***Seeing Eye to Eye with Your Doctor: An Excerpt from the Patient Whiz

Through no fault of their own most patients do not understand how to communicate effectively and efficiently with their physicians. The layperson cannot be expected to grasp complicated scientific principles it took their physicians many years to learn.

Nevertheless, this gap in communication often results in a less than perfect medical outcome. This section will empower you to narrow this gap and optimize your encounters with physicians and other health care providers.

In many instances, the overall patient-physician interaction is not as productive as it could be. After all, patients do not exactly walk into their doctor’s office and say, "Doctor, I believe I have an overactive thyroid gland and I want to be treated with radioactive iodine." If it were that simple, perhaps M.D. really could stand for "Mountain Doctor" (as Granny Clampett claimed); Jethro Bodine could really be a brain surgeon with a grade school education.

On the contrary, a physician is trained to listen to the presenting complaints of his patient. Then he works backwards by asking questions, examining the patient, and finally devising a mental list of possible diagnoses that could account for her symptoms. At that point, he may need to order tests to confirm or rule out specific conditions. Obviously, the stronger the doctor's suspicion about a particular illness, the fewer tests he will need to order to confirm that diagnosis. Therefore, if the patient's problem is communicated clearly, there is a tremendous potential to save a significant amount of money and time. Even more significant, the patient will be treated in a prompt, efficient manner with the least amount of risk and discomfort.

When relaying an explanation about a given illness, the following things should be considered:

1. When did you first notice the symptoms?
You don't have to pinpoint the exact time, but to the best of your ability, try to recall approximately how long ago you first noted the problem, such as two days ago, two weeks ago or two months ago.

2. Has anyone around you, or related to you, had similar problems?
Some conditions are contagious, while others commonly run in families.

3. Describe the chronological sequence of the symptoms.
example: "When the pain first started three to four months ago, I noticed the pain almost every day. But gradually over time it has been coming less and less frequently. Over the past few weeks I have only noticed the pain two or three times.”

4. Describe the severity of the symptoms, or relate them to the impact they have on every day activities.
example: "My symptoms have been mild; I have been able to work and do my regular activities without any difficulty."

5. If the symptom is pain, does the pain move any place, (if so, where) or does it remain in one place?
example: “The pain in my chest moves to both arms and my neck.”

6. Describe the quality of the pain. Physicians commonly use terms such as dull, sharp, piercing, achy, throbbing, burning, or tight to describe pain.
example: "It feels like someone is stabbing me in my stomach."

7. Are the symptoms constant or do they come and go?
If the symptoms are constant, is the intensity the same or does it wax and wane?
example: "I’m always short of breath, but it’s worse when I lie down.”

If they are intermittent, how long do the symptoms last each time and how long is the relief between attacks?
example: "When I have chest pain, it lasts for 15 to 20 minutes at a time. Then the pain goes away for a few days before it comes back."

8. What other symptoms, if any, accompany the problem?
example: "I have noticed when I have chest pain, I often break out in a sweat."

9. What things improve or worsen the symptom?
example: "One full-strength aspirin completely resolves my headaches within an hour.”

10. Do the symptoms improve on their own or do you need to take something for relief? If something brings relief, how long does it take to notice this improvement?
example: "Within 10 minutes of taking an antacid, I begin to feel significantly better."

11. Have you ever been evaluated by a physician for this problem in the past? If so:
• What tests were done and what were the results?
• What diagnosis was given at that time?
• What treatment was prescribed?
• Did that treatment help?
• Why did you stop seeing that doctor?