Two major warnings are in order. First, be very careful which websites you trust. Previous columns from June 2001 and September 2001 will help you find sound medical information. Second, don’t expect your doctor to test for every scary thing you read about. Way too much of that stuff is just alarmist pap -- much like media sound bites -- and we want our doctors to appreciate, not resent, our involvement. [OTOH, my table comparing my vertigo symptoms with the known causes of vertigo helped 10 interdisciplinary physicians determine that I had a treatable inner ear problem (Meniere’s disease) rather than a few days to live with the brain stem emboli they feared a decade ago.]
So, if we don’t hit our doctors over the head with it, how do we use this extra knowledge? Concepts like preparation, comprehension, presentation, justification, decision, and action come to mind. That’s a lot of benefit from free effort.
Read. Learn enough about your medical issue to understand it, discuss it intelligently with your doctors, ask important questions, understand the answers, anticipate follow-up steps, and recognize departures from treatment norms. Example: reading led me to anticipate my prostate biopsy and learn that it requires a week without aspirin, so I avoided aspirin for the week preceding my urology appointment. This let my urologist biopsy me right away, accelerating my overall treatment by a week.
Present your case to your doctor clearly. List your symptoms and questions on paper, present them clearly and thoroughly, listen to and make notes on her answers, and be sure both of you understand the next step each will take. I’ve been praised by many physicians for my preparation and involvement, which, I am certain, helped motivate and enable them to speed up the ongoing process. They knew the next doctor in the chain could review my case very quickly and efficiently because everything they needed was in my hands, well organized and ready to discuss. I anticipated this (anticipation is cheap), and always had my lists of data and questions prepared at least one optimistic step in advance, just in case. When I first visited the surgeons, for example, I had my data and questions ready for the anesthesiologist in case they sent me directly to him. They did, and within the hour, rather than the next week, he pronounced me qualified for surgery. Another week cut from my timeline.
Compress the timelines. If it takes too long to get follow-on appointments with your doctor, make an extra one in advance each time you think it may be necessary. If you’re wrong, you can cancel it later (cancel well in advance). Each time this works may accelerate your treatment another week – important if you’re in pain or at risk, and cumulatively worth several weeks in a complicated, repeat-visit case. If your next test or appointment is right after a current test, ask people administering the current test whether they can accelerate its analysis and reports to meet that follow-on schedule. If the schedule is tight, call the doc’s receptionist a couple of hours before that follow-on appointment to make sure they have all the data they need. That buys a few more days’ compression without pressuring anyone. Don’t coerce, just ask, but only if your case warrants urgency. Remember: impatience and urgency are not the same. These people are in the business of helping others, and most are glad to oblige if they have the time and you justify your urgency.
