Patient safety and communication

Experts share tips for effective consultation with the doctor

Patient safety and communication

How often do you go to a doctor’s clinic and leave feeling confused or not having all the answers? Do you think you have a role to play, or are you a passive recipient of care?

Even though health and healing are complex conditions, your active and informed participation in a doctor’s clinic is a step towards achieving that.

While the doctor-patient interaction mostly hinges on the doctor, well-informed patients can effectively improve their experience.

A routine non-urgent medical consultation is best done via a pre-scheduled visit. It consists of the following parts:

Discussion of presenting

complaint(s): The doctor starts with asking you the reason for your visit. At times they inquire about details of the complaint, e.g. duration of symptoms, severity etc and may ask about previous health problems, medicines used etc.

Examination: The next step is a physical examination as necessary, e.g. checking the stomach if there is pain.

Diagnosis: After gathering information, the doctor reaches a probable/definitive diagnosis. They may advise investigations to confirm a diagnosis or check disease status like blood sugar in diabetic patients.

Treatment: The doctor prescribes medicines and advice linked to it, e.g. a special diet. Ideally, treatment should be a mutual decision. The doctor may ask you to follow up if needed.

In ideal circumstances, a doctor listens to a patient’s complaint(s) in detail, allowing patients as much time as they want. The patient in turn, should trust the doctor and faithfully follow treatment. However, reality often differs from this ideal and is generally because of time and lack of effective communication. All over the world, doctors are pressed for time, often having only 10 to 15 minutes per patient. Hence the focus has to be on effective communication, which helps improve understanding at both ends. Doctors can access various professional sources to enhance their communication/consultation skills. However, sources for patients are limited. The following tips can help improve interaction during a clinic consultation.

Be organized:

come prepared

Organising your complaint(s) is important before meeting your doctor. Trying to remember information or discussing it with family members while in the clinic wastes precious time. You must share relevant and focused information.

If you have more than one concern, prioritise according to its importance. Talk first about the problem that is bothering you the most.

Limit the number of complaints. A doctor can only focus on 1-2 issues at a time and may not do justice if you have 4-5 complaints. Expecting a solution to several complaints will set you up for disappointment, and you may leave without adequate understanding of your important health problems.

Effective communication: brevity is key

Be brief and precise, e.g. when being asked how the stomach pain started don’t start describing in detail how you went to a wedding where you ate salad for dinner and then had biryani after which your stomach started hurting. That is too much information. It would be better to say “I have been eating out because of a family wedding”.

Complaints at the end of consultation: do not be tempted

Do not bring up new complaints at the end of the consultation. Remember, the time to share a problem is when the doctor initially asks you the reason for the visit. If you forget something significant you can always ask the next time. The fact that you forgot may suggest it is not urgent.

Active listening: paying attention helps

After sharing your concerns, try to give time to your doctor to think and plan your care. Active listening helps improve understanding.

Using a cell phone at the clinic is a distractor

Always keep your cell on silent mode and do not answer calls during consultation. If it is urgent, ask the person accompanying you to take the call outside.

Medication list

Bringing your prescription or medicines is important if drug names and dosages are hard to remember. This saves time and allows the doctor to choose treatment appropriately and not add an in appropriate medicine.

Also, report any recent medication or dosage changes. Calling home to inquire about medicines takes time away from important doctor’s advice for you.

Allergies are important

If you are allergic to some medicine, always remember to share this information with your doctor and, including what reaction you had to it. A helpful way is to write this information on a paper that you keep next to your driver’s licence or ID card that you carry. This may help prevent you from being prescribed medicine that may cause harm.

Previous test reports

may be useful

Bringing recent lab reports and other investigations may be helpful to the doctor. Try to keep these in an orderly fashion in case the doctor wants to review them. A big thick file that is disorganised, with papers falling out, makes it harder to go through the information. Old reports (more than five years) are generally not useful. Keep any X-ray or other films in a clean, dry place, watermarks can be damaging.

Clarity is crucial

Nothing is more important than your health, so don’t hesitate to ask questions (linked to your current complaint) to understand the treatment plan. However, if you have a long list of questions, a follow-up appointment may be required as a doctor may not answer many questions at once.

Use consultation time for yourself

Your visit to a doctor is for your health only. As time is limited, use it effectively and for yourself. Do not expect the doctor to address the health issues of other family members.

We hope these tips are helpful for patients to understand their role better and improve their interaction when visiting a doctor’s clinic.

Dr Iqra Muneeb, FCPS (Family Medicine) works at Aga Khan University

Dr Saniya Sabzwari is an associate professor at the Department of Family Medicine at Aga Khan University 

Patient safety and communication