When Doctors And Patients Talk

Can refocusing conversations between doctors and their patients lead to better health? Despite modern medicine’s infatuation with high-tech gadgetry, the single most powerful diagnostic tool is the doctor-patient conversation, which can uncover the lion’s share of illnesses. However, what patients say and what doctors hear are often two vastly different things. Patients, anxious to convey their symptoms, feel an urgency to “make their case” to their doctors. Doctors, under pressure to be efficient, multitask while patients speak and often miss the key elements. Add in stereotypes, unconscious bias, conflicting agendas, and fear of lawsuits and the risk of misdiagnosis and medical errors multiplies dangerously. Though the gulf between what patients say and what doctors hear is often wide, Dr. Danielle Ofri proves that it doesn’t have to be. Through the powerfully resonant human stories that Dr. Ofri’s writing is renowned for, she explores the high-stakes world of doctor-patient communication that we all must navigate. Reporting on the latest research studies and interviewing scholars, doctors, and patients, Dr. Ofri reveals how better communication can lead to better health for all of us.

Do you feel that your doctor doesn't pay attention to what you say? Does your doctor cut you off when you try to explain how you feel? Do you think your doctor could remember your name without referring to your chart? Does your doctor seem to be in such a hurry that you don't even get a chance to ask your most important questions? Do you spend more time waiting than actually talking to your doctor? Do you understand what your doctor says? At one time or another, we have all had these complaints. This book will teach you how to ask the right questions, understand the answers, and show you how to take more control of your visits to the doctor and your own health. This is the first book in which communication pioneer Barbara M. Korsch, M.D., reveals what she has learned about the doctor-patient relationship dilemma during almost half a century of investigation. In clear, simple language, Dr. Korsch answers most of our common questions: How do I know when I'm sick enough to go to the doctor? How do I know if it's serious enough to go to the emergency room? What do I do if I can't follow the advice my doctor gives me? She walks us through a typical visit to the doctor, showing us how to prepare ourselves so we don't forget the question that has been worrying us for weeks as soon as we walk through the doctor's door. She gives important tips on how to survive the dreaded hospital experience. And she offers insight into the doctor's side of the relationship, showing how doctors are trained to be task-oriented and how their natural human sympathy is discouraged throughout their careers. Finally, she offers patients useful strategies for humanizing the relationship. Korsch's helpful, commonsense recommendations are extensively illustrated with real-life doctor-patient conversations which she recorded on audio and video tape over the course of the last thirty years. She was one of the first medical professionals to emphasize the importance of teaching doctors how to talk to patients as part of their medical training. She serves as consultant and lecturer to medical schools, hospitals, and medical practices throughout the world to help the next generation of doctors communicate with their patients. Above all, after years of research, she has found abundant evidence that the relationship patients form with their doctors directly determines the quality of the care they receive. This is a vital book for anyone who is concerned about their health and who wants to take control of their medical care. So much depends upon asking the right questions and on finding a doctor who will listen to you. This book gives you the tools and the confidence to do just that.

This book discusses communication between doctors and patients and how to overcome common communication problems.

For many doctors, their role as powerful healer precludes thoughts of ever getting sick themselves. When they do, it initiates a profound shift of awareness-- not only in their sense of their selves, which is invariably bound up with the "invincible doctor" role, but in the way that they view their patients and the doctor-patient relationship. While some books have been written from first-person perspectives on doctors who get sick-- by Oliver Sacks among them-- and TV shows like "House" touch on the topic, never has there been a "systematic, integrated look" at what the experience is like for doctors who get sick, and what it can teach us about our current health care system and more broadly, the experience of becoming ill.The psychiatrist Robert Klitzman here weaves together gripping first-person accounts of the experience of doctors who fall ill and see the other side of the coin, as a patient. The accounts reveal how dramatic this transformation can be-- a spiritual journey for some, a radical change of identity for others, and for some a new way of looking at the risks and benefits of treatment options. For most however it forever changes the way they treat their own patients. These questions are important not just on a human interest level, but for what they teach us about medicine in America today. While medical technology advances, the health care system itself has become more complex and frustrating, and physician-patient trust is at an all-time low. The experiences offered here are unique resource that point the way to a more humane future.

Spoken language is the most important diagnostic and therapeutic tool in medicine, and, according to Dr. Cassell, "we must be as precise with it as a surgeon with a scalpel." In these two volumes, he analyzes doctor-patient communication and shows how doctors can use language for the maximum benefit of their patients. Throughout, Dr. Cassell stresses that patients are complex, changing, psychological, social and physical beings whose illnesses are well represented by their own communication. He proposes that both listening and speaking are arts that can be learned best when they are based on the way that spoken language functions in medicine. Accordingly, Volume I focuses on the workings of spoken language in the clinical setting. It analyzes such important aspects of speech as paralanguage (non-word phenomenon like pause, pitch, and speech rate), how patients describe themselves and their illnesses, the logic of conversation, and the levels of meanings of words. Volume II is a practical, detailed, how to guide that demonstrates the process of history taking and how the doctor can learn the most from the information that the patient has to offer. His arguments are amply illustrated in both volumes by transcripts of real interactions between patients and their doctors.

I interviewed 50 doctors using about four pages of questions developed based on the professional research literature on doctoring and my personal professional experience working with doctors. The interviews lasted between 30 minutes and two hours. I sat down with the doctor interviewees, one by one. They talked, I typed. They met with me in between patients, taking breaks to answer emails, texts, phone calls, or deal with emergencies, or after hours, on time off, during paperwork time, or while eating a rushed meal. It is also worth mentioning that some of the doctor interviewees experienced their own traumas close to the time of our interview, such as their own illness or that of someone close to them, or the death of a family member or close friend. Several of them experienced the death of their own child. Remarkably, they all kept working, each one saying that helping others helped them to cope with their own pain. After completing the interviews, I am left with an even deeper understanding of the health care crisis. It is my hope that these interviews will expose an intimate portrait of the gravity and urgency of our healthcare crisis. It is with the utmost gratitude, admiration, and humility, that I thank my doctor interviewees for their help with this task.