Treating your oncologist with respect

How You Treat Your Doctor Can Affect Your Care

This is a tantalizing and infrequently discussed topic. Discussed publicly, that is, as you can be sure doctors and other caregivers have this conversation privately quite often. Stimulated by this article from The Washington Post, I am motivated to add my thoughts to the discussion.

First and most importantly, no one will ever suggest that you camouflage your basic self and try to be someone whom you are not. No one will ever suggest that you return to the old days of Doctors as Gods. Health care is now routinely seen as a partnership, and we rely on our patients to fully participate in their care and any decisions that must be made. We need to hear your voice and understand your feelings and values.

However, sometimes we all need a basic reminder about good manners. My mother, and probably yours, always told me that Manners make the world go around. Even in my most cranky childhood moments, I knew she was right. A situation is never improved by rudeness or snide comments or overt anger. This can be difficult when one is immersed in Cancer World, scared and probably not feeling so well and often caught in long waits or institutional tangles.

You aren't there to make friends, but you are there to secure the best possible care and have the most pleasant experience possible in this tough context. Always open with a smile and a pleasant greeting, whether that first interaction is with a garage attendant or someone at a desk as they may be having a tough day, too. Yes, your tough day trumps theirs; you are the patient and the one with cancer, but it won't help to share your worry or unhappiness with them through anger. If you are truly in pain or otherwise miserable, try leading with an apology: I am sorry if I seem brusque; I have been having a lot of pain today. That will likely smooth over any situation.

Try to sustain this honest and neutral presentation in the doctor's office. The one part of The Washington Post article that I really dislike is the suggestion to refrain from tears or emotional upset. That writer suggests the doctor's office is not the right venue and recommends saving your feelings for your therapist. While this is not bad advice, it does not take into consideration the realities of human response and the possible terrors and grief of cancer care. It would, obviously, be better not to have a complete melt down in your doctor's office, but tears may be exactly the right response to a particular moment.

In my experience, it is not tears that disrupt patient/doctor relationships, but anger or demands or too much assertive pushing. Yes, express your thoughts and your needs, but do so politely. There is never an excuse for losing your temper with your doctor's admin who can't schedule the appointment you want or connect you immediately to the doctor. Save your off-hour calls for true emergencies. Try not to demand special attention or favors. When you have an appointment, you have every right to be the most important person at that moment and to be the recipient of your doctor's full attention. If she is taking other phone calls or looking only at the computer screen, speak up. But speak up politely: I feel as though you aren't paying full attention to our conversation. Could you please look at me while we are talking? (As an aside, remember the old rule about starting with "I" statements. These sentences usually work better than ones that begin with an accusation). Being calmly assertive and clear about your needs is always the best strategy.

Your doctor shares your frustrations with the demands of today's health care environment. She wishes there were more time to sit and talk with you, but the realities are otherwise. Here are some tips for improving communications with your doctor:

• Come prepared to your appointments and bring written questions.
• Try to edit those questions in advance, so that you are not going over and over the same things.
• Ask the most important questions first so, if you run out of time, you have those answers.

These suggestions can be reduced to the Golden Rule: Do unto others as you would have them do unto you. Your doctors want to take the very best care of you, but all of us are human and respond best to kindness. This holds true in any circumstances.