Introduction

Reviews

Is Your Doctor a Good Teacher?

Timothy B. McCall, M.D.

After completing the interview and the physical exam, the doctor and the patient typically return to the interview room to talk. There the physician tells you what he or she has deduced, recommends further tests and treatment and instructs you on what to do to get better. This is often the best time to ask questions.

If you leave the doctor's office feeling like you didn't understand what the doctor told you or that your questions weren't answered, then the doctor isn't doing a good job as a teacher. A good doctor will often ask his or her patients at the end of the visit if they have any other questions or concerns that weren't addressed. Again, if there isn't sufficient time to deal with them all, a return appointment can be scheduled.

It’s important that the doctor speak in a language appropriate to your intelligence and level of education. Jargon should be avoided but patronizing baby talk isn’t much better. (I’m reminded of an Edgar Argo cartoon in which an elderly woman says to her doctor, “I appreciate you explaining it to me in terms I can understand—especially that part about Mr. Stomach and the food choo-choo.”)

Below, I'll list some rules of thumb to help you determine how well your doctors teaches. The degree of detail the doctor goes into will, of course, depend on the severity of your condition and on your level of interest.

The Diagnosis

Whenever possible, for each diagnosis made, the doctor should discuss the following:

• what it is
• how you got it
• how the diagnosis was reached
• how certain the diagnosis is
• what makes it better
• what makes it worse
• what to expect will happen
• what follow-up you'll need
• what would indicate your condition is worsening
• what to do if that happens

When doctors can't make a diagnosis, they ought to speculate on the possible causes of your symptoms and tell you how concerned they are. If they doubt your problem is significant, they should tell you why. Even when doctors are satisfied that there's nothing wrong with you, if they can't convey their reasoning effectively, you're unlikely to feel satisfied.

Planned Tests

For each recommended test the doctor should explain the following:

• how it's done
• what's being looked for
• what side effects it may have
• how the test's results will affect therapy
• alternative ways of diagnosing your condition
• their pros and cons of the alternatives

Drug Therapy

For any drug prescribed the doctor should outline the following:

• how and when it should be taken
• how long it should be taken
• why it's necessary
• what side effects are likely
• possible serious side effects even if they are less likely
• what to do if you feel you may be experiencing a side effect
• what to do if you miss a dose

Prevention

During the education phase of the office visit, a lot of preventive medicine happens or ought to happen. Here the doctor should tell you how your habits, of exercise and diet for example, influence your medical problems and how modifying your habits could benefit you. For people whose problems are related to environmental or occupational factors, the doctor should recommend how to prevent future hazardous exposures.

Written Instructions

Studies show that people forget about half of what a doctor tells them within a few minutes. It's therefore a good idea for the doctor to write out instructions, possible side effects or other important points. It's also not a bad idea for you to take notes on what the doctor says. Pre-printed handouts describing various drugs, tests or medical conditions can be helpful as long as they're written at a level appropriate to your education and avoid medical jargon.

Next: Is Your Doctor Misdiagnosing Environmental- and Job-related Illnesses?

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