How to get your doctor to listen
Originally written by Dr Stephens for the Montrose Mirror.
When I was a third-year medical student in 2004, I did a pre-hospital trauma rotation with a Trauma/ER doctor whom I very much looked up to. Not only did I get to turn on the blue lights and sirens in the ambulance (at this stage, I was thrilled – we had only just started our clinical rotations as medical school is five years in England) but I also received probably the most important advice of my career before or since:
“The art of medicine involves this much medical knowledge,” he said, holding his hands a couple of inches apart, “and this much good communication,” moving them about a foot apart.
In the 22 years since, that advice has served me well. Even when patients and I have different opinions, if I can make sure I’ve heard and understood them—and demonstrate that I understand what they are saying and why they are concerned—the tension usually diffuses quickly.
(I should also note, for anyone who doesn’t know me, that I highly respect a patient’s right to autonomy. My job is to give advice and help patients understand their options, while respecting their decisions, even when their choice isn’t what I would recommend.)
While most Americans report positive experiences with their healthcare providers, not everyone feels heard. In a national survey by the Agency for Healthcare Research and Quality, only 49% of uninsured adults aged 18–64 said their doctors always listened carefully to them. And in a Pew Research Center survey, nearly 1 in 4 people who had seen a healthcare provider for an illness or medical condition in the previous year said they felt rushed during their care.
So, I thought it might be useful to give some tips from a doctor’s perspective for anyone who wants to ensure they feel heard by their healthcare provider.
1. Find out how long your appointment is
If it’s only 15 minutes rather than 30 or 60, this will affect how assertive you might want to be from the get-go, especially if it is a follow up appointment and you know there are results or other topics your provider will also to want to discuss. This leads to my second bit of advice.
2. Be upfront at the start
I would suggest saying clearly “I know you have things on your agenda to discuss today, but there is something I’m concerned about that I’d also like to talk about”.
Saying this right at the start, instead of after a few minutes of catching up with each other, helps the provider mentally reschedule how they had planned to spend the appointment. If you leave it to the end, there’s a chance then that the provider will be thinking about the next person they are keeping waiting and may feel the need to rush their advice.
3. Bring a friend
This can be especially helpful if the issue is something you find embarrassing or difficult to talk about. Having a friend there who knows you’re concerned might give you the support you need to go ahead and say it.
Also, from a doctor’s perspective, while your feelings of embarrassment are absolutely valid, we deal with “embarrassing” things every day and we aren’t judging you for them. We know how bodies and mental health work—and how sometimes they don’t work so well. I would always want you to tell me if there’s something you’re worried about.
I can’t help if I don’t know about it.
4. Be blunt
If you’re not feeling heard, say so!
If it’s easier to have a phrase ready, you could use “I’m not sure we’re on the same page, do you mind telling me what you think my main concern is?” Then see how close your provider comes and correct anything they may have misunderstood or missed.
5. Persist
If despite the above, if you still aren’t feeling heard, don’t be afraid to say so.
Again, if you want a go-to phrase, you could try “I’m actually still not sure we understand each other.” Then explain your concern again, or ask your provider to summarize what they have understood from what you’ve said.
6. Request documentation
If you are still not feeling heard, one final option is to ask your provider to document your concern in your chart.
And if you repeatedly feel that you and your provider simply aren’t communicating well, it may be worth seeking a second opinion or finding a provider with whom you communicate more easily.
It really is important that you feel heard and listened to. While I expect most people reading this have a good relationship with their healthcare provider, for those who don’t, I hope these tips help you get there.
Good medical care isn’t just about making the right diagnosis or choosing the right treatment. As I learned more than 20 years ago, good communication is vital too.
At Cimarron Family Practice, I intentionally keep my practice small and schedule longer appointments, because good communication takes time. If you’re looking for a different approach to primary care, you can learn more here.