In this article, I refer to your aging parent, since many of our readers are doing so, but this information applies to any relationship, if you are caring for a person and help them advocate for their health.
You have concerns about your aging parent’s health. At their next health care appointment, you try to mention your feelings to the practitioner, but you leave the appointment not feeling like you have any answers. Or perhaps you mention a concern that you’d like to discuss with the doctor, but instead of a discussion, expensive tests are ordered; tests you feel in your heart aren’t necessary at all.
Clearly what is needed in both situations is for better communication to exist between yourself as your parent’s caregiver and their health care practitioner. Dr. Leana Wen and Dr. Joshua Kosowsky, practicing at Harvard University have recently published a new book to help in this cause. It’s called “When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests.”
They share their opinions about health care and communication in their recent article on CNN Health. Patients, or their caregivers, often feel out of control and out of touch with their health. We know doctors have the best of intentions, but the system of health care, Drs. Wen and Kosowsky say, is dysfunctional and rewards “cookbook medicine”, which treats every person as alike. What can you do as a caring and responsible caregiver? You must advocate for getting the diagnosis right. You must speak up and insist that you are heard, and consider yourself a partner with the physician in making a diagnosis and treatment decisions.
The 8 Pillars to Better Diagnosis, discussed in their book, will help you as your parent’s caregiver to build a great partnership with their physician.
- Tell your whole story. It’s a good idea to practice a complete, to-the-point explanation for your aging parent’s doctor to hear. Studies show that more than 80% of diagnoses can be made based simply on a descriptive history.
- Assert yourself in the doctor’s thought process. Be sure to find out what is on their mind as you recount your loved one’s history.
- Participate in the exam. As your parent is being examined, try to find out what the doctor is looking for. Speak up and ask about what any findings may indicate.
- Work together to make a differential diagnosis. A differential diagnosis is a list of all the possible diagnoses that could explain the symptoms. Keep asking the doctor what else could be going on.
- Partner in the decision-making process. Together, you and your parent’s doctor can narrow down the list of possible diagnoses. Many times you can come to a working diagnosis without many tests.
- Use test results rationally. If further testing is needed, have your loved one’s doctor explain how the test will narrow down the possibilities and what the risks and other alternatives could be.
- Use your common sense. If the conclusions don’t make sense to you, don’t assume that the doctor has to be right.
- Understand that diagnosis could be a process. Understand the predicted course of the diagnosis, and ask the physician to help you understand what warning signs you should look for should the working diagnosis be incorrect.
As Drs. Wen and Kosowsky emphasise, our patients can not afford to wait until the entire health care system is reformed. The health of your loved ones is on the line, and you must work together with your loved one’s doctor to communicate effectively. You must be your parent’s best advocate in their health.