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When Doctors Don't Listen

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WASHINGTON, D.C. (Ivanhoe Newswire) - You've heard people talk about the elevator speech as an effective strategy to grab the attention of a prospective employer. Well, using that strategy with your doctor can save your life. ER insiders share their advice on how to make sure your doctor is really paying attention to your medical needs.

A trip to the ER can be scary, but a misdiagnosis can be deadly.   

"It's so easy for doctors to order a test, like a cat scan, an MRI, or blood tests, but it's really important to know why every test is done and what the diagnosis is in advance," Leana Wen, MD, Author of When Doctors Don't Listen, told Ivanhoe.

In their new book When Doctors Don't Listen, ER doctors Leana Wen and Josh Kosowsky spell out critical mistakes doctors and patients often make when they fail to communicate.

"Telling the doctors all of your symptoms is very important," Nancy Graham, patient, told Ivanhoe.

Symptoms are important, but Wen said a patient's history can be even more valuable.

"Eighty percent of your diagnosis can be made just based on your history," Dr. Wen said.

Since you know your time with a doctor is limited, you have to grab their full attention in the first ten seconds.

"Doctors are not listening to their patients. They're hearing the words they say, but they are not really listening," Josh Kosowsky, MD, co-author of When Doctors Don't Listen, told Ivanhoe.

To get them to really listen doctors suggest practicing your high impact story.

"For example, ‘I've been so short of breathethat I can't walk from the bed to the bathroom without getting very short of breath.' That really gets the doctor's attention, and then it should have a couple of short sentences that talk about how they got to where they are and how it has impacted their life," Dr. Wen explained.

The added details could prevent a misdiagnosis and unnecessary and potentially dangerous testing.

The doctors suggest practicing your story at home, even having it on paper. If your doctor still doesn't listen, get a new doctor.

RESEARCH SUMMARY

BACKGROUND:  The cost of health care is skyrocketing; $2.7 trillion spent on health care, 18 cents of every dollar, with up to a third of medical costs wasted.  However, the problem goes much deeper than cost.  More than 100,000 Americans die from medical error every year, while the majority of errors are attributed to mistakes in diagnosis.  Every day patients are going undiagnosed or misdiagnosed despite doctors' increasing reliance on tests.  Patients feel out of control and out of touch with their own health.  Dr. Lena Wen and Dr. Joshua Kosowsky are two ER physicians who started noticing their patients becoming increasingly frustrated at getting more tests, but fewer answers, which led them to write the book When Doctor's Don't Listen.  So, to rebuild the patient/doctor relationship they say to follow their eight pillars to better diagnosis.

EIGHT PILLARS TO BETTER DIAGNOSIS: 

  1. Tell your whole story.  Studies show that more than 80 percent of diagnosis can be made based on history alone.  So learn to tell an effective story and prepare it for the next doctor visit.
  2. Assert yourself in the doctor's thought process.  Find out what the doctor is thinking as you recount your history, and let the doctor know what is on your mind.
  3. Participate in your physical exam.  Don't be afraid to ask about the implications of any findings.
  4. Make a differential diagnosis together.  "Differential diagnosis" means to just have a list of all the possible diagnoses that could explain symptoms. 
  5. Partner in the decision-making process.  Devise a strategy with the doctor for narrowing down the list of possible diagnoses.  By pairing up with the doctor, a working diagnosis without tests is often achieved.
  6. Apply tests rationally.  If a test is needed, then understanding how a particular test works will narrow down the risks and alternatives. 
  7. Use common sense.  A patient should not leave until they understand what the diagnosis is. Don't just assume the doctor must be right.
  8. Integrate diagnosis into the healing process.  Talk through the diagnosis with the doctor and make sure to understand its predicted course.  (Source: www.cnn.com)

FOR MORE INFORMATION, CONTACT:

Leana S. Wen, MD, MSc
Director, Patient-Centered Care Research
Department of Emergency Medicine
The George Washington University
(617) 901-1277
wen.leana@gmail.com

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