By Vicki Rackner, M.D.

Despite technologic advances, the most powerful medical intervention we have is still a trusting, caring relationship between you and your doctor. You get the best care when you and your doctor work well together as a team. Historically the interactions between doctor and patient have been patriarchal, like those between a parent and a child. But now, that relationship is evolving into a team effort.

Seeking Someone That Cares

I invite you to write a job description for your ideal doctor. It might look like this:

“Wanted: Caring professional with excellent communication skills, solid clinical judgment, and honed technical abilities. A person I can proudly call My Doctor.

You collect key medical and personal information and put the puzzle pieces together in a way that makes sense. You recognize that I am the expert on my own body and offer insights based on your knowledge and experience that guide me to choices that make the most sense for me.

When we don’t see eye-to-eye, we respectfully agree to disagree. I trust you deeply.

One day my life could be in your hands.”

Be the Ideal Patient

Patients have ideal doctors…and doctors have ideal patients. If your doctor were to write out a job description for YOU, it might look something like this:

“I’m in the driver’s seat in my journey to health. I recognize that all day-to-day lifestyle choices can lead in the direction of health or disease. I want to make

consistent choices that help me stay healthy. If I get sick, I collaborate with my doctor to restore my health.”

You get the best, safest, and most cost effective health care when you assume ultimate responsibility for your health. But do let your doctor be your doctor. Good healthcare is not an end in itself; healthcare is a means to a healthy life best achieved in partnership with your doctor.

Ask not what your doctor can do for you; ask what you can do with your doctor.

Set Reasonable Expectations

It would be great if doctors had the magical powers Dorothy sought from the Wizard of Oz. Unfortunately, doctors aren’t magicians. Just keep in mind that:

• Doctors are not mind readers. Your doctor doesn’t know what you think or how you feel. You must tell him or her. If, for example, your doctor does not seem concerned about your fatigue, you can say, “Being tired all of the time is a big problem for me. I want to have more energy. I’m also worried that my fatigue could be a sign of cancer.” There is no need to be embarrassed or shy; your doctor has heard it all before.
• Doctors don’t have crystal balls. Have you asked a doctor a question like, “How long will my father live?” and gotten an answer like, “At his stage of disease there is a 70% chance for five-year survival.” That means that if there are 100 patients just like your dad, 70 will be alive in five years. Your real question is whether your father will be alive in five years. But remember, statistics from clinical studies describe what happens with a group of people studied; they do not predict what will happen to your loved one.
• Doctors spend a limited amount of time with you. Most doctors are employed by clinics or hospitals, and they’re expected to meet productivity goals defined by their employers. That means your doctor is expected to see a certain number of patients each day and spend a limited time with each patient. Frequently it does not seem like enough time–to you and to your doctor. Prepare for your appointments so you can make the most of the time you have. Write a list of questions. Ask for a longer appointment when needed, even if it means paying for the time out of your pocket.
• Doctors are people too. Doctors get angry, sad, and frustrated just like you do. The reaction from your doctor may be a response to something other than you. A doctor who seems impatient might be thinking about the critically ill patient in the ER. A doctor who asks you the same question twice may have just received a worrisome call from a family member. Ask again, be patient, and make appointments early in the day—before your doctor has a chance to be completely exhausted!
• You have a job, too. The action plan you and your doctor create is an unwritten contract. Honor your doctor and yourself by honoring the contract. Let your doctor know if the plan isn’t working and re-negotiate.

Hopefully the advice above will help you choose a doctor that truly cares for you or your loved one. Remember—keeping a strong relationship with your doctor is one of the key steps in staying healthy!