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Daniel E.

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10 Tips for Communicating More Effectively with Physicians -- and Others -- for Your Mental Health
by Joe Wegmann, P.D., L.C.S.W.
Psychology Today blog: PharmaTherapy

July 19, 2009

Learn how you can better communicate with your physician.


One of the most prevalent communications gaps is between doctors and and patients. Many people develop "white-coat brain lock" when it comes to asking questions. Others feel inferior and are intimidated by what they believe to be the doctor's superior expertise.

How well do you communicate with your mental-health medication prescriber? Whether that's your primary-care physician, psychiatrist, nurse practitioner, or physician assistant, the more open your communications, the better your chances at receiving optimal care. These 10 tips will have you communicating more effectively with prescribers during office visits.

1. Prepare for Your Appointment: Doctor's offices these days are a flurry of activity. So unless you're having an initial evaluation, your visit is likely to be as brief as 20 to 30 minutes. Here's how to come prepared:

  • Arrive early. Every doctor's office will ask you to fill out forms. Arriving early will help ensure that you've got everything in order before you meet with your doctor.
  • Bring a list of your symptoms. The more specific the descriptions, the greater the likelihood your doctor will be able to zero in on your problem. For example, these are clear, helpful descriptions:
    • "I've been feeling sad lately, and I have no energy."
    • "I've lost my appetite over the past several days, and I'm sleeping poorly."
    • "I've recently started feeling excited and agitated, but I can't seem to calm down."
  • Bring a list of all medications you now take. Be sure to include all over-the-counter medications -- including vitamins, herbals and other supplements. These are medications, too.
  • Bring all your insurance information and any healthcare directives. If you're seeing a physician for the first time, also bring your medical records -- or have them sent in advance of your appointment.
  • Purchase a spiral notebook and title it simply "My Mental Health." Use it to jot down specific questions you have for the doctor, and to take notes as your questions are answered. Word of caution: If you feel you're being answered in "doctor-speak," ask for an answer in plain English you can understand.
2. Keep It Simple: During your visit, ask your physician or other caregiver, "What do you think is wrong with me?" Then ask these three follow-up questions:

  • What led you to that conclusion?
  • What might be causing this to happen?
  • What else could it be?
3. Ask About Testing: Your physician may advise that certain psychological tests are warranted to better clarify your problem. If so, ask these questions:

  • What do these tests involve?
  • How should I prepare for these tests, if at all?
  • Will you conduct the testing? Or will I be referred to another mental-health professional?
  • If I am being referred, what can you tell me about the reputation of the mental-health professional for this type of testing?
4. Explore Your Treatment Options: Once your physician has prescribed a treatment for your condition, ask these questions:

  • Is there more than one treatment for my disorder?
  • If so, what are the pros and cons of each treatment?
  • With which treatments have you had the most success?
  • What are your experiences with these treatments?
5. Prescription Medication: This can be a thorny issue, as prescriptions are often generated at the end of a visit. But don't be put off by that. At a minimum, you need to know the following:

  • What kind of medication is being prescribed for me?
  • For what length of time will I be taking it?
  • What can I realistically expect from this medication?
  • What are the medication's typical side effects? Can I combat these side effects, and if so, how? Do these side effects diminish over time?
  • When might I start noticing the medication's results?
  • Is this medication habit-forming?
  • Are there possible interactions with other medications I already take?
  • If the initial medication is unsuccessful, what other options exist?
  • Are there foods, drinks or activities I should avoid while taking this drug?
  • Is a generic, low-cost version of this medication available?
6. Get Other Referrals: If you're seeing a family practice or internal medicine physician for your mental health treatment, ask if a referral to a specialist -- such as a psychiatrist -- might be in order. Given the complexity of today's medical information, no one expects every physician to be an expert in all disciplines.

7. Don't Hold Your Tongue: It can be difficult to deal with an impatient physician. Remember though, you are the customer! And without "customers," physicians have no practices. So don't leave the office until you have answers to all your questions. And be sure they're answers you actually understand.

8. Don't Withhold Information: Doctors aren't mind-readers. If you're not sharing information because you believe it is too sensitive or irrelevant to your visit, please reconsider. What you're withholding just might be a key piece of the puzzle to finding out what's wrong and how to treat you. Playing the guessing game can derail an otherwise satisfying visit.

9. Bring a Buddy:
Doctor visits are much more tolerable when you bring along a friend, family member or colleague for support. Also, most physicians will permit your companion to accompany you into the treatment room. Companions can help you relax, remind you of questions you need to ask, and help you interpret what the doctor said. If your visit concerns a particularly sensitive matter, your companion can always step outside while you talk with your doctor.

10. Always Follow Up: In today's frenetic world of medicine, physicians can barely keep up with their daily appointments. So following up with them is your responsibility. Don't wait for your physician to call you!

Ask your physician when you should have a follow-up visit. Before that date arrives, call the physician's office to make an appointment.

Finally, remember that building a trusting, positive and rewarding partnership with your doctor will take both time and effort. There may be ups and downs along the way. But trust your instincts. Is the relationship a good fit for you? If yes, do all you can to make it work. But if not, acknowledge that you may need to hand over your care to someone else. That way, your mental health will be your top priority.

Joe Wegmann is a licensed pharmacist and clinical social worker, professional speaker and trainer, and the author of Psychopharmacology: Straight Talk on Mental Health Medications.
 
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