Results of the COPD In America 2015 Study reported that almost a third of respondents were unaware of the stage of their COPD when they were diagnosed, and a similar amount are still unaware of their stage today. While this can be attributed to multiple factors, one of the most likely culprits is poor communication with his/her physician.
Communicating with our physicians, with or without a serious health condition, is always a fine balance – we want to have a say, but we also want our physicians to serve as the expert; we don’t want to be spoken to as children, but we also can’t understand some of their medical jargon. Pursuing the optimum level of discussion with our doctors is often easier said than done, so often, we just don’t bother. We sit quietly, nod at appropriate times, and hope for the best. Unfortunately, while this might seem like the path of least resistance to physician interaction, it could be harming you more than you think.
For some conditions, tests, numbers, and x-rays tell the doctor how the disease is progressing, how the treatment is working. But with COPD, a breathing test will only tell so much. Personal experience—your ability to walk to the mailbox, sleep without coughing, tell a story to your friends—is a large indicator of disease status and progression, but is the number one topic on which physicians and patients are misaligned.
So, what can be done to improve the communication and mutual understanding with your doctor? Well, it’s certainly a two-way street, and the recent drive toward patient-centric medicine within the professional community will hopefully improve physician interaction. But for those with COPD, here are a few tips to have a more beneficial relationship with your doctor:
- Make a list. Before your appointment, make a list of the topics/questions you want to address with your physician. This is obviously easier said than done since our lives, and our memories, tend to get in the way. So one suggestion is to keep a pad right by your medication/inhaler. When you go to take your medication, jot down how you’re feeling or how well you think this medication is working. When it’s time to leave for your appointment, grab the pad and take it with you.
- Talk to the nurse. Many people tend to feel more comfortable talking about personal experiences and life impact with a nurse instead of our doctor. When she/he shows you to your exam room and takes your blood pressure, etc., tell her what’s on your mind and ask any questions you may have. Even if she/he isn’t able to answer them, she’ll mention the topic to your physician and the likelihood of it being addressed is much higher.
- Tell a story. We as humans are more consistent and honest when we’re telling a story about ourselves1. You might think it takes too much time, but in fact, the narrative can reveal much more to your physician than if you’d simply answered yes/no questions. The more your doctor knows about your experience, the better he/she can treat you.
- Don’t be afraid to say “no”. Politeness theory, originally formulated by Brown and Levinson in 19782, postulates that we have an instinct to verbally agree with authority figures or those we don’t know very well, despite what we think! In an effort to avoid discomfort, we will readily say “yes” in response to a question, even if we don’t actually agree. Try to remember that your physician is there to help you; if you don’t understand something, or if you’re not satisfied with a decision, speak up!
- If my friend asks… When you and your doctor begin wrapping up the visit, be sure to ask two things:
- What are the next steps for my COPD?—This question will ensure that you and your physician have a management plan, and more importantly, that you’re aligned on that management plan.
- If my friend were to ask me what we discussed today in one sentence, what would I say? This will drive your doctor to recap the visit in simple terms, again ensuring a shared understanding of what was accomplished during your discussion.
Ultimately, our relationships with our physicians are as unique and diverse as our relationships with spouses, or family—there is no one-size-fits-all approach. But one way or another, it is important to understand your health, and your physician can serve as a great resource for that information.