Dr. Katharina Mahadeva Cadwell is a physician and health coach with interest in leveraging AI to create and achieve personalized health visions through her tailored programs. She is the founder of Vivo, Ltd., a health coaching company dedicated to reversing pre-diabetes by integrating Blue Zone principles and evidence-based behavioral strategies.
Navigating a doctor's visit can be daunting, especially when trying to convey your health concerns effectively. However, mastering the art of communication with your physician can significantly enhance your healthcare experience. This article delves into the importance of patient empowerment through clear communication and provides seven actionable steps to help you talk to your doctor like a pro, ensuring your voice is heard and your needs are met. Whether it's being concise, providing context, or articulating your health goals, these strategies are designed to make your medical consultations more productive and satisfying.
The importance of effective communication
“Wow, thank you so much! That was literally everything I needed to ask you!” My patient beamed as he finished his short and highlight-packed story about his medical issue. I think back to the few skilled orators in my practice who surely have had the benefit of a classical Greek university or are seasoned public speakers. Those patients are far and few between but are the dream of every busy physician – a stark contrast to our everyday experience. Patients do not receive any training or help about how to get their information across efficiently, especially in a setting where time is short and lines are long. But as physicians become more adept at communication skills, why not empower our patients to do the same and turn them into better advocates for themselves in the process?
Striving for a patient-centered approach
A patient-centered approach to healthcare is what we strive for, to honor patients’ wishes, autonomy, and right to self-determination. But doctor visits are fraught with difficulties in communication and suboptimal outcomes unless conducted by a well-trained physician. A recent study in the Journal of General Internal Medicine shows that patients get interrupted after an average of 11 seconds by their physician. Multiple reasons were identified for this, such as physician time constraints, burnout, and lack of training in effective communication. But effective communication has shown benefits in patient adherence to medical treatment plans, patient engagement, and participation in treatment decisions, as this article shows, especially when the stakes are high in more complex medical cases.
Challenges in eliciting patient concerns
As a physician with two decades of clinical practice, I have gained extensive experience in honing my communication skills. Over the years, I have also received input from many colleagues. They often discuss and sometimes bemoan their difficulties in eliciting the highlights of a patient's problem within the limited time of a visit. While post-graduate training programs and continuing education initiatives are working to address this skill gap, what can you as a (potential) patient do today to make your doctor visits more effective and efficient, with maximum value for both you and your physician?
7 steps to maximize your doctor visits
1.Be concise
Remember the 11 second ‘rule’. Convey your main concern and relevant background information as if you are presenting a pitch or are creating a video ad. State your problem and list the facts in order of importance, with the most important ones at the top. This article explores the relationship between highly efficient exchange of quality information and meaningful health outcomes.
2. Provide context
In what situations are you experiencing the problem? Is it only when you walk upstairs, does it wake you up in the middle of the night? State how the problem is affecting your life. It is quite different if you can no longer keep up with your job or your family responsibilities, or if the problem is barely noticeable.
3. What are your goals?
As a physician, I place particular value on this part as it gives me insight into your values and hopes for your health. Your goals might involve completely eliminating a problem because you have a busy professional career you want to pursue. There may be differing perspectives on control of symptoms (especially if you have a chronic illness) between you and your physician, based on your physician’s own values and experiences, which can lead to a misalignment in treatment goals. You as the patient must communicate your goals to your doctor and provide your own context.
4. Think about your values
This is a continuation of your goal statement – your values and how you envision your life. I ask this question a lot and find that not everyone spends much time articulating it. You may have spent time envisioning your ideal life but putting it into clear words can be tough. Articulate this through journaling and reflective writing. It will help you gain more clarity. It will also make it easier to discuss your vision, life, and health goals with your loved ones.
5. Voice your level of understanding
For two people to align their communication for clarity and to reduce misunderstandings, this is a high value talking point for you as the patient. A skilled practitioner will be able to ask the right questions but as we have seen, this may not be the case across the medical world. And of course, don’t be afraid to ask clarifying questions. This is your communication quality control. Your doctor will think you understand everything just fine if you don’t ask. At times you may even have to request your doctor to slow down, rephrase, and explain something in a different way. Repeat back what you do understand at various points as your way of taking an active role in your communicative partnership.
6. Ask questions
This can be tough for patients from cultural backgrounds that may consider it improper or even rude to ‘question’ their physician. However, doing so is part of shared decision-making with your doctor, and at the same time an exercise in patient empowerment. Write your questions down beforehand and bring them with you if needed. Don’t be afraid to read them off your list. If the stakes are high, such as a specialist appointment about a serious medical illness, I recommend bringing someone you trust along to the appointment.
7. Ask for an interpreter
This part is particularly important for patients whose language used in the medical office is not their native language. If you are quite proficient and feel confident it is not a barrier, don't worry. But if you are struggling with specialty words used in medicine, studies in Palliative Care show that using a certified medical interpreter ensures appropriate understanding on both sides, conveys accurate information, and leaves the patient with a complete picture of their diagnosis, evaluation- and treatment plan. Family members are a last resort and research shows that outcomes are improved if using a professional interpreter over a family member or friend in medical visits. (Most practices and hospital settings in the US will have professional interpreter services available via phone.)
The path to effective communication
Being able to meet your doctor on a more level communication field is a skill many patients aspire to. But without a clear path to acquire this skill, patients will have potentially less effective conversations with their doctors. Empowering and maximizing health outcomes is everyone's right. My coaching program dives further into this topic as my clients work on reversing their pre-diabetes and must build meaningful long-term relationships with their physicians and treatment teams. If you are interested in learning more, book a call with me here, and check out my website. I hope to connect with you soon!
Read more from Dr. Katharina C Mahadeva Cadwell
Dr. Katharina C Mahadeva Cadwell, Integrative Nutrition Health Coach
Dr. Mahadeva Cadwell is a thought leader in health and lifestyle as medicine with a focus on reversing pre-diabetes and insulin resistance. As an Internist, Palliative Care physician, and Integrative Nutrition Health Coach, she was inspired by her decade-long work with patients as well as her own family history. With a penchant for technical innovation, she was inspired to take on the challenge of leveraging AI to develop a tailored approach to optimizing health, making health and wellness more accessible for all.
She is the founder of Vivo, Ltd., a health coaching company that seeks to realize that vision. Her mission: live healthy longer at your most vital.
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