How to talk to your doctor: 7 expert tips for a better healthcare experience
In a shift towards patient-centered care, taking a proactive approach to your healthcare is important. This article, co-authored with Dr. Jill Marcus, explores how to talk to your doctor by effectively partnering with them for a personalized healthcare experience.
The Evolution of Patient-Centered Care
Picture this… It’s the 1950s and most patients with diabetes had their care managed by general physicians who lacked the experience and confidence to treat them, so they imposed super strict regimens to manage the disease. The patient had little to no say in their treatment plan.
Fast forward to the present day, and imagine this scenario… Your doctor informs you that a colonoscopy shows you have Crohn’s disease, tells you all the different kinds of healthcare choices you have and the pros and cons of each one, and then asks how you might like to proceed.
Which of the above scenarios do you prefer? I hope it’s the second one because that’s the direction medicine appears to be headed. This is part of the shift towards a more patient-centered practice.
Understanding how to talk to your doctor can transform your healthcare experience.
The Best Laid Plans: How to Partner with Your Doctor for a Better Healthcare Experience
The first time a doctor asked me how I might like to proceed with my course of action, I felt perplexed. I was used to a doctor giving me a diagnosis and then recommending (or flat-out telling me) what to do next.
Of course, I was free to choose whether I wanted to go their route or not (or get a second or third opinion). But after this new phenomenon of shared decision-making happened a few times, I decided it might be wise to adjust my mindset. I realized I needed to become more involved in my own health, more proactive for my next doctor visit.
Chances are you’ve experienced or will experience this situation as the landscape is shifting into a more patient-centered era and we’re being asked to take on a bigger role in our wellness journey, with the goal of improving the overall healthcare experience.
Preparing in advance for your doctor visit can go a long way in helping you and your physician build a plan based on your lifestyle and what you’re ready, willing, and able to try.
I’m super excited to share that I’ve written this blog post in collaboration with my brilliant sister Dr. Jill Marcus (I’ll call her Dr. J because she’s my sister and it feels strange calling her Dr. Marcus), a Family Medicine Practitioner and Assistant Professor at Rush University Medical Group in Chicago, Illinois.
I thought it might be interesting for you to get the medical perspective of a physician, along with some ways to prepare for the interaction with a health coach (that’d be me).
Shifting Care: Why Your Voice Matters
Dr. J and I will explore how the healthcare landscape has been moving away from top-down, directive medicine to a patient-centered model of care.
Developing the best plan for that individual patient is a shared decision-making process where the patient’s values and goals of care are considered alongside the physician's expertise. This shift is paving the way for a more responsive and engaging healthcare experience.
When I asked Dr. J whether she was seeing a trend in patient-centered care, her response was,
“Definitely! There has been a shift over the past couple of decades away from paternalistic medicine, toward a more patient-centered model.
“Physicians graduating from medical school and residency today are being trained in shared-decision making. This means:
- The physician’s role is to provide information, including the disease, treatment options, benefits and risks of each option, benefits and harms of screening for disease, etc.
- The patient shares their values and goals of care, and
- Together, the patient and physician develop the best plan for that particular patient.”
The Role of Doctor-Patient Communication in Shared Decision-Making
The American Medical Association (AMA) agrees.
“Ultimately, our goal is to be in a position where we are developing humanistic, patient-centered, system-citizen change agents” said Brian McGillen, MD, associate professor of health systems science at Pennsylvania State University College of Medicine."
The idea is that physicians will be trained to engage in a collaborative experience. Rather than expecting you to simply follow instructions, now seeing you as an active partner in shaping your own healthcare journey. The plan is formulated with your input and ideas, so that your healthcare experience becomes a two-way street.
Clearly, medical times, they are a changin'.
How Shared Decision-Making Leads to Better Health Outcomes
Studies have found that patients are more likely to adhere to their treatment plans if they’re more engaged in the process, which is more likely to lead to better results.
Benefits and Drawbacks of Being Part of the Process
As with most things in life, there are goods and not-as-goods with having more autonomy at the doctor’s office. But in reality, there’s very little downside to taking part in your care. And pretty soon you might find you have little choice anyway.
Dr. J agrees that there are few downsides to being involved. “I personally only see benefits to patients being more involved in their health care. When patients are more involved, they are more invested in the outcome. When they understand the decisions they are making and why, they tend to be more compliant with the care plan because they created it with their own goals, values, and desires in mind.”
“While there may be some patients who feel burdened by having to make difficult decisions, it is still worthwhile to try to have all patients remain involved in their own care."
One of the few drawbacks I can think of is that if you’re not feeling well, it can be difficult to want to participate. You may need to spend your energy healing. If that’s the case, and if at all possible, have someone who knows you and can be an advocate join you at your appointments and help out when doing research.
Navigating Health Care Choices with Confidence
Between you and your doctor, you are the only one who knows your lifestyle and what you will and won’t actually do, so you are the only real expert on you.
For example, if the doctor tells you to quit smoking, and you realistically know you’re not ready to do that, maybe you could develop your own plan that will work for you, like cutting back or going to a smoking cessation group.
Perhaps you’ve been newly diagnosed with diabetes and your doctor suggests you quit eating sugar, which is a completely unrealistic task. Are you really never going to eat anything that has sugar in it again? The food police aren’t going to come to your house and make sure you don’t ever touch that sweet magic again. So, you have to decide if that’s realistic for you. Or could you work with your doctor to figure out ways to safely incorporate small amounts into your diet?
