things I want to discuss. Sometimes we start with my list and sometimes we start with the doctor’s list, but this way we cover all the important points.

When I go in to a doctor with a specific issue, I usually go in with a goal. Sometimes it’s obvious if the appointment is for the flu or an infection. In the case of my new shoulder surgeon, he asked what he could do for me and I immediately replied, “You can schedule me for right shoulder replacement or, if you don’t agree with that treatment assessment, then we need to come up with a plan to improve the situation.” (I really did this so you can see why he might have been surprised.) But at least he knew that I had a goal of addressing my shoulder issues, even if it meant the most extreme case of replacing the shoulder.

Being a good patient

The second part of doing what you say you will is equally important – especially in medicine. If you are prescribed a treatment, and you agree with your doctor about that treatment, then it’s up to you to be a good patient, or else you’re not going to get the results you want. And if you don’t agree with it or won’t comply with it, tell your doctor so you can agree on a different option. For example, if you don’t think you can give yourself an injection and that’s what the doctor has prescribed, then say so. The doctor can recommend training with the injection procedure, using an auto-injector, or some other form of treatment that will work for you. When I was first diagnosed and prescribed a biologic, I had a co-worker who was on the same medication. She confessed that she hated the injections and often skipped them – then complained her RA was getting worse.

So if you’re struggling with your doctor/patient relationship (or other relationships for that matter), remember that it takes two. While it’s valid to ask if you have the right doctor (spouse, partner, friend, employer), it’s also critical that you assess whether you’re being the right partner in the relationship and how you might improve it.