Making the most of your Doctor’s Appointments
I imagine that most of us have had Doctor’s Appointments that have gone well, where we have felt satisfied but also other times when this really hasn’t been the case. Many people find going to see the Doctor difficult; even very confident people can find themselves behaving differently than they might usually. There can be many factors that come into play as to why we might come out of an appointment feeling that it hadn’t gone as well as we had hoped.
For instance, there is the power dynamic between Doctor and patient: the sense that the Doctor knows best. This can be accentuated by a feeling of vulnerability, not helped by possibly having to remove your clothes or sit in a hospital gown.
The type of appointment, or the seriousness of your health concern or symptoms, is also going to be a factor. The more crucial something is, understandably the more emotion and feeling will be around for everyone involved. There can be bad or difficult news – how do we cope with hearing that, as the patient or as the family or friend?
Things don’t always run smoothly in hospitals, reports get lost, notes can’t be found, staff can sometimes be offhand or rude, etc. which can lead to feelings of frustration. I’m sure it isn’t just me!
However, there are ways we can help improve our chances of getting what we would like from the Doctor and other medical staff.
Assertive communication: We are likely to increase our chances of being heard and getting the response we would like if we are able to communicate clearly in an assertive manner. This means clearly expressing our needs and concerns in a respectful adult way. E.g. I am worried about the next procedure you are suggesting, can you tell me more about it please? Making ‘I statements’ and owning our own feelings, rather than being aggressive and attacking or passive and saying nothing.
Assertiveness is about treating yourself and others with respect. The aim is to work in partnership with the Doctor or Nurse.
Keeping calm can be really hard at times as we can all just react to situations in response to our feelings. These reactions might not always be very helpful in getting what we need from the Doctor as they can lead us to keeping quiet and not asking questions, getting embarrassed, or being stroppy and angry or even walking out.
Be your own expert: Get to know your own health and body. Those of you born with a heart condition probably know much more about your heart condition than some other Doctors who aren’t specialists (GP or at A&E). Asserting what you know is true for you is really important, plus trusting your own intuition if you feel something isn’t right. Examples might be asking the Doctor to take advice from your Specialist Team, or telling them that your ECG always looks like that, and your concern is actually this. . .
Who is the best person to answer your questions: It is not always the Doctor. It could be the Specialist Nurse has more ideas about self management of particular symptoms or who might be easier to contact.
Remember, if you can communicate clearly and calmly you are much more likely to ‘be heard’. We all have different ways we can react when stressed. Be aware of your own tendencies so that you can help prevent your feelings getting out of control.
Preparation: before your appointment
- Take in any relevant information on your condition, any allergies or medication that you are taking.
- Note down any changes in your condition or symptoms you have been experiencing. It can be helpful to take in these notes to remind yourself of how your health has been.
- Write down any particular concerns or questions you might have (you could record them on your phone). Anticipate any questions they might ask you.
- Sometimes it can be helpful to ask someone to come with you to support you in the appointment particularly if you are someone who gets quite anxious or uptight or if the appointment is quite a crucial one. They are another pair of ears to hear what has been said, take notes or remind you of the questions you wanted to ask.
- Anticipate what possible feelings or reactions you might have during your visit to the hospital and the appointment. What might help with these? Learning a calming breathing exercise, taking in a book, puzzle or ipod if you know you might have to wait, etc.
During the appointment:
We all have the right to be treated with respect, including the medical staff. Focus on communicating your concerns as clearly as possible. Find ways to try to keep calm and deal with any feelings you might have. Practise a quick fix calming breathing exercise.
Remind yourself it is okay to:
- take your time
- ask questions
- ask the Doctor to repeat what they are saying if you don’t understand and to explain medical terms
- ask the Doctor to draw a diagram if that helps
- ask them about what they hope to achieve and the side effects of any procedure, medication or surgery that is suggested
- ask if there is any further information like a leaflet that explains procedures, your condition, etc.
Check out what’s the best way to contact them, or the Team, if you have any further questions once you get home.
Following the appointment:
Think about and go over what was discussed at your appointment. Call, write or email back if you have some unanswered questions.
If you are unsure about the effects a new medication is having on you or the pros and cons of a particular procedure etc then get back to the Doctor and their Team
How can you take care of yourself if you hear difficult or bad news at your appointment?
It is common for people to feel quite numb and shocked at the time and it’s not until later that they become aware of any feelings.
Get support and talk over with relatives, friends, or other people who have a similar condition, any thoughts or feelings about your appointment, your current health needs and ways of managing them.
If you are unhappy you can ask for a second opinion. If you are born with a heart condition you can ask to be assessed by one of the Specialist Centres.
You have the option to take forward a complaint both informally or formally.
You are entitled to apply to see your medical notes.
Sources of help and support
Here are some possible places you could get support:
- an understanding friend or family member
- from other people with experience of living with your condition
- the Somerville Foundation Helpline
- the Cardiac Liaison Nurse at the specialist unit you attend
- the Patient Advice and Liaison Service (PALS). They are a hospital department that provides information, advice and support to patients, families and their carers. PALS workers are NHS employees who are there to help, especially with concerns or informal complaints.
- from other kinds of support group e.g. a Carers Group
People who also have a learning disability or mental health need may be able to access support through specific advocacy schemes, or through disability support and learning disability liaison nurses at the hospital and in the community.
RAISING CONCERNS AND TAKING FORWARD COMPLAINTS
Hospitals and GP Practices all have policies and procedures for dealing with complaints. If you are unhappy about the service you are receiving or not receiving, you are entitled to ask for a copy of the complaints policy and make a complaint if necessary.
Sometimes issues can be sorted out informally.
To make an informal complaint or to raise a concern, speak with the person themselves to see if the issue you are unhappy about can be resolved If you don’t feel comfortable raising the issue with the person in question speak with their Manager or the Practice Manager (for GP’s).
In a hospital setting you can also contact the Patient Advice and Liaison Service (PALs). They are a hospital department that provides information, advice and support to patients, families and their carers. PALS workers are NHS employees that are there to help, especially with informal complaints or concerns.
If your issue has been unresolved by informal means you can take forward a formal complaint. Most hospitals will have their formal complaints procedure on their website. Generally you will need to act within 12 months to take forward your complaint. If your complaint is unresolved after this and you are not satisfied with their response, then you have redress to the Health Service Ombudsman.
The Patients Association have information on taking forward complaints against your GP or hospital service. They also have a helpline: 020 8423 8999
POhWEr are a charity that provides information, advocacy services across England, offering direct and local support, their services are independent and free. For further information on NHS Complaints and Advocacy or call 0300 456 2370.