It’s crucial that you’re involved in the conversation, because only you know whether a plan stands a chance of working with your lifestyle, your likes, dislikes, etc. For the best results, be honest with yourself and your doctor about what you’re willing to try. Otherwise, it won’t stick and you’ll be left starting over and over.
Co-Created Care Plans: Examples of Shared Decision-Making in Action
I asked Dr. J. for a few concrete examples of plans she and her patients have created together. Highlighting patient-driven initiatives, these examples showcased the core of shared decision-making for a more personalized empowering healthcare experience.
“There are so many…
Diabetes
"I’ve had several patients whose blood sugars have been so high that the guidelines recommend starting insulin. Many patients do not want to do this. So, we develop a plan with oral medications and intensive lifestyle intervention to lower their blood sugars without insulin.
"These patients check their sugars at home regularly, and follow up with me very closely. This ensures they are staying on plan and not spiraling out of control. We’ve had a lot of luck avoiding insulin in patients motivated enough to be more active in their care."
Hypertension (High Blood Pressure)
"For patients with newly diagnosed high blood pressure, I always discuss
- both medications and lifestyle interventions,
- the blood pressure-lowering effects of each option,
and work with patients to customize the combination of interventions with which they want to start.
"Patients monitor their blood pressure at home to see the impact of their choices (weight loss, lowering sodium in the diet, cutting back on alcohol, adding potassium). Again, I follow up closely to ensure they are reaching their goals."
Obesity
"We have a lot of options for helping people manage obesity (lifestyle changes, medications, surgery), so I usually ask patients about their preferences. In general, I like to start with assessing what the patient thinks is their biggest barrier to weight loss.
"Then I tend to refer to what we call behavioral intervention, where nearly any barrier can be addressed. This means referring them to a therapist or coach to help assess:
- what changes the patient has made,
- barriers to making change, and
- what motivates them to do or not do certain things that impact weight."
People do better when they are accountable for their goals, so seeing me or their coach/therapist regularly helps with that.
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How a Health Coach Can Help You Co-Create a Care Plan
The physician’s job is to give you the knowledge you need to take action. Your job is to take the action (or not). The health coach’s job is to help you create and follow a path that works for you so that action has a better chance of leading to results.
Because talking to the doctor can feel intimidating for many people, whether it’s because they’ve felt body-shamed or have experienced some kind of medical trauma, not all patients feel comfortable engaging with them.
Finally, and perhaps most importantly, a coach can help the patient create and follow their own path based on the balance between the doctor’s feedback and the client’s lifestyle.
And let’s not forget the loving accountability a good coach can provide (as well as a mighty dose of empathy). This collaboration can make the healthcare journey less intimidating and more effective, especially when you have support with doctor-patient communication.
7 Expert Tips on How to Talk to Your Doctor for a Productive Visit
- Prepare Ahead of Time. Think about what you want to discuss and any questions you may have before your appointment.
- Engage in Shared Decision Making. Get involved in discussions about your treatment options, the pros and cons of each, and be an active participant in your care plan.
- Be Open and Honest. Share your values, goals, likes, and dislikes with your doctor to create a plan tailored to you.
- Consider Professional Support. If needed, consider talking with a health coach to help you prepare for the interaction and create a follow-up path based on your lifestyle.
- Monitor Your Health. Track symptoms or health metrics like blood sugar or blood pressure at home to help your doctor make informed decisions.
- Seek Out Collaborative Physicians. Look for doctors who are trained in shared decision-making and patient-centered care.
- Involve Loved Ones if Needed. If you are not feeling well, involve someone who knows you and can advocate on your behalf.
When you know how to talk to your doctor, you can clearly convey your health concerns and understand your options.
The Times, They Are A Changin'
Medicine is evolving, and it’s time to change with it. Take a collaborative approach with your doctor and become an active participant in your care plan. Upgrade your next doctor visit! Prep for collaboration by using the resources and tools in this post.
These childhood photos, snapped by our loving parents, echo the family's core: a lifestyle woven with helping and togetherness. A healthy lifestyle is a journey that's about collaboration, empathy, and understanding each other's needs and desires.
Photos by my mom or dad of me and Jill when we were kids
Tailor your health journey with help! Craft an attainable plan that fits your lifestyle and needs with the support of doctors, health coaches, and loved ones. As Bob Dylan sang, "The Times, They Are A Changin'" - and so should your approach to healthcare.
Practicing how to talk to your doctor effectively is a skill worth mastering. Ask informed questions, share concerns, and work together. It will help you take charge of your health and ensure you receive the best possible care.
In the upcoming second part of this three-part series on how to maximize your doctor’s visits, we’ll look specifically at how to do a deep-dive before your appointment so you feel fully prepared to get what you need most from the interaction.
Thanks to my uber-intelligent and compassionate sister for helping me highlight ways to make your next doctor’s visit a more collaborative healthcare experience so you can get started on an action plan that you’re ready to conquer.
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Perfection rejectionist Lisa Kiersky Schreiber is a nutrition and lifestyle coach who helps clients take a holistic and realistic approach to wellness. Lisa got off the diet carousel and can help you do the same.
Find other articles written by Lisa on her coach profile. Her philosophy will help you simplify your nutrition lifestyle so you can learn to trust yourself implicitly around food.
