async="src="/ Taking the Long Way Home: How to Partner with Your Doctor and Take Charge of Your Health

Friday, August 9, 2019

How to Partner with Your Doctor and Take Charge of Your Health

As an athlete, I've always been someone who likes to be in charge of my body. I'm also a nurse practitioner who works in a primary healthcare setting, managing patient care. When I was diagnosed with rheumatoid arthritis a few years ago, I looked for a specialist who would provide the medical care I needed but would also partner with me in medical decision making. In the early days of my diagnosis, I was more passive as a patient, letting my doctor order medications and treatments she deemed necessary. As time passed, I did the necessary homework, reading up on my disease and treatments and asking questions.

I took a more active role in my treatment plan when a serious side effect occurred with one of the medications I was taking. My doctor wanted to continue the medication but at a lower dose. We debated the pros and cons and in the end, she discontinued the medication. With my most recent disease flare, during which I had severe fatigue, we discussed options of how to best manage my symptoms. I agreed to a trial of a new medication. After 6 weeks of the medication, there was no improvement and I developed tinnitus, a non-reversible side effect. During those 6 weeks, I combed through the medical literature on my condition and symptoms. When I returned to see my doctor, armed with knowledge, I was prepared to discuss my perspective, as an athlete and as a patient. While she stopped the tinnitus-causing medication, alternative medications she wanted me to start would have further impacted my ability to exercise. There was an alternative medication I had learned about and when I presented it to her, she liked it.

Several months later, I can say that I am feeling and doing much better.

I see a lot of posts on social media from fellow athletes who have health problems, ranging from injuries to chronic illnesses like mine. As a health care provider myself, I can say with all honesty that not all medical providers are willing to partner with their patients to develop a plan of care that is customized to their needs. There are also patients who are willing to take a passive role in their health care and follow whatever their physician tells them. I am also amazed at people who refuse to follow conventional, proven treatments for health conditions. While there is a place for alternative medicine, it is as an adjunct to conventional medicine, not as a replacement. There has to be a happy medium here!

How do we partner with our doctors (and nurse practitioners) and still take charge of our health?



Find a provider who listens to you. 
To me, this is the most important quality in a medical provider. People always ask me why I see the doctors I see. I chose my doctors because they listen to me. My internist is my favorite medical provider because she "gets me". When I was struggling with fatigue this spring, I scheduled an appointment with her in addition to seeing my rheumatologist. When I discussed my issues and talked about what I was thinking with her, she was very supportive. On the other hand, if you don't like what you hear from a medical provider, move on. Years ago, I saw an orthopedic surgeon for a knee issue and he told me that I run "too much". I left him for another doctor and found a real solution and resolution to my knee issue.

Arrive early for your appointment. But be prepared to wait.
To be sure, I always have to wait to see my doctors. As a medical provider, I can tell you from 'the other side' that there are a couple of reasons for the wait to see the provider. Quite often, patients arrive late and providers will still see them. Unfortunately, the time your provider spends with a late arrival can often bleed into your appointment time. Sometimes a visit isn't so straightforward. Providers are given 15-20 minutes to solve all the problems. We all do our best but know that a good provider who runs behind will give you the same attention they are giving to the patients before you.


Put your phone on silent and put it away.
As a medical provider, there is nothing more irritating than someone's phone ringing while I'm seeing the patient. If you want to alienate your provider, take the call. When this happens to me, I excuse myself from the room, telling the family that I am going to see another patient while they take their call. This is just so disrespectful. And it happens to me more often than you can imagine.

Do your homework but use reputable sources for information.
My favorite mantra and one that I repeat throughout my day is that Dr. Google is NOT your friend. If you're "googling" information about your condition, include the words "evidence-based" or "scientific literature" in your search. This ensures that you will pull reputable articles, guidelines, and other information. If you're going to partner with your doctor, you want to sound educated. Whenever patients tell me that they "read something on Facebook", I want to roll my eyes. Guys, how would you feel if your doctor based their care on something they read on Facebook?

Prepare a list of questions ahead of time.
Sitting on the exam table in a flimsy gown can suck the confidence out the most self-assured person. It's intimidating! It happens to me when I see my doctors. I write down questions before I go in. A lot of my patients do that as well. When your doctor discusses a treatment or medication with you, ask them what to expect and ask about alternatives. There's nothing wrong with taking notes, too. While seeing patients, I've been put on speakerphone to talk with trusted family members and there have been times I've been recorded. If your provider doesn't like any of this, it's time to look for a new provider.

Be open and forthcoming with your medical information.
How can you expect to get the best care if you don't share everything with your doctor? Even in pediatrics, where I work, I'm always amazed at the things parents and patients don't tell me! My job is part detective work as I try to obtain the information I need to sort out the medical mysteries that appear at my door. Even if you think a symptom isn't relevant, bring it up! You never know. Be truthful about your lifestyle, too. We can only do our best with the information we are given.

Remember that the doctor isn't always right.
Trust your gut. If what your doctor is proposing doesn't sound right to you, you may want to get a second opinion. Not all doctors treat patients equally and not all of them keep up with the latest medical developments. When I was diagnosed with RA, I asked for a referral to a rheumatologist who would still let me run. There are many who won't, even though there is plenty of research to support vigorous exercise and RA.

Keep an open mind. 
Remember that your doctor is most likely more educated than you are. They've been trained to review research and interpret the data. If your provider is suggesting a new treatment for you but you're not sure about it, unless it's a life or death situation, ask them if they have more information for you to review before starting. You might not like what you're hearing, but most providers are in the profession because they want you to feel better.

How to partner with your doctor and take charge of your health /via @oldrunningmom #healthcare #curearthritis

Did I miss anything? Do you have a medical provider you trust? Where do you get your information from?




