“Don’t let the doctor cut you off,” says M. Barton Laws, a medical sociologist at Brown University who researches provider-patient relationships. What researchers call “verbal dominance” is a known issue in the medical field, and Laws has established that the more of the talking the physician does, the fewer things a person remembers. When faced with someone in a white coat, don’t go mute. Assert yourself, particularly if you’re confused. Try repeating what you’re hearing (“Wait, I think I heard you say … ”).
In a study of 189 outpatient encounters, Laws and his colleagues found that people recalled less than half of what their doctors told them a week earlier. There are many reasons a doctor’s words might slip your mind. “People who are under stress don’t remember,” Laws says. What is said after a traumatic diagnosis might disappear altogether. Laws says that patients are most likely to recall directives (“Get your blood drawn down the hall”) and least likely to recollect explainers (“This is how diabetes can damage your liver”). There can also be a kind of motivated forgetting when a doctor suggests behavior changes (“Eat less sugar”).
Many appointments are allotted just 15 minutes, during which medical providers often home in on what they think is “the chief complaint.” In practice, though, patients bring up as many as 15 different issues during a visit. Show up with a list of the three main things you want to talk about, and go over all three before your doctor starts talking. “Avoid doorknob questions,” Laws says — what doctors call inquiries they get when the appointment is already over. You can always ask to see your medical records and doctor’s notes; you’re legally entitled to them.
Some 20 years ago, Laws was hired to investigate how people living with H.I.V. were taking, and sometimes skipping, their prescribed antiretroviral medications. Those accounts made him realize that what patients understand is just as vital to care as what doctors say. He believes the communication onus should be on medical providers. Still, as a patient, you have agency. “When people participate, they remember better,” Laws says.
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