Common Gaffes

The common gaffes patients make include:

* Getting bogged down in irrelevant details.
* Not providing all the facts.
* Not furnishing the information in a chronological sequence.
* Jumbling up the details, so that they jump from one problem to another completely unrelated one.

Giving a clear medical history

It is a medical truism that if the doctor listens to the patient intelligently, he will be able to make the diagnosis correctly. However, just like learning to take in a good history is a skill the doctor needs to master, providing an intelligent history is a skill the patient needs to learn. Patients are often slipshod while recounting their medical history so that the doctor needs to methodically extract the facts from them: and this exercise can be a painful for both!

Giving a clear medical history

It is a medical truism that if the doctor listens to the patient intelligently, he will be able to make the diagnosis correctly. However, just like learning to take in a good history is a skill the doctor needs to master, providing an intelligent history is a skill the patient needs to learn. Patients are often slipshod while recounting their medical history so that the doctor needs to methodically extract the facts from them: and this exercise can be a painful for both!

Categorize your problems systematically

If you remember to categorize all your problems systematically, not only can you make better use of your time with your doctor but you can also help him arrive at a correct diagnosis more quickly! You could rehearse the details you are going to provide to your doctor with a friend or a relative. You could also summarize them on a single sheet of paper, just to make sure you don't forget any vital aspect.

Important Details

In this context, a useful aide memoir includes the following details:

* Site: Location (e.g., pain is in the chest and then spreads to the left arm).
* Quantity: Bringing up a cupful of sputum when coughing.
* Quality: It feels like an elephant is sitting on my chest!
* Setting: I usually develop such aches after fighting with my wife.
* Aggravating factors: Stomachache becomes worse after eating.
* Alleviating factors: Breathlessness becomes better after resting.
* Associated Symptoms: Other related complaints.

Give a Clear Description

You need to be able to describe your problem as accurately as possible. For example, if your problem is a headache, you should be able to provide all the details! For instance: Where does it hurt? Has the pain spread elsewhere? How severe is the pain? What does the pain feel like? Is it a sharp, dull, or throbbing pain? When does it occur? What makes it better? What makes it worse? Have you noticed any other symptoms or signs recently, such as fever, shortness of breath or blood in the urine? When did the problem start? Has it changed since then? Have you felt like this before? If so, when? What made the pain better then? Is it affecting your daily activities such as sleeping or eating?

Medical History

The simple fact that in over 80 per cent of cases the diagnosis of the illness can be made purely on the basis of what the patient tells the doctor (what is called a medical history) should emphasize the importance of one's ability to talk intelligently to one's doctor! While the capability of absorbing the relevant details of an individual's medical history is one of the key skills of a competent physician, being able to provide a lucid history is a key skill on the part of a good patient.

The Final Analysis

In the final analysis, remember that the most reliable test for a doctor's suitability for you is your own gut instinct - after all, if you don't feel comfortable with your doctor, you are not likely to be able to work well together in your health care partnership with him! On the other hand, if you have faith in his abilities and can trust him that he will do his best for you, you are likely to get excellent medical care

No Doctor is Right for everyone

There is no single who is Dr. Right for everyone, and you may need to hunt patiently and persistently for the doctor who is right for you, depending upon your temperament, personality, and perhaps age and sex. Different patients have different expectations- some need to be told what to do while others want all their questions answered. Obviously, they will need different types of doctors. Most people invest a lot of brain power and analytical skills deciding which shares or stocks to buy, but doing in - depth research for finding the right doctor is likely to pay much better dividends for you and your family!

Changing your Doctor

Changing doctors is never easy, because, over a period of time you do build up a personal relationship with your doctor. However, you should consider changing doctors if you strongly feel that:

* the doctor is incompetent (i.e. he has ignored obvious symptoms, missed a diagnosis, prescribed the wrong drug, or can't get to the bottom of your problem);
* the doctor does not communicate with you effectively ( i.e., his explanations are not in lay person's language or no time is given to you to ask questions and bring up related problems);
* the doctor does not pay attention to your needs and concern
* you have lost confidence in the doctor's skill and ability.
* you find the doctor is too inconsiderate ( i.e., he makes you wait a long time for an appointment, he fails to return your phone calls, he does not provide clinic time during evening or weekend hours ); and
* your doctor is too expensive.

Evaluate your Physician

In order to feel good about your medical care, you should feel good about your doctor, too. In this context, ask yourself the following questions in order to evaluate your physician:

* Does your doctor listen to you and answer all your questions about the causes and treatment of your medical problems, or is he vague, impatient or unwilling to answer them?
* Are you comfortable with your doctor? Can you openly discuss your inner most feelings and talk about intimate personal matters, including sexual and emotional problems?
* Does your doctor take a thorough history, asking for relevant factors about past physical and emotional problems, family medical history, medications you are taking and other matters affecting your health?
* Does your doctor address the root causes of your medical problems or does he merely prescribe medicine to treat the symptoms?
* Is your doctor well-groomed? A doctor who cannot be bothered to take care of how he looks may not look after you carefully either!
* Does your doctor smoke? (if yes, this should be a black mark against him!)
* Are you satisfied with the doctor's stand-in when he or she is unavailable?
* Do you feel at ease while asking your doctor questions that may sound "silly"?
* Does your doctor explain complex medical jargon in simple terms?
* Are the office staff members friendly? Do they listen to you patiently?
* Does your doctor answer your telephone calls promptly?
* Are you usually kept waiting for a long time even if you have fixed an appointment before hand?
* Does the doctor have hospital privileges at a respected medical institution?


If you are not satisfied with the answers to the proceeding questions, discuss your concerns with your doctor. Even after this discussion if you are still not satisfied, you should consider looking for another doctor.

