Communicating with Your Cancer Care Team

Much has been written about managing communication with your healthcare team during cancer. The focus is usually on interactions with your oncologist, but there can be similar challenges in connections with others who are important in your care. Most cancer patients have a team that may include several physicians, an infusion nurse, a radiation nurse, a radiation tech, an oncology social worker, and, maybe, a nurse navigator or other specialty nurse.

You may not be aware that there is a great deal in the medical literature about communication. Doctors worry about this issue, too. It is important to remember that all of these relationships go both ways, and it is safe to assume that your doctor is also invested in a satisfying bond. The catch is that you may define "satisfying" differently than your doctor does.

In my role as an oncology social worker, I often talk with people who are unhappy about their conversations with their doctors or other providers. They may feel misunderstood or disrespected, but the most common problem is feeling rushed during appointments. Other common concerns include: not understanding what is being presented, worrying that something important is being withheld, feeling overwhelmed by information, feeling that the doctor is emotionally insensitive, dissatisfaction with systems or routines of the office, and, sometimes, just bad chemistry.

It is easy to remind you that you are the consumer, and that you are hiring your doctor. It is not so easy to feel that way. The realities of health care may mean that you have limited choices in selecting a hospital or physician that will be covered by your insurance. The balance of power is inevitably very much on the doctor's side, and it is hard to feel empowered and entitled when you are undressed and scared. There are strategies that are likely to help you feel better connected and more in control in this important relationship.

• Prepare for appointments and for phone calls. Make a written list of your questions, and start with the most important ones. Recognize that your doctor likely does not have time to go through three pages of questions at every meeting, so prioritize and organize.
• Take someone with you to every important appointment. The extra eyes, ears and memory will be helpful, and it may be useful, too, to hear how someone else experiences your doctor's words and style.
• Ask early on what is the best way to reach your doctor between appointments. Will she respond to emails? Will she herself or a nurse or fellow return most calls? Don't call with minor questions that can wait, but always call with anything that feels urgent. Being respectful of her time will make her more respectful of yours.
• Tell your doctor a little about yourself. Force some normal social interaction. Your doctor should know that your daughter is being married next summer, and that your primary goal is to dance at her wedding or that your finances are very tight and you are worried about high medical expenses. Having information about your life will help your doctor relate to you as a "real person."
• Let your doctor know what your priorities are and remind her as necessary. For example, one of my patients frequently repeats her goals: to minimize the difficulties for her family, to minimize her own emotional and physical pain, and to make memories. This clarity helps everyone.
• Finally, remember always that you and your sense of security and comfort with your care are most important. If you don't like, respect, and trust your doctor, find another. No matter how daunting that may seem, it is well worth the effort.