getting the doctor to stay to listen to you

[spork]

You can always ask other people for recommendations on a PCP. The psychologist/psychiatrist. A nurse. Friends/colleagues. I had surgery as part of my ongoing medical travails. One of the physicians I see recommended a particular surgeon. Every nurse I spoke to described the same person in glowing terms, and he had operated on many of them. So he was my choice.

Generally I have better results when I use physicians affiliated with major academic medical centers. They are not under as much pressure to limit office appointments to 15 minutes per patient, they are familiar with the latest clinical research and treatments, and often you'll interact with multiple physicians (resident, fellow, attending) in one appointment, so there is more than one set of eyes looking at your case. Don't know if your insurance gives you that option, but if it does it's worth looking into.

What clean says about management is correct. I learned the hard way many years ago that I have to manage my own health care because no one else will do it for me. This often means telling physicians the results of tests ordered by other physicians because they don't bother looking at information that has originated elsewhere. Sometimes during appointments I have pulled up a history of past lab tests on my laptop and said "I have been out of the normal range of X for Y amount of time despite doing Z. What might be the cause of that?" In other instances I have used a patient portal to send electronic messages to physicians about test results to save myself the hassle of an appointment. Usually I find that physicians are very responsive to written queries.

[polly_mer]

Ask the people at the church for recommendations on physicians.  Make a particular point of asking the picky people who complain about everything.  If they've found someone who makes time to listen to them, then that's probably a medical professional who will listen to you.

If you need backup to be more assertive, then get one of the church ladies who bulldoze everyone to advocate for you with the doctor, receptionist, or anyone else who is pushing for too little time.  For example, booking an appointment for a given duration to have a lengthy discussion can be done.  Your advocate doesn't have to go in the exam room with you, but can watch the clock and confront the doctor who leaves the room too soon.

[AmLitHist]

Don't be shy about speaking frankly to the doctor.  He's working for you--you're paying for his time. Why would you pay good money (yours and that of your insurance company) for poor service?

[San Joaquin]

Power is something you give other people over you.

I've been known to say firmly "Wait.  I am not finished."

Only had to fire one doctor over it (and related behaviors).

[mythbuster]

I will also emphasize something alluded to upstream. You can ask for a longer appointment time. Some appointments are scheduled to be as short as 10 minutes. Things like physicals get longer appointment times. When scheduling your appointment, tell them the minimum length you want. It gets coded slightly differently for the insurance (encounter level 3 or something), but if your insurance is half way decent, the extra time should be covered.Then come with your list of questions and concerns.

[Vkw10]

In other instances I have used a patient portal to send electronic messages to physicians about test results to save myself the hassle of an appointment. Usually I find that physicians are very responsive to written queries.

I initially disliked the concept of a patient portal, because I want to talk with doctor. But I've grown to appreciate it, because my PCP puts visit notes and test results with notes in the portal, responds to questions via the portal, and walks into exam room saying "I know you wanted to discuss [whatever] and you need three prescriptions refilled. Let me check a couple of things, then we'll do that."

I suspect the medical practice has expectations about response time, possibly with financial incentives. When my PCP was sick, another doctor responded to a portal question the day I sent it.

[kaysixteen]

Random thoughts:

1) It would stun me if this doc, a sole practitioner, has anything resembling a patient portal.  Indeed, it would pretty much stun me if he were to read anything I sent him via any media, and indeed be aware that I had sent it.  How common would it be for any overworked PCP to do otherwise?

2) I could ask for recs, yes.  But I would have to be pretty darn careful wrt the judgment of the person whose recs I sought.   One could easily get burned this way too.

3) I suppose it is possible that there would be varying length of appointments, outside of my annual physical, which the guy does spend at least somewhat more time on (largely because he does an EKG and a prostate exam).  But I would not necessarily count on it, nor on its making much of a difference given how far behind he almost always is.

4) now for the biggie-- what exactly is it about MDs that inspires such fear and reluctance to speak up?  Obviously I am paying for his time, he is not offering charity, etc.   Were he a JD... or a plumber, well,  I would speak up, but I am actually afraid of being 'fired' by him, and thus forced to immediately find an alternative GP....

[nebo113]

Replying to #4:  Fear of speaking up.   I get it.  My opthomalogist (sp)  calls me sweetie.  I asked him not to.  He did it anyway.  I have a followup appointment with him next month, which I will keep, after which I will consider finding another eye doc....not an easy thing to do here in a medical desert.  I already drive an hour and a half to see him, in another state.  And he's a good clinician.......except for sweetie. 

K16.....I'm neither shy nor an introvert, and I GET IT!!!

[clean]

My opthomalogist (sp)  calls me sweetie.

Reply to 'sweetie' with something like 'sugar lips' and see if that changes the conversation.  (Hopefully for the better!)

[nebo113]

My opthomalogist (sp)  calls me sweetie.

Reply to 'sweetie' with something like 'sugar lips' and see if that changes the conversation.  (Hopefully for the better!)

It didn't.

[kaysixteen]

"sweetie" would indeed probably be a one-strike you're out deal-breaker, yes.  And I am a guy.   I saw recently one of those PSAs on TV, talking about sexual harassment, with a staged example scene of a boss kissing a female coworker.   I saw it and thought--- this is not harassment, it is sexual assault.  Maybe I am liberalizing, but yes,  it was sexual assault.   There ain't no call for docs treating people like this 'sweetie' nonsense.  Things have changed.

Now anyone else want to weigh in on the issue of how not to be intimidated by an MD?  Part of it seems actually to be that I do have the PhD.  I rarely tell docs that, until/ unless I have been their patient for a while, or they ask leading questions that would force me to lie if I wanted to avoid telling them this.   I find that docs generally do not really know how to act around PhD patients, and this may well create an overreaction on their part, perhaps to maintain their self-perceived status or authority?   Anyone else see this?

[nebo113]

I agree with the list of questions.  And I really like the idea of asking the doc "What else do you think I should know."  Finally,  (as with my dilemma about sweetie doc) it may be time to find another doc.