Gary McClain, PhD, is a therapist, patient advocate, and writer who specializes in helping clients—as well as their family members and professional caregivers—deal with the emotional impact of chronic and life-threatening illnesses.
Two people just left their doctor’s appointment feeling pretty frustrated. Why? Because they didn’t get answers to their questions.
Dave had thought a lot about what he wanted to ask his doctor and had come prepared with a list of questions. About a dozen. He was planning to go through them with his doctor, one by one.
Lisa had also done a lot of thinking about her appointment. While she didn’t actually make a list, she knew she would remember them.
Dave and Lisa didn’t get their question answered for two different reasons. But for the same reason.
Dave had said to his doctor: “I have a list of questions to go over with you. Can you go through it now?”
Dave’s doctor, who has always been willing to share information, had smiled as he looked through the list, and then said: “There are a lot of questions on this list, Dave. Some of them are too early in your treatment for me to have answers to. Others you can find out on the Internet. But I see a couple I can answer today.”
And while Dave’s doctor had provided the answers to these questions, Dave felt like he hadn’t been given the information he thought he needed and deserved.
Lisa’s doctor started the appointment by asking her some questions. She was considering making changes to Lisa’s medication regimen, and wanted to review Lisa’s current progress before she made her decision. This caught Lisa off guard. As a result, not only did she forget her questions, but she forgot she had questions in the first place.
Get the answers you need
What’s next for Dave and Lisa? Chances are, another appointment to get the answers that they didn’t get this time.
So how could this situation have been avoided? After all, while Lisa didn’t have her questions written down, Dave had taken the time to make a list. Yet they both walked out with unanswered questions.
The solution here lies somewhere in the middle. Not remembering to ask your questions basically guarantees that you won’t get answers. On the other hand, bringing a long, overwhelming list of questions pretty much guarantees the same thing. But how about coming to the appointment with a reasonable list of questions, based on what you most need to know? And that your doctor can answer within the time that you have together? Maybe three questions?
Sound like a plan? Here’s how to get started:
Prep Your attitude
Keep realistic expectations. Physicians are limited by their organizations and/or managed care in terms of how much time they can spend with each patient. As a result, they usually don’t have time to pore through long lists of questions. So both patients and physicians each have a responsibility to make the best use of that time. Time is money. That’s the system.
Don’t view your doctor as your only source of information. In the not too distant past, physicians rolled their eyes in annoyance when patients started to talk about what they had learned in their own research. Now, most doctors expect their patients to take responsibility for keeping themselves informed.
Give yourself permission to participate actively in your healthcare. Sometimes patients feel hesitant about asking their doctor questions. They may be concerned that their doctor might think they doubt his/her competence. Or that they will be viewed as “high maintenance.” But doctors appreciate when patients take an active role in their healthcare, and that includes asking questions.
Prep your list
Do some brainstorming with yourself. To start the process of coming up with the best questions to ask your doctor, keep an ongoing list between appointments. Anything that comes to mind, jot it down. As your appointment gets closer, take some time to sit down and add any other question that pops into your mind. Don’t hold back. The idea here is to have a big list that you can then narrow down to a few key questions.
Do some of your own research. When you brainstorm on questions to ask your doctor, you may come up with a few that you haven’t thought about before. This might be a time to jump on the computer and go to some trustworthy sites to update your research. You may find some of your own answers, or you may come up with some better questions based on what you learn. It’s never a bad idea to keep your knowledge up to date.
Narrow your list down to what you need to know now. After you have done your research, go back through your list and decide what questions you most need answers to. (Our friend Dave could have benefitted from this exercise.) Not sure how to make this decision?
Here are some areas of questioning to consider:
-Symptoms you aren’t sure about or need to be on the watch for
-Anything else you should be doing to take care of yourself
-How your doctor feels the treatment is working and any anticipated changes for the future
-Any testing that might be needed in the future
-Anything you learned in your research that you want your doctor’s opinion on
Ideally, limit your list to three questions. These should be the questions you are most concerned about, or you feel are the most urgent. Keep in mind that three questions will not be sufficient in every situation. For example, if you are newly diagnosed, making a major medication change, or are experiencing unusual symptoms, you will most likely need to ask your doctor more than three questions. Also, some physicians are better communicators than others. If your doctor tends to be more reserved, then you may routinely have to do more digging to get the information you need. If your doctor is talker, he/she may anticipate your questions before you even ask.
Record your questions. Write/type them on something you can easily access and won’t leave behind. Your smartphone or some other electronic media. A notecard. A piece of paper. And then make sure you take this with you when you are at your doctor’s office. You may have to tie a string around your finger to remind yourself to pull out your questions. Whatever it takes. You’ve only got one chance here, unless you want to make another appointment or get your doctor’s attention by phone or email.
Get down to business with your doctor
Start by listening. It’s human nature to be so concerned about what you want to say next that you don’t hear what the other person is saying. Remind yourself to begin the appointment in listening mode. Your doctor is most likely seeing one patient after the other, so you may benefit by not breaking his/her train of thought. And, after having reviewed your record, your doctor probably has an initial agenda for the appointment, e.g. to ask you some questions, to tell you something, or to examine you. It might help to have your questions in front of you so you don’t have to worry about forgetting them. Your doctor may answer some of your questions before you even need to ask them.
Choose the right time to bring up your questions. You may want to ask a question or two at appropriate times during the appointment. Or you may want to save your questions until the end. Use your judgment. You know your doctor, and you know what’s comfortable for you.
Assert yourself. For example, your doctor may be talking about one of your medications and one of your questions may pertain to that medication. If so, wait until he/she pauses, and jump in, or hold a finger up to signal that you need to speak, and introduce your question with something like: “I actually have a question about ____.” And ask your question. Or it may be more appropriate to wait until the end of the appointment, and then say, “I brought in a couple of quick questions that I need to ask you before we finish.” And ask your questions.
Don’t take "no" for an answer… or at least try not to. Physicians don’t always seem very receptive to being asked questions. They may be in a rush. They may not understand the importance of the question to you. They may feel they have already answered that question (and maybe they did, but you didn’t get it the first time, or they have you confused with someone else). Gently but firmly let your doctor know that you expect an answer. Ways to get your point across include: “This has been on my mind and I really need to know your thoughts.” “You may have told me this before but I didn’t understand your answer.” “I need just a couple more minutes of your time before we finish.”
And if no is the usual answer, then maybe it’s time to consider talking to another doctor. We live in age of empowered medical consumers. Doctors have learned to appreciate, and even welcome, questions from their patients. That’s how doctors and patients communicate. If your doctor doesn’t seem willing to answer your questions, or if you don’t feel like you are getting complete answers, then it may be time to obtain a second opinion, or find a physician who considers you to be a member of the team.
Dave and Lisa were better prepared for their next doctor’s appointment. Lisa took the time to write a couple of questions on her smartphone. Dave pared his list down to three questions, which he wrote on a notecard. As a result they left the appointment with answers instead of questions. And probably avoided having to schedule another appointment to fill in the gaps.
Your time is important. Your doctor’s time is important. Get prepared for your appointments by knowing what you already know, and being ready to ask what you need to know.