Why Being Able to Talk with Your Doctor Matters
In the past, the doctor typically took the lead and the patient followed. Today, a good patient-doctor relationship is more of a partnership. You and your doctor can work as a team, along with nurses, physician assistants, pharmacists, and other healthcare providers, to manage your medical problems and keep you healthy.
How well you and your doctor talk to each other is one of the most important parts of getting good health care. But, talking to your doctor isn’t always easy. It takes time and effort on your part as well as your doctor’s.
This means asking questions if the doctor’s explanations or instructions are unclear, bringing up problems even if the doctor doesn’t ask, and letting the doctor know if you have concerns about a particular treatment or change in your daily life. Taking an active role in your health care puts the responsibility for good communication on both you and your doctor.
All of this is true at any age. But, when you’re older, it becomes even more important to talk often and comfortably with your doctor. That’s partly because you may have more health conditions and treatments to discuss. It’s also because your health has a big impact on other parts of your life, and that needs to be talked about, too.
How to Choose a Doctor You Can Talk To
Finding a main doctor (often called your primary doctor or primary care doctor) who you feel comfortable talking to is the first step in good communication. It is also a way to ensure your good health. This doctor gets to know you and what your health is normally like. He or she can help you make medical decisions that suit your values and daily habits and can keep in touch with the other medical specialists and healthcare providers you may need.
If you don’t have a primary doctor or are not at ease with the one you currently see, now may be the time to find a new doctor. Whether you just moved to a new city, changed insurance providers, or had a bad experience with your doctor or medical staff, it is worthwhile to spend time finding a doctor you can trust.
People sometimes hesitate to change doctors because they worry about hurting their doctor’s feelings. But doctors understand that different people have different needs. They know it is important for everyone to have a doctor with whom they are comfortable.
Primary care physicians are frequently family practitioners, internists, or geriatricians. A geriatrician is a doctor who specializes in older people, but family practitioners and internists may also have a lot of experience with older patients. Here are some suggestions that can help you find a doctor who meets your needs.
Decide what you are looking for in a Doctor
A good first step is to make a list of qualities that matter to you. Do you care if your doctor is a man or a woman? Is it important that your doctor has evening office hours, is associated with a specific hospital or medical center, or speaks your language? Do you prefer a doctor who has an individual practice or one who is part of a group so you can see one of your doctor’s partners if your doctor is not available? After you have made your list, go back over it and decide which qualities are most important and which are nice, but not essential.
Identify Several Possible Doctors
Once you have a general sense of what you are looking for, ask friends and relatives, medical specialists, and other health professionals for the names of doctors with whom they have had good experiences. Rather than just getting a name, ask about the person’s experiences. For example say: “What do you like about Dr. Smith?” and “Does this doctor take time to answer questions?” A doctor whose name comes up often may be a strong possibility.
If you belong to a managed care plan – a health maintenance organization (HMO) or preferred provider organization (PPO) – you may be required to choose a doctor in the plan or else you may have to pay extra to see a doctor outside the network. Most managed care plans will provide information on their doctors’ backgrounds and credentials. Some plans have websites with lists of participating doctors from which you can choose.
It may be helpful to develop a list of a few names you can choose from. As you find out more about the doctors on this list, you may rule out some of them. In some cases, a doctor may not be taking new patients and you may have to make another choice.
Learn About Doctors You Are Considering
Once you have narrowed your list to two or three doctors, call their offices. The office staff is a good source of information about the doctor’s education and qualifications, office policies, and payment procedures. Pay attention to the office staff – you will have to communicate with them often!
You may want to set up an appointment to meet and talk with a doctor you are considering. He or she is likely to charge you for such a visit. After the appointment, ask yourself if this doctor is a person with whom you could work well. If you are not satisfied, schedule a visit with one of your other candidates.
When learning about a doctor, consider asking questions like:
- Do you have many older patients?
- How do you feel about involving my family in care decisions?
- Can I call or email you or your staff when I have questions? Do you charge for telephone or email time?
- What are your thoughts about complementary or alternative treatments?
Make a Choice
When making a decision about which doctor to choose, you might want to ask yourself questions like:
- Did the doctor give me a chance to ask questions?
- Was the doctor really listening to me?
- Could I understand what the doctor was saying? Was I comfortable asking him or her to say it again?
Once you’ve chosen a doctor, make your first actual care appointment. This visit may include a medical history and a physical exam. Be sure to bring your medical records, or have them sent from your former doctor. Bring a list of your current medicines or put the medicines in a bag and take them with you. If you haven’t already met the doctor, ask for extra time during this visit to ask any questions you have about the doctor or the practice.
What Do I need to tell the Doctor?
Talking about your health means sharing information about how you feel physically, emotionally, and mentally. Knowing how to describe your symptoms and bring up other concerns will help you become a partner in your health care.
