doctor-patient communication

The Complication of Doctor-Patient Communication

Do you ever think about what it means to visit the doctor? Most people do not attach much meaning to such visits but rather consider them as just any component of one’s yearly routine. Experienced quite differently, visiting the doctor when living with a chronic physical illness is accompanied by a host of complicated emotions. There are many layers to consider. For example, there is the literal communication style of the doctor one is treated by. Is s/he authoritarian, collaborative, or passive? Another layer is comprised of all the associations and emotions that journeying to a doctor’s office brings up. Similarly, such visits may elicit anxiety or fear about one’s condition. These are some of the thickest layers, although if one takes the time to reflect many more may emerge.

How have you interacted with authority figures throughout your lifetime? Do you feel comfortable with others telling you what you should do or do you react negatively to such direct suggestion? Perhaps you grew up in an environment where you were directed on how to make personal decisions and feel anxious in situations when you are not told specifically how to proceed. Maybe you feel like you have had enough of others telling you what to do and seek a relationship where you feel like you are an equal collaborative partner. Regardless of your personal history and style, it is important to identify what interpersonal communication style works for you when seeking out a doctor. If you prefer a doctor with a more collaborative approach and yet you visit a doctor with an authoritarian approach who insists on doing things his/her way, then you are probably going to leave the appointment feeling a bit more uneasy than if you sought out a doctor with a communication style that works for you. Of course there is probably going to be moments when your doctor recommends something that you do not want to hear but which is the best option for you, but this is different from a consistent communication style. Reflect on yourself and on your needs. If you see a doctor with whom you do not feel comfortable communicating with, you are probably going to be less likely to adhere to treatment recommendations, even if they are the most appropriate recommendations for you.

Sometimes less tangible than communication styles, are the associations and emotions that come up when visiting the doctor. These vary depending on the person, the time in the person’s life, among other factors. Feelings regarding self-image may emerge. The appointment may serve as a reminder of the changes that have occurred in one’s life, including visible changes in one’s body, mental state, and relationships. Associations to trust and betrayal may be present. What happened the last time you shared with someone the results of your doctor’s appointment? Can you trust this doctor when you had a bad experience with the last? Frustration is also quite common. Imagine having 2-3 medical appointments a week, which is not that uncommon with people who live with chronic conditions. It can feel like not only is the illness taking time away from your life but that the visits to the doctor are also eating away at your time. In its more intense form the frustration can also be anger.

Perhaps the most obvious layer and at times the most uncomfortable is the anxiety and fear that looms a few days, and at times weeks, before a specific appointment. One's initial diagnosis can very often be a traumatic experience which can shatters one's sense of security in the reality s/he believed to be. The what if factor may arise. What if the results of the tests are not good? What if there is an additional diagnosis? What if I am told I need more treatment? What if the treatment recommendations come with side-effects? The list goes on. This fear and anxiety can be maddening. 

This brief essay has not even scratched the surface of what is involved for a person with chronic illness when communicating with doctors. Much of these fears and associations may feel uncontrollable and at times usually very helpful coping mechanisms may feel powerless. Sometimes it is just a matter of finding a way to tolerate whatever comes up and knowing that it will pass. However, one thing that is more in one's control is finding a doctor one feels comfortable with, can trust, be honest with, and who takes you seriously. Additionally in one's control is the power to educate. Educate your loved ones, family, friends, coworkers, and ignorant strangers on what it is like to interact with medical professionals when living with a chronic illness. It will be worth it, even if you can stop just one person from saying, "your going to the doctor, what's the big deal?" That is one more person who now understands.