A colleague recently forwarded a New York Times article, “The Appointment Ends. Now The Patient is Listening.” The author Paula Span notes new efforts to help patients understand their health status by recording appointments.
I have often been asked about how to prepare for appointments with doctors. Although many of us do not know what questions to ask, it’s still important to bring a list and a recording device. My reason for suggesting patients record their appointments was not based on scientific principles but what I learned in my role of medical humanist at a cancer center in Vermont (2003-2005). I documented–in the patient’s own words–what they understood or misunderstood about their diagnosis, treatment options and how they were coping with illness. After having read and signed off on my medical humanist’s note, doctors would often say, “They never told me that.” In an emotionally charged conversation much is not retained. So, using the note as a reference, doctors would then ask, “What don’t you understand?”
Ms. Span notes that Dr. James Ryan, a Ludington, MI physician, recognizes it’s difficult for patients not to feel overwhelmed by what they hear during the medical visit. With permission he records appointments so his patients can listen to what was discussed. “At some point,” he believes, “it will become a normal thing.” In a 2013 blog “Why Every Patient Should Be Recording Appointments” I addressed the issue of recording visits.
It is now 2017. The time has come for patients to have every resource available to help with understanding what questions to ask. Whose life is it anyway?
Right on, Celia; I’d say not only a recording but ideally also a TRANSCRIPT should be available for those who (like me) take in info better by reading than hearing it.
It is really striking how little many doctors avail themselves even of email, voicemail, texting. Speed and clarity of response make a huge difference.
And there is this: failing a recording or transcript, or even with them, it helps many (especially older or in some way compromised) patients to have an advocate right there in the doctor’s office with them, to ask questions, supply info, clarify, etc etc. I did this for my late husband (dx: dementia) and am now sometimes helping my mother-in-law (mentally sharp, but 92 years old and not always comfortable in English) this way. My sister helps her sometimes absent-minded partner with medical terminology. Think of visits to the pediatrician or the vet; the patient often needs help communicating. Not to be condescending here, just to try to cover all the bases. Also, if a patient is uncertain about his/her feelings about their doctor, reluctant to seek a better communicator etc., a transcript or an extra listening ear in the office may help them reach a considered decision.
I think the transcripts my internist now provides me of her notes at the end of the visit is just the thing I always used to vaguely hope for . Everything we discussed during the exam, plus the names of medications with instructions, is neatly stated there for me to refer back to. I no longer have to scribble notes while in my paper gown. A huge improvement. Thanks Ceil for reminding me here of this.
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