‘A careful history will lead to the diagnosis 80% of the’time’—this aphorism has been drilled into our heads ever since the second year of medical college. Our teachers could not stress enough the importance of good history-taking skills. However, as a doctor in the government service, I have found this an extremely arduous task. Patients generally exhibit resistance to parts with relevant information. The reasons could be many: the long queues that afford the doctors very little time to develop a rapport with the patient, the crowded OPD rooms, or the din in a busy hospital. Sometimes patients, having been to many doctors, are tired of repeating their history. A few patients are here only to get certain investigations done, and they are busy figuring out how to get the doctor to advise on that particular investigation. Some are shy, embarrassed, worry about being judged, or simply do not understand the relevance of the information sought in their treatment. This being the case in government hospitals, our counterparts in private practice face a different issue. They receive patients who have Googled all their symptoms and arrived at various diagnoses and treatment modalities. Equipped with knowledge acquired after hours of browsing, they are prone to showing it off. Patients’ half-knowledge can be a dangerously maddening thing for the doctor.
As doctors, we need our patients to help us help them.
So here, I’d like to share a few tips to make the most of your time with your doctor:
- Firstly, prepare a list of the symptoms you are experiencing along with the timeline. Prioritise by keeping the most important symptom at the top.
- Think about and write down all your concerns and questions.
- Bring all your medical information—a summary with dates, a list of medicines you are taking, and any latest investigations.
- mention any changes you may have noticed in your appetite, weight, sleep, or energy level.
- Let the doctor know of any chronic conditions or diseases that run in your family.
The only way for your doctor to know what’s on your mind is for you to tell them. So, be honest. Once they have a better picture of your overall health, they can help you. For instance, I have at times noticed that patients are reluctant to share what they do for a living. This piece of information provides us with the nature of the person’s job and any contribution it may have to the illness.
Similarly, certain conversations may seem awkward or embarrassing, especially about bladder and bowel movements, sexual health, or other intimate topics. Remember that your doctor has most likely heard similar things before. So do not be embarrassed to discuss them. For example, there are patients with a fever who may have a burning sensation while passing urine. Many such patients give us a history of fever only and do not consider it necessary to mention the burning pain. Usually, the doctor elicits this history. But, in the rare case that it is overlooked, a urinary tract infection can be missed.
Medical visits can be overwhelming, and sometimes even the most well-meaning doctor can present too much information too quickly and in complex terms. It’s OK to ask questions. Ask your doctor to clarify what they’re saying in plain language if they’re talking in medical lingo. Next, repeat the information back to your doctor. This will help you absorb it, and it will also help the doctor know whether you understood. Pay attention to what your doctor is saying by keeping your mind clear of distractions. If you are overly focused on the next thing you want to say while your doctor is talking to you, you may miss important information. calls for some active listening.
Another tactic for better communication is to bring along a close friend or family member, especially if you have concerns that require complex treatment. Their extra set of ears can prove helpful. If you are an elderly patient or if your anxiety is elevated, a friend or family member can help you think of questions you might not recall otherwise. However, remember that if you want time alone with the doctor to discuss personal matters, you can ask your friend or family member to wait outside.
Taking notes or writing them down immediately after the consultation can come in handy later when you’re trying to recall exactly what your doctor told you. So do take notes.
Finally, keeping an open mind and learning to trust your doctor will help make your visit more efficient.
Dr. Uma K