How To Talk So Your Doctor Will Listen
Lissa Rankin, M.D., is the New York Times bestselling author of "Mind Over Medicine," "The Fear Cure," and "The Anatomy of a Calling." She is a physician, speaker, founder of the Whole Health Medicine Institute, and mystic. Lissa has starred in two National Public Television specials and also leads workshops, both online and at retreat centers like Esalen and Kripalu
As I travel around the country, facilitating community conversations about the topics in my book Mind Over Medicine: Scientific Proof That You Can Heal Yourself, many patients have expressed frustration with their doctors, claiming that they feel unheard. As patients have complained, many doctors in the audiences I’ve been speaking to have piped up in defense, claiming that patients aren’t communicating in a way that facilitates healthy dialogue and is respectful of the limitations on the doctor’s time.
The resulting conversations have warmed my heart, as doctors and patients have born witness to each other, teaching each other how to talk, how to listen, and how to become effective partners on a healing journey. I’ve been taking notes and sharing much of what I’m learning with the health care providers I’m teaching in the Whole Health Medicine Institute.
Since there’s a good chance you’re either a patient or a health care provider (or both), let me share some “Do’s” and “Don’t” I’ve learned from the wise patients and doctors who have been my teachers on my book tour.
1. Be empowered, not entitled.
Empowered patients are a relief for us doctors. When you accept responsibility for your health and become a proactive partner in your own health care, it takes some of the burden off us. Plus, the scientific data shows that empowered patients have better health outcomes. But it’s a fine line between empowered and entitled. If you start making insensitive demands of your doctor or trying to control often uncontrollable situations, your doctor is less likely to really hear you.
2. Warn your doctor that you have questions at the beginning of the appointment.
Many patients don’t have any idea how much time they’re scheduled to have with a doctor, so they don’t realize that they may only be scheduled to have 15 minutes of a doctor’s time. (Many get even less time. When I had a clinical practice, I was often expected to see two patients every 15 minutes.) If you’re 20 minutes into your 15 minute appointment and you pull out a list of 20 questions without having warned your doctor, your doctor is going to have a hard time answering your questions without upsetting all the other patients who are now stacking up in the waiting room, not to mention the staff who are praying they get to take a lunch break. If you warn your doctor beforehand that you have a list of questions, your doctor can more effectively plan the visit so that your needs are met without falling so far behind schedule that the needs of other patients are disrespected.
3. If your doctor gives you a diagnosis, ask “What else could it be?”
It’s easy for doctors to jump to snap diagnoses, especially if they're overworked or exhausted from a long night of hospital call. Don’t be afraid to gently challenge your diagnosis, not from a place of confrontation, but from a place of curiosity.
4. Get to the point.
Personal stories are great, and your doctor really would love to hear about how Johnny’s lizard ran away this morning. But if you want to take full advantage of your doctor’s time, skip the small talk and jump straight into what you want your doctor to hear.
5. Do your homework, but keep an open mind.
Feel free to bring in printouts from the internet, but if you’re tempted to self-diagnose, be willing to be wrong. Admittedly, you know your body better than any doctor, but your doctor may have experience or insights that will lead to a different diagnosis, even if your symptoms exactly match something you learned from Dr. Google.
6. Avoid victim speak.
Accept responsibility for your circumstances. A surefire way to lose your doctor’s attention is to start whining and blaming everyone but yourself for your health issues. It’s much harder to help a patient who perceives him or herself as the victim of bad luck or bad genes. When you show up as a proactive patient willing to participate in your health care, your doctor will be more inclined to listen.
7. Be vulnerable.
Intimacy arises when you’re willing to open your heart, expose your imperfections, and express emotion. When you communicate with a “just the facts” manner, it’s easier for your doctor to tune you out than when you appeal to the doctor’s humanity. If you express that something is difficult to talk about, for example, your doctor is more likely to be sensitive to your vulnerability.
8. Give your doctor the same respect and attentiveness you expect to receive.
The means please, please, please turn off your mobile devices! You’d be surprised how many patients of mine have answered calls when I’m in the middle of trying to explain something important.
9. Behave like an equal.
Yes, your doctor is in a position of authority and holds a position of respect, but that doesn’t mean you’re not both human beings with equal rights to be heard and respected. Avoid meekness. Be forceful, but gentle. Speak your mind. Say what you have to say with authority. Don’t let your doctor interrupt you or steamroll you. Say no when you don’t agree. Be willing to question what your doctor says. (Respectfully, of course!) Make your voice heard. When you’re not easy to walk all over, your doctor is more likely to respect and listen to what you have to say.
10. Express compassion to your doctor.
You shouldn’t have to do this, but I promise that if you express compassion for how busy your doctor is and how little time he or she has to truly listen, your doctor will reward you with better listening. Having spoken to doctors all over the country, as well as the ones I’m training in the Whole Health Medicine Institute, I’ve learned that most doctors are genuinely caring, and they’re as frustrated with our broken health care system as you are. But the only way to heal our broken health care system is by starting a grassroots movement to repair the doctor-patient relationship. If you acknowledge the struggles your doctor faces, your doctor is more likely to be compassionate and attentive with you.