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Making the most of doctor's appointments

Making the most of doctor's appointments

Article adapted from the workshop run at The Somerville Foundation Conference, October 2012.

Many people find going to see the doctor difficult. There can be many factors that might lead to us leaving an appointment feeling that it hadn't gone as well as we had hoped.

For instance, there is the power dynamic between doctor and patient: the sense that the doctor is the one in control of the appointment. This can be accentuated by a feeling of vulnerability, not helped by possibly having to remove your clothes or sit in a hospital gown.

The type of appointment, or the seriousness of your health concern or symptoms, may also be a factor. People are likely to become more emotional the more crucial something is. There may be bad or difficult news to deal with - how do we cope with hearing that, as the patient, or as their family or friend?

Things don't always run smoothly in hospitals: reports get lost, notes can't be found, staff can sometimes be offhand or rude; any of which can lead to feelings of frustration.

However, there are ways we can help improve our chances of getting what we would like from the doctor and other medical staff.

Assertive communication: We are likely to increase our chances of being heard and getting the response we would like if we are able to communicate clearly in an assertive manner. This means clearly expressing our needs and concerns in a respectful adult way. E.g. "I am worried about the next procedure you are suggesting, can you tell me more about it, please?" We should try to make ‘I statements' and own our own feelings, rather than be aggressive and attacking, or passive and saying nothing. Assertiveness is about treating yourself and others with respect. The aim is to work in partnership with the doctor or nurse.

Keeping calm can be really hard at times, as we often act in response to our feelings. These reactions might not always be very helpful in getting what we need from the doctor, as they can lead us to keeping quiet and not asking questions, getting embarrassed, or being stroppy and angry or even walking out.

Be your own expert: Get to know your own health and body. People born with a heart condition probably know much more about their heart condition than some doctors who aren't specialists (e.g. your GP or at A&E). It's important to assert what you know is true for you and to trust your intuition if you feel something isn't right.

Who is the best person to answer your questions? It is not always the doctor. It could be the Cardiac Liaison Nurse who has more ideas about self management of particular symptoms or who might be easier to contact.

Remember, if you can communicate clearly and calmly you are much more likely to be 'heard'. We all have different ways we can react when stressed. Be aware of your own tendencies so that you can help prevent your feelings getting out of control.

Hints and tips

Preparation before your appointment: Take in any relevant information on your condition and any allergies or medication that you are taking.

Note down any changes in your condition or symptoms you have been experiencing. It can be helpful to take in these notes to remind yourself of how your health has been.

Write down any particular concerns or questions you might have (you could record them on your phone). Anticipate any questions you might be asked.

Sometimes it can be helpful to ask someone to come with you to support you in the appointment, particularly if you are someone who gets anxious or if the appointment is quite a crucial one. They are another pair of ears to hear what has been said, take notes, or remind you of the questions you wanted to ask.

Anticipate what possible feelings or reactions you might have during your visit to the hospital and the appointment. What might help with these? Perhaps learning a calming breathing exercise, taking a book, puzzle or iPod if you know you might have to wait, etc.

During the appointment:

We all have the right to be treated with respect - this includes the medical staff. Focus on communicating your concerns as clearly as possible. Find ways to try to keep calm and deal with any feelings you might have. Practise a quick fix calming breathing exercise.

Remind yourself it is okay to:
  • take your time
  • ask questions
  • ask the doctor to repeat what they are saying or explain medical terms if you don't understand
  • ask the doctor to draw a diagram if that helps
  • ask them about what they hope to achieve and the side effects of any procedure, medication or surgery that is suggested
  • ask if there is any further information (like a leaflet) that explains things
  • Try to find out the best way to contact the doctor, or the team, if you have any further questions once you get home.

Following the appointment:

Think about and go over what was discussed at your appointment. Contact the doctor or team if you have any unanswered questions.

It is common for people to feel quite numb and shocked if they hear difficult news at an appointment. Sometimes it's not until later that they become aware of any feelings. It can be helpful to talk about any thoughts or feelings about your appointment, your current health needs and ways of managing them with relatives, friends, or other people who have a similar condition.

If you are unhappy with what the doctor has said you can ask for a second opinion. If you were born with a heart condition, you can ask to be assessed by one of the Specialist ACHD Centres.

You have the option to take forward a complaint both informally or formally.

You are entitled to apply to see your medical notes.

Sources of help and support

Here are some possible places you could get support:
  • an understanding friend or family member
  • from other people with experience of living with your condition
  • the Somerville Foundation Community Forum
  • the Somerville Foundation Helpline
  • the Cardiac Liaison Nurse at the specialist unit you attend
  • the Patient Advice and Liaison Service (PALS). They are a hospital department that provides information, advice and support to patients, families and their carers. PALS workers are NHS employees that are there to help, especially with concerns or informal complaints.
  • from other kinds of support group e.g. a Carers Group
People who also have a learning disability or mental health need may be able to access support through specific advocacy schemes, or through disability support and learning disability liaison nurses at the hospital and in the community.

You are also very welcome to contact me if there is anything you want to talk through in relation to getting information, coping strategies or taking forward concerns or complaints.

Anne Crump Mental Health Support Worker anne@thesf.org.uk / 020 8240 1165
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