26 comments :

  1. Our family physician is a friend who was a resident in our unit a good 25 years ago. He was one of the best then and is amazing now. I remember how fondly he spoke of his grandfather back then, and I knew he would be perfect for my mom as well. You and I are lucky to have the added perspective in choosing our health care providers. All good tips - especially about asking questions and trusting your gut.

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    1. We are lucky to have insider knowledge. I say it all the time--I fear for people who don't know any better.

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  2. This is great! I love my medical provider and have been seeing her for years. She listens and understands me too. In the past my older sister used to accompany my mom to the doctor. Since she had her stroke, my young sister and I have taken over and it is exhausting. I like her medical provider as well. I always have questions for her and ask for clarification because everything is new to me. We have to choose another medical plan for her since the one she had (County Care) expired on 7/31. So many to choose from and it is intimidating.

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  3. You know I've had my share of bad drs. But from your stories I realize there are SO many bad patients out there too. I can't even imagine pulling some of that stuff.

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  4. I do think it's really important to do your hw and have a list of questions prepared. As a Dr's daughter, I am not afraid to be assertive and get second opinions. Really great tips!

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    1. It's interesting for me being on the other side, as a patient. I'm grateful for my medical background!

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  5. Excellent blog! I am lucky to have a PCP who is easy to partner with, converses with me as an equal, and really listens and responds. He makes any treatments for what ails me feel more like a collaboration than an ultimatum.

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    1. As it should be! My biggest fear now is that my doctors are going to retire...

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  6. Wonderful life experience examples you shared as well as the advice - my first real experience with a prescription discussion with my doctor did not go well and he amped up the scare tactics big time. I found another doctor who has been wonderful and I am so glad I had the courage to switch.

    With my most recent "event" (haha, where are the party streamers?) I, by luck, ended up with not only a great doctor who will speak with me as long as necessary, but also the entire staff is very warm, empathetic, and friendly. I would hope that had this not been the case I would have looked for another doctor but honestly I don't know - at least at the state I was in for the first few months, anyway. But it's really important to get the doctor who understands you and what is normal for your lifestyle...I have that except for the fact that no one is encouraging about me ever running again, argh.

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  7. I had to laugh at the image of a medical degree from Google. I'm a chronic Googler, especially about things that could have terrible outcomes, and I enjoy bragging about my hard-earned MD from Google, especially to one of my good friends who actually does have an MD (in jest, of course. I do recognize that I'm not actually a doctor and don't really know what I'm talking about, like, 99.9999999% of the time). I should print that out and frame it :P Fortunately (?), I only use my Google MD to diagnose myself with worst-case scenarios until I go to the real doctor and they tell me I'm not actually moments from death. Though there have been two different occasions where I've gone to the doctor worried that I had DVT due to calf pain (and taking hormonal birth control), and when the doctors have asked about my symptoms and I've told them ("my calf hurts, but I haven't had any swelling, redness, or heat in the area,") both times they've replied with a, "Wow, you really know your stuff," which has been VERY vindicating. They don't just hand out those Google MDs, you know! Hahaha :P But to your greater point, having a doctor who you can connect with is so important. My best medical experiences have always been with doctors where I felt heard. That makes me feel like I can trust the doctor so I don't go on a ridiculous Googling spree down the rabbit hole.

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    1. I think an intelligent search is always good. Knowledge is power! But some of the stuff you find on Google...some days I spend more time talking people off the ledge!

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  8. Great tips! It was so hard for me to find a PCP that I felt comfortable with and who understand my need to be as active as I am. It was tiresome but now Im happy with my Dr and know the search was well worth it!

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    1. I'm always surprised when people stick with a doctor just because. My parents were always like that. I've really had to advocate for them!

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  9. This is excellent, Wendy! I went round and round with my Dad about his health. "I don't have an MD after my name," was his usual response. No, I don't have an MD after my name, but it's ME living in this body.

    I feel like I won the lottery with my doctors (GP and GYN.) I'm also not afraid to ask questions. It's taken a lot of years, but I feel like I have a relationship that can withstand an awful diagnosis if the time comes.

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    1. That is my relationship with my internist. When I was unhappy with my rheumatologist this past spring, I sought advice from my internist. She is a gem!

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  10. I feel fortunate to have fantastic doctors at the Dartmouth Hitchcock Medical Center. I like it too because it is a teaching hospital. Love these tips!

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    1. Being affiliated with a teaching hospital is definitely a bonus!

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  11. Medical care is super frustrating in a "small town." We have herds of general care doctors (who are great), but very few specialists. Thankfully, there are specialists rotating in every few weeks (from DSM and the UofI Hospital), so we do have access if more in depth answers are needed. I appreciate your tip about going into your appointment with questions written down...I have a tough time remembering all the things I want to ask, especially when some of the answers lead to tangent discussions.

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    1. I always want to live where I have access to a university health care system--I see a lot of physicians who 'get stuck' practicing as they always have. It's important to have a provider who stays up to date.

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  12. It gets even harder for patients as they age, as beloved drs retire. 😔

    I was just saying today I don’t know how drs do it, just cramming all this yoga stuff in my brain is overwhelming.

    For a quiet person, though, I can be pretty assertive as well. Probably the NYer in me. 😊

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    1. Some days I swear my brain hurts from all the thinking and knowledge I've tapped into. The brain is an amazing organ!

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  13. I wish more patients would do a little research before heading straight to the ED. So many things we see could be treated at home. I'm talking about mild headaches, colds, fevers x 2 hours, and so on.
    I love the Price's Right meme. I call patients from the waiting "John Doe! Come on down!!"
    It does feel like detective work when patients only tell you bits and pieces.
    Great post!

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    1. Same goes for the office! But no matter how much I educate parents, some of them don't understand that fever isn't dangerous.

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