Share Any Symptoms
A symptom is evidence of a disease or disorder in the body. Examples of symptoms include pain, fever, a lump or bump, unexplained weight loss or gain, or having a hard time sleeping.
Be clear and concise when describing your symptoms. Your description helps the doctor identify the problem. A physical exam and medical tests provide valuable information, but your symptoms point the doctor in the right direction.
Your doctor will ask when your symptoms started, what time of day they happen, how long they last (seconds? Days?), how often they occur, if they seem to be getting worse or better, and if they keep you from going out or doing your usual activities.
Take the time to make some notes about your symptoms before you call or visit the doctor. Worrying about your symptoms is not a sign of weakness. Being honest about what you are experiencing doesn’t mean that you are complaining. The doctor needs to know how you feel.
Questions to ask yourself about your symptoms:
- What exactly are my symptoms?
- Are the symptoms constant? If not, when do I experience them?
- Does anything I do make the symptoms better? Or worse?
- Do the symptoms affect my daily activities? Which ones? How?
Give Information about Your Medications
It is possible for medicines to interact, causing unpleasant and sometimes dangerous side effects. Your doctor needs to know about ALL of the medicines you take, including over-the-counter (nonprescription) drugs and herbal remedies or supplements. Make a list or bring everything with you to your visit – don’t forget about eye drops, vitamins, and laxatives. Tell the doctor how often you take each. Describe any drug allergies or reactions you have had. Say which medications work best for you. Be sure your doctor has the phone number of the pharmacy you use.
Tell the Doctor about your Habits
To provide the best care, your doctor must understand you as a person and know what your life is like. The doctor may ask about where you live, what you eat, how you sleep, what you do each day, what activities you enjoy, what your sex life is like, and if you smoke or drink. Be open and honest with your doctor. It will help him or her to understand your medical conditions fully and recommend the best treatment choices for you.
Voice Other Concerns
Your doctor may ask you how your life is going. This isn’t being impolite or nosey. Information about what’s happening in your life may be useful medically. Let the doctor know about any major changes or stresses in your life, such as a divorce or the death of a loved one. You don’t have to go into detail; you may want to say something like: “It might be helpful for you to know that my sister passed away since my last visit with you,” or “I recently had to sell my home and move in with my daughter.”
Making Decisions with Your Doctor
Ask about Different Treatments
You will benefit most from a treatment when you know what is happening and are involved in making decisions. Make sure you understand what your treatment involves and what it will or will not do. Have the doctor give you directions in writing and feel free to ask questions. For example: “What are the pros and cons of having surgery at this stage?” or “Do I have any other choices?”
If your doctor suggests a treatment that makes you uncomfortable, ask if there are other treatments that might work. If cost is a concern, ask the doctor if less expensive choices are available. The doctor can work with you to develop a treatment plan that meets your needs.
Here are some things to remember when deciding on a treatment:
- Discuss choices. There are different ways to manage many health conditions, especially chronic conditions like high blood pressure and cholesterol. Ask what your options are.
- Discuss risks and benefits. Once you know your options, ask about the pros and cons of each one. Find out what side effects might occur, how long the treatment would continue, and how likely it is that the treatment will work for you.
- Consider your own values and circumstances. When thinking about the pros and cons of a treatment, don’t forget to consider its impact on your overall life. For instance, will one of the side effects interfere with a regular activity that means a lot to you? Is one treatment choice expensive and not covered by your insurance? Doctors need to know about these practical matters so they can work with you to develop a treatment plan that meets your needs.
Questions to ask about Treatment
- Are there any risks associated with the treatment?
- How soon should treatment start? How long will it last?
- Are there other treatments available?
- How much will the treatment cost? Will my insurance cover it?
Learn about Prevention
Doctors and other health professionals may suggest you change your diet, activity level, or other aspects of your life to help you deal with medical conditions. Research has shown that these changes, particularly an increase in exercise, have positive effects on overall health.
Until recently, preventing disease in older people received little attention. But, things are changing. We now know that it’s never too late to stop smoking, improve your diet, or start exercising. Getting regular checkups and seeing other health professionals, such as dentists and eye specialists, helps promote good health. Even people who have chronic diseases, like arthritis or diabetes, can prevent further disability and, in some cases, control the progress of the disease.
If a certain disease or health condition runs in your family, ask your doctor if there are steps you can take to help prevent it. If you have a chronic condition, ask how you can manage it and if there are things you can do to keep it from getting worse. If you want to discuss health and disease prevention with your doctor, say so when you make your next appointment. This lets the doctor plant to spend more time with you.
It is just as important to talk with your doctor about lifestyle changes as it is to talk about treatment. For example: “I know that you’ve told me to eat more dairy products, but they really disagree with me. Is there something else I could eat instead?” or “Maybe an exercise class would help, but I have no way to get to the senior center. Is there something else you could suggest?”
