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Frank H. Boehm, MD, chairman of the ethics committee at Vanderbilt University Medical Center, has come up with guidelines for how patients can ensure they receive the care they expect from their doctors. 'I'm tired of hearing patients' cries of 'My doctor always seems so rushed and doesn't appear to take an interest in me or my health concerns,' ' Boehm says. 'The legendary doctor-patient trust relationship has become an endangered species.' Here is Boehm's advice to patients: (1) Learn as much as you can about your condition. Go to libraries, the Internet, or ask your doctor for articles that will help you understand many of the complicated issues surrounding your health. A well-informed patient is easier to care for. (2) There are no stupid questions. Write down questions you want answered or issues you want to discuss related to diagnosis, treatment, side effects, or prognosis. During the hectic pace of a doctor's visit, you can easily forget. (3) Don't be afraid to ask your doctor to repeat what was said. Take a close relative or friend with you if possible. Patients will often block out or misinterpret medical information, especially if it's distressing or bad news. Having a less nervous pair of ears present may prove helpful on the ride home. If this is not possible, taking notes may be helpful. (4) Ask your doctor to talk to you before you get undressed for the examination. Patients are usually more comfortable, attentive, and thorough when discussing their medical complaints while fully clothed. For that same reason, it is best to dress before once again discussing your condition and course of action. (5) Don't assume your doctor always has the best answer for you. Be prepared to ask about alternative treatments that may be available. (6) You don't have to accept your doctor's opinion if you aren't comfortable with it. A second opinion can also prevent treatment for a wrong diagnosis. A second opinion that concurs with your doctor's diagnosis can help build trust and confidence, thus reducing the need for other such opinions in the future. If your doctor has a problem with this, find a new doctor. (7) Call. You're not 'bothering the doctor.' Call immediately if any problems develop once you begin treatment. And call your doctor's office when you are improving and your treatment is going well. Like everyone else, doctors enjoy hearing good news. (8) Invoke your right to patient autonomy. You have the right to say no to your doctor's treatment plan, to deny a particular course of action, and even to suggest another form of treatment. Your doctor should explain the risks and benefits of his or her recommended course of action versus any treatment you suggest. Be sure you understand fully the risks involved in the decision you make. (9) Speak up if you feel rushed, confused, or brushed off. If you do not feel your doctor has been attentive to your questions, a simple 'Doctor, can you please sit down and go over this again,' 'I don't understand,' or 'I am feeling rushed' works quite well. (10) Ask for help in resolving an insurance issue if your insurance company is not cooperating. Health care should be a team effort. Excerpted from Doctors Cry, Too: Essays From the Heart of a Physician by Frank H. Boehm, MD, Hay House.
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