What can test a patient's patience?
Poor bedside manner
- Doctors who don't listen to what their patient is saying, don't appear interested or don't act empathetically. Many patients sense a lack of respect, and say they're made to feel like hypochondriacs.
- Fear of judgment and sermonising from doctors if a patient comes clean about taking drugs, sexual practices or lifestyle issues. If patients find some doctors' contempt for alternative medicines and therapies irksome, they're also less likely to mention using them.
- Personality traits or mannerisms of one or both parties may sometimes prove too hard to deal with.
Waiting can be especially frustrating if an appointment has been made for a specific time. However, the nature of medical practice means it's not always possible to run on time.
- Some patients arrive with a long list of ailments, queries and concerns - without booking a longer appointment.
- Some patients present with what seem like simple issues that turn out to be more complex.
- Emergency cases need to be fitted in.
- Extra time may be needed for doing tests.
- Patients get frustrated when doctors don't look beyond the obvious diagnosis and treatments.
A patient's perspective:
"I had horrible dermatitis on my hands and kept being given creams to put on it. It never went away and I suffered for months. I hopped on Google and it suggested giving up milk/lactose. I did and my hands cleared up in less than two weeks. Coincidence? Maybe. But food allergies and intolerances are not uncommon - doctors should know or perhaps suggest these things, rather than just attempt to cure a particular symptom."
- Some patients would prefer a pill to make all their problems go away, others would prefer constructive lifestyle advice or alternative therapies. If nothing is needed, they'd rather have nothing.
- Consumers have expressed concerns that doctors sometimes don't know enough about medications they're prescribing and are overly reliant on information from the drug companies. Many are also disappointed by the lack of information they receive about how to take the medicine and possible side effects.
Mind the gap
- Patients resent paying a full consultation fee just for a repeat prescription or referral renewal, which takes a matter of minutes. By contrast, doctors get frustrated when patients happily pay hundreds of dollars for alternative practitioners and therapies with no evidence they work, but complain about having to pay a few dollars for the Medicare gap.
How to be a better patient
Doctors' frustration with certain behaviours or habits of patients can affect the quality of health care the patient gets.
Disregarding lifestyle advice
- Doctors advise that many health complaints can be treated or reduced by making lifestyle changes: eating less or better food, exercising regularly, stopping smoking and/or getting enough sleep.
- Many patients don't follow this sensible advice and can be unwilling to make lifestyle changes, preferring instead to take a pill – and some doctors just go along with it.
- Sometimes the patient doesn't know where to start. Broad advice to eat less and exercise more could be supplemented with a referral to specialists such as an Accredited Practising Dietitian or exercise physiologist, or perhaps even a psychologist.
A patient's perspective:
"Having an overweight, unhealthy-looking doctor lecturing me about my lifestyle is a bit rich."
- It's now becoming increasingly common for patients to begin the consultation with a demand for a prescription medicine they've researched themselves, rather than seek their doctor's expert opinion for a diagnosis and treatment recommendation. It's usually better to leave medical advice to your doctor than the internet.
- If a medicine doesn't agree with you, don't just stop taking it – tell your doctor, as there may have been a dosage error or the side effects may be otherwise avoidable. Side effects may also be important and noteworthy in terms of the medicine's safety profile, and should be officially recorded on adverse events databases.
A doctor's perspective:
"It's good when patients do their own research, but I hate it when they just demand a particular medicine without asking my opinion as to whether that's the best option."
"Nothing worth mentioning..."
- Patients often don't mention taking herbal medicines, either because they assume they're "natural" and therefore don't count as drugs, or because they're worried the doctor will be dismissive or negative about them. But herbal medicines are not always safe for people with certain conditions, and may not be safe when taken in conjunction with certain prescription medicines. Herbal doesn't mean harmless!
- Patients argue that until doctors show more respect for alternative therapies, they're unlikely to be more forthcoming.
- Procrastinating before going to the doctor means valuable treatment time has been lost and the patient has suffered. Some patients may be embarrassed about coming to the point and may skirt around the key issue, leaving their doctor unsure what's really going on.
- Then there are the "doorknobbers" who spend the appointment chatting about matters of little significance, and just as they're leaving, with their hand on the doorknob, will say "oh, and by the way..." – and out comes the main concern.
- Finally, there are the patients who spend months compiling a list of maladies and requests for tests and referrals, and save it all for one bonanza appointment – for which they've been allocated the standard timeslot. If you have a lot to talk about, make a longer consultation, or better still, several.
Getting the most out of your appointment
Asking the right questions can go a long way towards better health. Here are some key tips and strategies to help you get the most out of your appointment.
Just ask your doctor
Our US sister organisation, Consumers Union, compiled these questions to help you make the most of your consultation with your doctor:
- What is my exact diagnosis?
- What's the cause of my problem?
- How long will I be sick?
- How long before I'll see improvement?
- Under what conditions should I call you or come back?
- Can you recommend any sources of information?
- Why is this test necessary? What will it tell us that we don't already know?
- Will the results significantly alter any treatment plans?
- When will the results be ready? Should I call you for them, or will you call me?
- What treatments are used for my condition? Which is best for me, and why?
- What does the research show about this treatment?
- Is there any research on the horizon about treatments for my condition?
- What can I expect from this treatment, based on your experience?
- What are the side effects of this medication? Will it interact with alcohol, caffeine, or other drugs or supplements I take? Will it make me sleepy?
- Are there any alternative treatments appropriate for me to try, either before or along with conventional treatment?
- How will these changes help my disorder?
- How soon should I expect to see an effect?
- How drastic do the changes have to be to produce real results?
- Do you have any tips that would make these changes easier?
How can you get the best health care?
- Ask friends and relatives for recommendations. There are many great doctors around, and if you're not happy with your own, you can always look for a new doctor.
- Ask for a longer appointment if you have more than one issue to discuss.
- Take someone with you. A friend, relative or spouse can help you remember everything you want to raise with the doctor. They can take notes for you while you talk, and also help you make sense of what you were told. However, this can be counterproductive if that person makes it difficult for you to speak frankly or if they interfere with the conversation, so choose your companion carefully.
- Write down the medical concerns you want to talk about in order of priority, and make a follow-up appointment if necessary.
- Talk clearly and frankly. You'll get better care if you explain your concerns as clearly as possible. Talk about your problem without embarrassment – the doctor's probably heard it all before.
- Ask questions. It's your body and your health – if you don't understand something, ask for clarification. If you feel you need to know more, ask where you can find further information.
When and how to complain
If you've had a bad experience with a doctor or any health professional, you should complain. The doctor may not actually realise they've caused mental anguish or offence, and your complaint may discourage them from doing it again.
For serious complaints, your actions can protect others from an incompetent or unprofessional GP. Put your concerns in writing, complete with names, dates and places. Do this as soon as possible after the event so you don't forget details. Send a letter to the practice manager or hospital, and give the doctor a chance to respond.
If there's no response, or you're not satisfied with the response, you can lodge a complaint with the Australian Heath Professionals Regulation Agency (AHPRA), which offers a step-by-step online complaints process. If it's considered unjustified or frivolous, it will be dismissed. If a serious complaint is upheld, it may warrant disciplinary action and/or the doctor's deregistration.
The most common official complaints about doctors:
- Poor treatment: misdiagnosis, wrong or inadequate treatment.
- Problems with communication: including poor attitude and the provision of wrong or inadequate information.
- Professional conduct: such as incompetence, assault, sexual misconduct, fraud and other inappropriate behaviour, and impairment due to drugs or alcohol.
- Medication: prescribing or administering incorrect or inappropriate medication.
Health Care Ombudsman