As with treatments, consider all the alternatives, look at pros and cons, and remember to take into account your own point of view. Tell your doctor if you feel his or her suggestions won’t work for you and explain why. Keep talking with your doctor to come up with a plan that works.
Many doctors no recommend that older people try to make physical activity a part of everyday life. When you are making your list of things to talk about with your doctor, add exercise. Ask how exercise would benefit you, if there are any activities you should avoid, and whether your doctor can recommend any specific kinds of exercise.
Questions to ask about Prevention
- Is there any way to prevent a condition that runs in my family – before it affects me?
- Are there ways to keep my condition from getting worse?
- How will making a change in my habits help me?
- Are there any risks in making this change?
- Are there support groups or community services that might help me?
Tips on Discussing Sensitive Topics with your Doctor
Much of the communication between doctor and patient is personal. To have a good partnership with your doctor, it is important to talk about sensitive subjects, like sex or memory problems, even if you are embarrassed or uncomfortable. Most doctors are used to talking about personal matters and will try to ease your discomfort. Keep in mind that these topics concern many older people.
It is important to understand that problems with memory, depression, sexual function, and incontinence are not necessarily normal parts of aging. A good doctor will take your concerns about these topics seriously and not brush them off. If you think your doctor isn’t taking your concerns seriously, talk to him or her about your feelings or consider looking for a new doctor.
Anyone at any age can have a drinking problem. Alcohol can have a greater effect as a person grows older because the aging process affects how the body handles alcohol. People can also develop a drinking problem later in life due to major life changes like the death of loved ones. Talk with your doctor if you think you may be developing a drinking problem. You could say: “Lately, I’ve been wanting to have a drink earlier and earlier in the afternoon, and I find it’s getting harder to stop after just one or two. What kind of treatment s could help with this?”
Falling and Fear of Falling
A fall can be a serious event, often leading to injury and loss of independence, at least for a while. For this reason, many older people develop a fear of falling. Studies show that fear of falling can keep people from going about their normal activities and, as a result, they may become frailer, which actually increases their risk of falling again. If fear of falling is affecting your day-to-day life, let your doctor know. He or she may be able to recommend some things to do to reduce your chances of falling. Exercises can help you improve your balance and strengthen your muscles, at any age.
Feeling unhappy with your Doctor
Misunderstandings can come up in any relationship, including between a patient and doctor or the doctor’s staff. If you feel uncomfortable with something your doctor or his or her staff has said or done, be direct. For example, if the doctor does not return your telephone calls, you may want to say something like this: “I realize that you care for a lot of patients and are very busy, but I feel frustrated when I have to way for days for you to return my call. Is there a way we can work together to improve this?”
Being honest is much better for your health than avoiding the doctor. If you have a long-standing relationship with your doctor, working out the problem may be more useful than looking for a new doctor.
Grief, Mourning, and Depression
As people grow older, they may lose significant people in their lives, including spouses and cherished friends. Or, they may have to move away from home or give up favorite activities. A doctor who knows about your losses is better able to understand how you are feeling. He or she can make suggestions that may be helpful to you.
There is no right or wrong way to grieve. Although it is normal to mourn when you have a loss, later life does not have to be a time of ongoing sadness. If you feel sad all the time or for more than a few weeks, let your doctor know. Also, tell your doctor about symptoms such as lack of energy, poor appetite, trouble sleeping, or little interest in life. These could be signs of depression, which is a medical condition.
Depression is a common problem among older adults, but it is NOT a normal part of aging. Depression may be common, especially when people experience losses, but it is also treatable. It should not be considered normal at any age. Let your doctor know about your feelings and ask about treatment.
After divorce, separation, or the death of a spouse, some older people may find themselves dating again, and possibly having sex with a new partner. It’s a good idea to talk with your doctor about how safe sex can reduce your risk of sexually transmitted diseases such as HIV/AIDS. It’s important to practice safe sex, no matter what your age.
Older people sometimes have problems controlling their bladder. This is called urinary incontinence and it can often be treated. If you have trouble controlling your bladder or bowels, it is important to let the doctor know. To bring up the topic, you could say something like: “Since my last visit there have been several times when I couldn’t control my bladder.”
Many older people worry about their ability to think and remember. For most older adults, thinking and memory remain relatively intact in later years. However, if you or your family notice that you are having problems remembering recent events or thinking clearly, let your doctor know. Be specific about the changes you’ve noticed. For example, you could say: “I’ve always been able to balance my checkbook without any problems, but lately I’m very confused.” Your doctor will probably want you to have a thorough checkup to see what might be causing your symptoms.
Problems with Family
Even strong and loving families can have problems, especially under the stress of illness. Although family problems can be painful to discus, talking about them can help your doctor help you.
If you feel that a family member or caregiver is taking advantage of you or mistreating you, let your doctor know. Some older people are abused by family members or others. Abuse can be physical, verbal, emotional, or even financial in nature. Your doctor may be able to provide resources or referrals to other services that can help if you are being mistreated.