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Key points
- Open communication can feel challenging but is the key to a successful doctor-patient relationship.
- You should always feel you are treated with kindness and respect.
- Asking questions helps you and the doctor, so it can be useful to take notes into your visits and follow up until you feel understood.
Stephanie Moulton Sarkis is a psychotherapist specializing in anxiety, gaslighting, narcissistic abuse, and ADHD. She is the author of seven books and one workbook, including Gaslighting: Recognize Manipulative and Emotionally Abusive People—and Break Free, and 10 Simple Solutions to Adult ADD: How to Overcome Chronic Distraction & Accomplish Your Goals. She has been in private practice for 20 years, is a contributor to Psychology Today, and is the host of the Talking Brains podcast.
I recently spoke with her about getting the most out of talking to health care professionals. In health care, strong communication between providers and patients has been linked with less burnout for providers, happier patients, and better clinical outcomes.
MB: For starters, Dr. Sarkis, why is this even a problem? What makes communication in clinical care difficult?
SS: Communication can be a challenge in any human interaction, with the potential for awkwardness, misunderstandings, and misinterpretations, particularly when discussing sensitive information. Add in the stress of a medical or psychological concern, and the possibility of miscommunication grows.
In addition, there is often a tangible power differential between the provider and patient. This power differential must be recognized by a provider to move past it, aiming to develop rapport instead. Kindness is always welcomed and a clear starting point, especially when patients seem anxious.
MB: Before we focus on what patients can do, can you summarize what clinicians can do to facilitate strong communication?
SS: Start with being aware that your patients may already have heightened anxiety when they walk through your office doors or click on a teleconferencing link. For that reason, they may forget details when answering questions or may give more information than you necessarily need. Monitor your facial expressions and aim to transmit kindness and understanding.
As you begin, ask your patient open-ended questions. Try to figure out their motivation and understanding of whatever you’re discussing. And if your client has an issue directly related to cultural practices you aren’t knowledgeable about, ask. If it feels awkward, preface your question with, “This feels awkward to ask, but….” Stating the obvious upfront can help ease tension.
MB: What about when we're the patient? What can we do to get the most of our time with a physician, mental health professional, or other provider?
SS: Between appointments, take notes regarding your health. Write down questions you want to ask your provider. Include dates, times, and preceding events. Did you have any changes to your usual routine before you experienced a migraine? Did you have increased stress? Did you experience an aura or light sensitivity? The more detail you can provide, the better.
Aim to get to your appointments at least 15 minutes early and be kind to front office staff. Call the office and let them know if you are running late due to circumstances beyond your control, such as a car accident on the freeway or your internet being down.
Once you meet your provider, have your questions open and ready to go. This makes your appointment more efficient and makes it less likely you'll miss something. Check in with how you’re feeling too; notice any fear of asking questions to your provider and try to ask anyway. Through open dialogue, you and your provider can better work together to help you get the best care.
As your visit progresses, if you feel your questions haven’t been answered to your satisfaction, gently let your provider know. It is acceptable for your provider to say, “I don’t know,” and possibly give you a referral to someone that might better be able to help you. Providing referrals is part of a providers’ ethical code and isn’t a comment on their skills or how they feel about you.
After your visit, compliance with prescribed treatment is critical. It helps when your provider knows you are making an effort and narrows down the causes of issues. If you are having difficulties complying, let your provider know. It’s possible that the treatment prescribed isn’t the best fit for you. You and your provider are on the same team, working together to optimize your health.
MB: Would you add anything specifically for parents?
SS: Again, take notes ahead of time, maybe for a week. Note date, time, and any potential behavior triggers or when your child seems “off” or not like themselves. A trigger is anything preceding the behavior that may have “set it off.” For example, did a meltdown occur after your child didn’t go down for his usual nap? Did a sibling fight precede an anger outburst? It doesn’t have to be exact; just do your best. The more detail your provider has, the more they can tailor their recommendations.
You are the expert on your child. Contact your provider when your intuition tells you something is wrong with their health or behavior. Your provider would generally prefer you let them know about any significant problem rather than wait until your appointment. It always helps to get out ahead of an issue.
MB: Of course, in or out of clinical care, any conversation can fall short. What can we do if we feel we weren’t understood or didn’t get our point across?
SS: Say that exact thing to your provider. “I feel like maybe I wasn’t understood or didn’t ask that question in the way I intended. What I would like to know is…” A confident provider welcomes questions and wants to know if you feel yours weren't answered clearly. A good provider also is willing to say “I don’t know” when they don’t have an answer. They may also add how they will find those answers or provide you with a referral.
Spend some quiet time thinking about what you would like to get out of your interactions during your next session or office visit. What would an ideal appointment look like? If your appointment went the way you wanted it to, how would you hope to feel as it ended? Write down these details and share them with your provider if you like. A healthy patient-provider relationship consists of you feeling comfortable asking questions, your provider answering those questions to the best of their ability, and you following through on recommendations as best as you’re able.
