Doctor-Patient Encounters Can be Difficult: Here is How to Take Ownership

Question: What can I do to make those unavoidable clinic encounters with a doctor less of an emotional ordeal for me. I usually find all that probing of my personal details and body parts by a stranger to be unsettling and honestly sometimes discouraging. Can’t they find an app or something to make it more dignifying?

Answer: The doctor-patient interaction process followed by most medical practitioners today is guided by regulations which have been continually fine-tuned over many decades to first of all do no harm, then protect the primary interests of the patient, and minimize the risks to both the patient and the health care provider. Once people understand that their engagement with health care providers is a process that they actually have power to influence by taking certain steps, pre-encounter anxiety and/or intense feelings of dissatisfaction after not-so-great encounters usually ease off. Generally, an embrace of the concept called “patient-centred care” by patients and physicians has the potential to make the medical consultation process better for all.

A patient is anybody who has agreed to be assessed by a healthcare professional. Following through on personal health issues sometimes requires allowing one’s private details to be disclosed or exposed to one or more strangers with professional health science training, and a role in an organized health care system.

Generally, healthcare professionals are trained to initiate patient encounters by obtaining relevant information from willing individuals using interview techniques. They then use such confidential disclosure to gain more revealing information about the patient’s situation during methodical physical examination and laboratory investigations. The ultimate aim is to match the patient’s revealed and confirmed need to the most appropriate remedy that is available and acceptable to him/her.

A patient who changes randomly from one health care provider to another every time there is a health need will necessarily have to go through a tiresome repeat of that fundamental probing process every time a new medical caregiver is engaged. This does not happen when the patient is properly referred by one healthcare provider to another.

Most people find disclosure or inspection of private details somewhat uncomfortable. That feeling of being vulnerable to misinterpretation or abuse is stronger when the circumstance of interaction or the person being encountered and permitted to move into one’s personal space is not familiar or not preferred.

Familiarity with the routines of healthcare providers sometimes helps to reduce the anxiety and discomfort of being emotionally and physically uncovered. But it is well known that health professionals receiving medical help as patients also find the inspection of their privacy just as sensitive as do persons who are not health workers.

So, what simple things can an average person do to make their medical encounters less stressful?

• Make a good choice of healthcare provider and stick to it: Aim to gradually establish familiarity with a preferred and selected medical caregiver well ahead of the time of special need. Intentional interactions with a preferred health care professional or team when in good health (such as for routine travel immunizations or an annual physical examination) can be helpful to turn interactions with “strangers” into a more relaxed relationship with “healthcare allies”. When the need eventually arises for deeper clinical interactions, such as during a stressful illness, personal difficulties should be easier to negotiate and overcome because the professionals would have become not only familiar with the patient, but also usefully armed with accumulated information about the patient from previous encounters when there was no pressure.
• Respect the engagement: Keep your clinic appointments, and develop personal health expectations about your medical encounters. Generally, patients who invest time ahead of clinic visits to plan what they need to get from the appointment tend to perceive encounters more positively than others who approach visits passively. Some people find it helpful to write down the key issues they would like to discuss with their provider so as not to forget them.
• Choose to communicate openly: Lack of trust and openness can undermine a patient-provider relationship and leave both parties feeling frustrated. Most health practitioners will respectfully take a cue from the patient if in the course of regular conversation, a patient asks what they think about patient’s right to informed consent. Basically, informed consent is a trust agreement for a healthcare provider to be transparent and not withhold any information that is relevant for a patient to make decisions about his/her healthcare.

Healthcare’s new buzz word- “Patient-centered care” enshrines many of the ideals of shared decision-making, and active involvement of patients (and their family or designated caregivers) as collaborating partners with healthcare providers to “customize” an individual’s healthcare. The Institute of Medicine defines patient-centered care as “providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.” The concept of patient-centered care is actually not altogether new, and it should be the goal of every doctor-patient encounter. What is new is that patients now have improved access to health apps and electronic tracking devices that they control. These digital applications empower patients to collect and use personal data on their own or share such with their doctors if they choose, creating opportunities for individualized healthcare. This development has real potential to improve the overall health and wellness of individuals.

Doctors all over the world are taught that the opportunity to care for another person is one of the greatest privileges that can be conferred on a professional. Every encounter with a patient must reflect this solemn privilege and the duty to first do no harm. The word “patient” has its roots in the Latin word patientem, which means one who is suffering. Rightly, the encounter with a healthcare provider must not add to a patient’s suffering in any way. Reaching this goal is a two-way street, however. It pays to do your part.

                                                                                                                                Contributed by a CH writer