When you have a doctor's appointment (or go to an emergency department), the diagnosis process starts the moment the physician steps into the examination room. That's why what you say and how you say it are so critical to getting an accurate diagnosis and the best possible medical care.
You have probably heard that the average patient has less than 20 seconds (some studies say just 12 seconds) to describe the ailment before being interrupted by the doctor.
What's even more interesting is that the average doctor will have already made a diagnosis during those crucial first seconds. But if he/she hasn't gotten your full medical history, your odds of getting a correct diagnosis dramatically decline.
Talk So Your Doctor Will Listen
To prevent this scenario, when you see any doctor-whether it's your primary care physician, an emergency department physician or a specialist—what's most important is to tell your story in a way that will help him truly understand what's happening. My advice…
- Plan what you're going to say beforehand. If you have a doctor's appointment, write down your complete story and practice beforehand how you'll deliver it with a family member or a friend. While practicing, work out the details that most accurately describe what you are feeling.
- Don't use medical jargon or diagnose yourself. Because you probably haven't been trained in medical terms, you may use them incorrectly. In your own words, give a clear, chronological and vivid description of what's going on without a self-diagnosis. For example, instead of saying, "My stomach ulcer pain is an eight out of 10," you might state, “I woke up with a terrible stomachache. I felt like my belly was on fire."
- Describe how symptoms have impacted your life. You could say, "I have had such a bad headache that I could not get out of my bed for three days." If a symptom is chronic, describe how it's changed over time. For example, "My joint pain improved for a month, but it has now come back and is worse than ever."
- Answer your doctor's yes/no questions with details. Doctors use yes/no questions because it is a quick (though incomplete) way to gather information. What works best for you, the patient, however, is to answer your doctor's questions your way, giving pertinent details.
Example: If your doctor asks, "Do you have pain in your chest?" you might say, "Not pain, exactly...but I felt a kind of dull discomfort right here, around the time I got up. It lasted about an hour, and now I have a throbbing sensation in the same place from time to time."
- Don't let go of your real concerns. If you think the doctor is ignoring your concerns, you might say, "I've tried to answer your questions about my chest pain, but I also want to know why I've been feeling so queasy after most meals for the last two weeks.
If you want to be fully involved in your medical care, you'll also need to understand the reasoning behind a diagnosis. When making a diagnosis, doctors develop a list of possibilities (known as the "differential diagnosis"). From this list, doctors select one or more) that seems most likely called the "working diagnosis"). After you've told your story, ask your doctor what could possibly be wrong and what he thinks your problem is.
Important: If the diagnosis or anything the doctor says—doesn't make sense to you, ask more questions. For example, you might say, "Does this explain why I've been feeling so tired for weeks?" As the doctor performs a physical exam, participate actively by asking questions such as, "Just what is it we're looking for?"
If the doctor orders tests: Find out why.
Specific questions might include: Just what will the test show? Will it change treatment? Are there risks? Are there risks in not doing the test? Are there alternatives? Is waiting an option?
Important: If your regular doctor is not open to this type of dialogue, it might be time to find a new one—or if you're in an emergency room, offer to wait until the doctor can spend a little more time with you.
