When you see your doctor, you want her complete, undivided attention— but how often do you get it?
Doctors are busy, so it’s perhaps not surprising if yours sometimes seems distracted or rushed during your visit. But we all know that when people aren’t focused on their jobs, they make mistakes. And when doctors are distracted and make mistakes, the consequences can cause a lot of problems, including an incorrect diagnosis, which can lead to being treated for a condition you don’t have. About 1 in 20 patients are misdiagnosed each year, according to a new report by the Institute of Medicine — a rate that hasn’t decreased since the IOM last estimated it in 2000.
It can be easy to blame that all on physicians, but there are things you can do as a patient to help your doctor stay focused on you. If you come prepared and ask the right questions, you and your doctor can get to the root of what’s ailing you sooner, and start taking care of it.
Packed schedules lead to distraction
Doctors have to see a lot of patients, and they have little time for each one. “Doctors aren’t paid for critical thinking time,” says Dr. Armand Leone Jr. , a radiologist and medical malpractice attorney in Glen Rock, New Jersey.
It’s hard to quantify critical thinking time and t0 bill an insurer for it, so doctors’ time is usually billed per patient visit. When a doctor has only 15 minutes to spend with you, and a busy schedule nagging at the back of his mind, he may be more likely to zone out than you’d expect, Leone says.
The result might be that the doctor can’t figure out the problem during your short visit. “At that point, it’s easier to order a CT scan and a battery of lab tests than it is to ask more questions and spend more time in the room,” Leone says. “He knows the tests will probably get reimbursed by insurance, but they won’t pay him for asking more questions.”
If you have insurance, those tests might get covered, but you’ll probably still be stuck with some out-of-pocket costs and lose time in the extra appointments.
Alternatively, your doctor might misdiagnose you altogether— something Leone says is more likely to happen when a doctor is preoccupied. After that, every clinician you see will be working on the basis of that misdiagnosis. Medications, tests, and specialist visits will all revolve around assumptions about a condition you don’t have, which can cost a lot.
During the short visit you have with your doctor, try to limit the time you spend rehashing your medical history. The less you have to think about what you’re taking and how you’ve been feeling, the faster this portion of the visit can go.
That’s why you’ll want to come prepared with a list of any medications or supplements you take, regardless of whether this is the doctor who recommended or prescribed them. Note any side effects, and any other symptoms you’ve had.
If you’re there for a specific reason, do some research on your symptoms ahead of time — but stop short of diagnosing yourself. Coming to the office with a diagnosis in mind can be counterproductive and costly, especially if your physician recommends a test that ends up showing nothing.
Knowing the types of conditions that fit your symptoms may help you identify related symptoms that you’ve been ignoring. It will also help you ask your doctor better questions so you can identify a root cause together.
Ask the right questions
When you’re in the exam room, it’s all about engaging with your doctor, rather than just going through the motions of a physical. Don’t just ask simple yes or no questions. “Asking questions that require your doctor to think critically will take him off autopilot and bring him back to the present, with you,” Leone says.
Here are some examples of critical thinking questions you could ask your doctor:
● How long until we know if this is the right diagnosis?
● Why would that diagnosis cause this symptom?
● What else could it be?
● How will I know if this medication is working?
● I’ve been researching X disease— how would we know if it was that?
● I’ve been having these symptoms. What’s the worst it could be?
If these don’t fit your situation, a good general rule is to ask questions that start with why, what, and how. With a little effort, you can help keep your doctor’s head out of the clouds and in the room with you, where it belongs.