Doctor-Patient Communication: An SLE Workshop Support Group summary

1. Introduction
2. Doctor/Patient Responsibilities
3. Partnership and Communication
4. Advocating for yourself: Addressing the issues
5. Overcoming Fear and Anxiety
6. Conclusion

Introduction

It's all about you.
The medical community is working very hard to find a cure for lupus. In the meantime, the doctor-patient relationship is the critical component of ensuring that patients stay healthy and receive optimal care. Patients are the soul of what medicine is about, though it may not always seem this way because of system constraints. Patients often perceive a power differential with their doctors because of their white coats and medical knowledge. However, it's really you, the patients, and not the doctors, who hold all the power.

Doctor/Patient Responsibilities

Just as each individual patient may have a job and a set of accompanying responsibilities, doctors are charged with their own set of responsibilities. The doctors' role is to make your lives better by focusing their medical knowledge on your personal health needs. They do this by opening up the lines of communication through trust and gathering just the right medical and personal facts about you. These facts are then woven into your own personal tapestry, assuring a correct diagnosis and the right treatment plan.

As a patient, you deserve the best care, no matter what.  Physicians should treat you the same way they would treat a member of their own families.

Patients and doctors should follow these guidelines to ensure open, effective communication:   

Partnership and Communication

The doctor-patient partnership is like any other relationship, in that there must be compromise and understanding on both parts. This helps to build trust, mutual respect, and honest communication between doctors and patients. Through this partnership, doctors should be able to form a complete picture of their patients, both medically and personally. Patients should also be able to get a feel for their doctors' style and approach to care.

Advocating for yourself: Addressing the issues

If your relationship with your physician does not appear to work to your benefit, you should inform your doctor about your dissatisfaction.  There are several positive ways to bring your concerns to your physician's attention:

• Schedule a face-to-face interaction where you are prepared to clearly and assertively address your concerns.
• Send an email that speaks to the issues you are facing with the interaction (if you and your doctor communicate through email).
• Send a fax addressing your concerns.
• Write and send a traditional letter detailing the issues.
• Schedule a phone conference with your doctor.

You can use a combination of these suggestions to advocate for your best care. You can feel empowered to challenge your doctor because you, the patient, bear most of the risk in the relationship. A feeling of having ineffective care can compromise the quality of your life - or even your life itself.

Overcoming Fear and Anxiety

You and your doctor should be partners in working together to secure the best quality care for you.  You should not fear your doctor and settle for care that is inconsistent with your medical needs. Patients sometimes report that they do not have a good relationship with their doctors because they feel like they are a burden to them; their doctors are too busy, and they are afraid to challenge the "expert." At the same time, the possibility of needing to change doctors creates a great deal of anxiety.  Patients may be fearful of confronting their doctor because they don't want to lose that doctor, even though they may feel they are not receiving optimal care.

Tips for overcoming fear and anxiety:

• Bring a family member or friend to your appointments so that you may have an ally in the room and not feel like it's you "against" the doctor.
• Write out your concerns, questions, and expectations before appointments 
• Practice your approach of addressing your doctor as someone who can give you useful feedback.

Conclusion

Remember, it's all about you. If you feel that you are receiving poor care, you may need to change doctors. Don't compromise your health, or more importantly, your life. Speak up, ask questions, and work hard to create a respectful, open, and honest partnership with your doctors.

SLE Support Program at HSS
Learn more about the SLE Support Program, a free support and education group held monthly at Hospital for Special Surgery.