Searching a Specialist

The best way of beginning the search is by asking your doctor. To start with, your doctor knows you and your situation better than any other physician, also since most doctors are aware of the accomplishments of "super-specialists" who practice at large university hospitals or research based facilities, your doctor can help you identify there experts. If you can find a book relating to your problem, then the author (if he is a doctor) is likely to be a good choice. The other option is to find the name of a doctor or the head of a clinic or department which is actively publishing their medical research in this field (you can easily do this by doing a Medline search). This doctor (or the head of the clinic) is likely to be an authority in the subject, and will be well-informed of the latest advances in the field. Many patients naively assume that all they need to do to get good medical care is to make a beeline for the west. However, do not automatically assume that just because you go to the USA, the UK or Germany, you will find a competent doctor - you need to do your homework thoroughly before making the trip!

A Bad Doctor

In contrast, a bad doctor is one who:

* Does not value your time, and makes you wait interminably on a routine basis
* Is more interested in treating your reports than in treating you
* Does not spend enough time with you
* Seems to be too busy and rushed all the time
* Orders tests whether or not they are needed
* Does not explain your options to you
* Discourages questions or refuses to answer them
* Promises too much.
* Makes remarks like "that's my secret."
* Doesn't explain clearly what he is doing during treatment. Sometimes, if you are a victim of a rare or complex problem, you may need to find a “Doctor’s Doctor" i.e. the best doctor in the city, country or the world for your particular problem. How do you go about locating such a doctor?

Attributes of a Perfect Doctor

At this stage, one may well pose the question: what are the attributes of a perfect doctor? In my opinion, a perfect doctor is one who:

* is respectful and treats you with dignity;
* makes you feel welcome;
* treats more than the symptoms;
* recognizes the expertise of the patient;
* listens to you, explains the relevant facts, asks you questions and answers your questions;
* makes home visits if you require them, or arranges for another doctor to visit you after hours;
* uses pictures and diagrams to explain complex medical terms;
* explains everything, including diagnosis, procedures, treatment and what you can expect in the future;
* is easy to talk to and gives you clear - cut information;
* is open to discussion about alternative systems and is willing to refer you to say, a natural therapist;
* is interested in you, is down-to-earth and treats you as an equal;
* prescribes medication that you can afford;
* fits you in if you are really sick despite a tight schedule ;
* is up-to-date with the relevant information;
* refers to various sources (e.g., books, journals, internet )to clarify information;
* refers you to an appropriate specialist when required;
* refers you to other support services or self-help groups;
* phones back when additional information or tests results are obtained; and
* gives adequate consultation time.

Useful criteria to consider while selecting a doctor

Useful criteria to consider while selecting a doctor are as follows:

* Is the location of the doctor's clinic important? (In other words, How far do I have to travel to see the doctor? Is it

convenient for me? Is there parking space?)
* Is the hospital to which the doctor admits patients important to me?
* Are factors such as the age, sex, race, and religion of the doctor important?
* Do I prefer a solo consultation or a group practice?
* Do I have to choose a doctor who is covered by my insurance plan?
* Is the doctor duly qualified and in which field? For example, a patient with a heart problem may prefer to see a

cardiologist, rather than a general physician.
* What days/hours does the doctor see patients? Are the timings convenient to me?
* Does the doctor ever make house calls?
* How much in advance do I have to make appointments?
* What is the length of an average visit?
* In case of an emergency, how fast can I see the doctor?
* Who takes care of patients after hours or when the doctor is away?

Influenced by a doctor’s degree?

While looking for the ideal doctor, beware of quacks! While many of us tend to be overawed by a long list of alphabets behind the doctor's name, you need to remember that not all of them are legitimate degrees. For example, many doctors will use the 'embellishments' FICA (USA) and FRSH (London) to give the impression that they have been trained abroad. These acronyms are not qualifications- they merely indicate memberships in a society abroad, which are open to anyone- even a barber- on payment of a nominal fee, can acquire such memberships!

A concerned doctor

A concerned doctor will organize the clinic and its functioning so as to minimize your visits- for example: blood samples can be collected in the clinic itself, to be forwarded to a reliable laboratory, so that you don't need to go there yourself. Similarly, many obstetricians provide the facility for ultrasound scans in the clinic itself, so that patients need not run around from one place to another.

Your First Consultation with a doctor

During the first consultation, not only should the doctor get to know you and your medical problems by examining you, but you should also get to know a lot about him. Such a initial assessment is important in answering the following vital questions: Are you comfortable with him? Does he explain the details properly? Does he use relevant teaching aids? Does he ask for your views? Does he listen to you carefully?

The Doctor’s Clinic

While it is true that many mediocre doctors flaunt posh clinics, the setting in which the doctor functions can reveal a lot about him. Is the clinic located in a decent building? Is public access easy? Has the doctor bothered to provide the basic amenities you need (e.g., drinking water, comfortable seating)? What kind of reading material is kept in the waiting area? (Old and torn magazines should qualify as a negative mark. Patient educational literature and current issues of health magazines indicate that the doctor respects your waiting time and wants to use it to educate you). Are the office staff members helpful? How do they answer the telephone? How do they treat other patients? You can learn a lot about a doctor and his practice from the personality of his employees: remember that efficient, caring physicians tend to hire competent, friendly personnel!

To find a doctor

The best time to find a doctor is when you don't need one! This statement may seem paradoxical, but finding the right doctor when you are ill becomes much more difficult, because of the stress of the illness - as well as the pressure of time. Ask your friends for recommendations. A good source of referrals can be nurses and other paramedical staff. If you have a friend who is a doctor, seek his advice as well.