You're on the Team: Talking to your Doctor

Getting my Doctor to Listen

If you and your doctor have agreed to make decisions together, your doctor should be prepared to listen to your concerns and take them into account. However, what if your doctor does not use shared decision-making or does not seem to hear or accept your concerns?

Seeing a doctor can feel intimidating, and you may feel pressed for time.  Even so, there are several things you can try to improve communication with your doctor and have more say in decisions about your care.

If you think you are not being heard, tell your doctor that your concern is important to you and that you want to talk it over. Explain why it matters to you and ask the doctor what can be done.
  
If you have doubts about a treatment your doctor prescribes, explain your doubts and ask for more information. 

If your doctor suggests a treatment you object to, explain why you object and ask if there are other options to try.

If you feel the doctor is deciding for you, tell the doctor you want to take part in deciding about your treatment and you would like to use shared decision-making. Shared decision-making is a new concept, so your doctor may not have considered it before. Ask your doctor to look at this website (youreontheteam.org) which has a section just for doctors.
    
If you feel the doctor is rushing past your concerns because the appointment time is short, you can save time by preparing for your appointment. By writing down your questions and concerns beforehand, you can quickly inform the doctor about how you are doing and what you need.  You can also print out a checklist and fill it out to organize your thoughts in advance. It will help you remember what you want to say. Give a copy of the form to the doctor to help save time.

If you feel like you and your doctor are not understanding each other, ask to bring a person you trust to your appointment. It could be a trusted friend, an advocate, a peer specialist or a family member.  The presence of another person can help you and your doctor listen carefully to each other.  After the appointment, go over what you heard and understood with your friend. Ask for their feedback on what they heard you say and what they heard the doctor say.

My Doctor and I Don’t Agree

Sometimes, you and your doctor may not see eye to eye on what the problem is or what to do about it. This can happen even when you both try to make decisions together.  What should you do?

If you disagree about causing your problem, you can still reach an agreement on what to try. For example, you may not agree with you doctor that you have a mental illness, or you may disagree with their particular diagnosis. Even so, you may still agree and what to try next to help you feel better.

You may disagree with your doctor on what approach to try. For example, the doctor may want to try a medication first, while you may want to try talking therapy before taking medication.  Or you may be attracted to “alternative” approaches such as mindfulness meditation or help that comes from your own cultural tradition. Get your doctor’s feedback and discuss the pros and cons. You may decide to try a combination of approaches.

If you have doubts about what your doctor recommends, ask for more information.  If you are concerned about side-effects from a drug, for example, knowing more may help you make a decision.

If you disagree with what your doctor recommends, explain why and ask for different options. You may find one that is more satisfactory.

If you still disagree about what to do, make sure that each of you understands what the other is saying, and why.  You can start by saying “I hear that you said……, and your reason is…..”  Then ask the doctor to tell you what he or she heard you say.  You might find that you haven’t understood each other. 

If you still don’t agree, tell the doctor what you plan to do and make arrangements to check back and let the doctor know how you are doing.  It’s OK to disagree, but it’s not a good idea to stop seeing your doctor at the first disagreement. Give the doctor a chance to respond to your plans, and come up with a plan of action on how to follow up with your doctor.

You can tell your doctor you would like a second opinion from another doctor.  Different doctors may have other treatment approaches, or they might confirm that your doctor is giving you the right advice.