Why don’t patients ask questions of their doctor?

My wife came back from a doctor’s appointment the other day, and immediately, I noticed that she looked puzzled and somewhat confused. So, I asked her about her appointment.  She went over her discussion with the doctor as I kept probing with questions about their conversation.  I found myself asking the following question more than any other: “Well, did you ask him about…?” Before too long, doing what I do for a living, I could not help but wonder why patients aren’t more inquisitive. Is there something about the patient-doctor relationship that makes patients not want to ask questions of their physicians?

Surely, the primary responsibility for gathering information about the patient’s medical conditions is and should be with the physicians. After all, their knowledge of medicine is vastly superior to that of the average patient. Still, when a patient has questions, there is often no good reason not to ask them. Consider a physician who orders hormone replacement for a female patient with a history of blood clots or hypercoagulability of which the physician is unaware. Consider another patient who develops a series of complications after a surgical procedure but who decides to tough-it- out and not ask any questions during follow-up appointments with the physician. In both of these examples, the patient risks developing potentially life-threatening conditions, and, if the patient knows or suspects that possibility for whatever reason, it is probably not a good idea to assume that the doctor will be the one to ask the right questions. So, why are patients sometimes reluctant to ask more questions about their medical care or condition?  I don’t presume to know the answer, but I suspect, in part, it has to do with the patient’s expectations.

For example, when I am pain, I don’t really want to have an extensive Q & A session with my doctor. I just want treatment!  It is simply mentally relaxing to just let go and have someone else take care of me. In addition, my knowledge of medicine is superficial at best. I don’t feel comfortable asking questions if I don’t know what I am talking about. My ego would rather have me in pain than allow me to question a doctor at the risk of looking like a fool.

On a subconscious level, I am probably also dealing with preconceived notions about doctors.  As long as I can remember, I have been told that doctors are intelligent and in control. After all, who else is capable of getting into medical school and then have the stamina to survive some seven to ten years of medical training? All of this makes me think that my doctor can only make the right decisions about my medical care. And then there is the medical office or the hospital. The smells, the patients (most with problems far worse than I have), the complicated machines that look like they belong in a sci-fi movie don’t exactly add-up to a familiar, comfortable environment.  I am in pain, uncomfortable, and somewhat intimidated – not exactly an environment conducive of critical thinking.

Well, if this is how other people feel, I think that might explain why patients are sometimes not as inquisitive as they should be.  What do you think?  If you are a patient or a physician, your feedback is much appreciated. Of course, everyone is welcome to comment.

Contributing author: Jon Stefanuca

Editor’s Note: This piece was written by Jon Stefanuca. My own wife has an advanced degree in pathology, did surgical pathology and autopsies. She DOES ask questions! Do you really need a medically-related degree, however, to ask the basic questions so that you have a clue what you’ve just agreed to by way of medical care? I think not. Moral of the story: be your own patient advocate! If you need help, then have a family member or a close friend accompany you if you have any doubt.

Patient satisfaction scores improve when doctors sit down – well, that’s part of the answer perhaps!

One of the people I follow on a daily basis is KevinMD on Twitter. Why would a medical malpractice lawyer follow a physician?, you ask.  Simply put – this doctor seems to get it.

In a blog he wrote today –Patient satisfaction scores improve when doctors sit | KevinMD.com – (we’ll call him Dr. Kevin – his name on his Twitter page is Kevin Pho, M.D.), Dr. Kevin brings yet another practical tip to his colleagues in the medical profession – when dealing with patients, the ‘act of sitting down’ can have a profound effect on patient satisfaction.  Believe it or not, this was actually the subject of a study According to the study performed at a University of Kansas Hospital.  In this study a physician documented 120 visits, half of which he conducted sitting, and the other half, standing.

What the medical community still does not seem to get is that their interactions with patients are critical many times in situations where the outcome is not good.  I simply cannot tell you how many initial client interviews share a common theme – “the doctor really gave me the bums-rush and just didn’t seem to care about me as an individual.”  I just had that very same conversation three times in the past two days alone.  One variant on this theme occurs after a bad outcome and the patient simply wants to know what happened.  Time and time again clients tell the story of trying to seek out their doctor, who dodges them, to find out what happened.  I know – doctors are concerned that if they get involved in such a discussion, this will turn out to be evidence used against them by some plaintiff lawyer.

What I can share with the medical community is that if you sit and just explain a situation to a loved one or the family in general is that this is all most people (yes – not all) want to hear.

Photo supplied by KevinMD.com

Granted – I can only speak from my limited perspective.  That being said, one of the things we look for during the initial interview is the motivation of the prospective client for being in our office.  If it’s financial – we shy away.  Those cases are always problematic.  The over-ridding theme or characteristic of a ‘good client’ is their desire to (a) just want to know what happened that went wrong or (b) make sure that what happened (which they often don’t understand because no one would tell them) doesn’t happen to someone else.  Those are the clients who are appreciative even when you ultimately reject their case following investigation.

So, Dr. Kevin, you have part of the answer right.  I might suggest you add on – actually trying to care about why you are sitting down talking to your patient, knowing what’s important to them and when something goes awry, taking the time to help them understand what happened.  Again, from my limited experience base (which is better than the 120 people in the “Kansas Hospital’ study, that time spent with your patient or the family will probably cause you to spend less time giving a deposition in your malpractice lawsuit.  In fact, you just may never have to give a deposition at all!

Keep up the good advice Dr. Kevin!  Maybe I will be able to field less calls from disgruntled patients and families if your colleagues follow some of your sage advice.