Adam's Apple
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- Apr 25, 2004
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11 Things You Should Discuss with Your Doctor
By Harvard Health Publications
Its easy to suggest that you talk to your doctor. Its much harder to know what to say.
Some of us are fortunate enough to have built up a relationship with a physician over many years, so theres some genuine rapport and trust to bank on. But it can be a difficult exchange to navigate. Often you dont feel great to begin with. The doctor seems hurried and speaks in jargon. Youre intimidated and reluctant to talk about personal issues. Besides, even in the best of circumstances, its hard to know whats important to mention.
We asked several members of the Health Letters editorial board to suggest topics and issues that patients should discuss with their doctors. We were particularly interested in things that patients should bring up, but usually dont. Here are 11 of their suggestions for things you should tell your doctor:
What you want to do or used to do but cant do any longer
Either out of stoicism, denial, accommodation, or some combination of all three, people often come to accept a certain level of disability, especially if its the result of a condition that has come on slowly or involves something private like sex. Lab tests or a physical examination arent going to reveal the compromises youve made along the way. If you dont tell your doctor about them, you may be missing out on treatments that would ease the problem, or even solve it.
What youre afraid of
Particularly after the diagnosis of a serious disease, many people dwell on the worst. Even without a diagnosis, some people carry around pretty wild fears about medical conditions. Your doctor cant become your psychotherapist. But a thoughtful, attentive doctor (not all of them are, of course) might reassure you by giving you some facts or a calmer, more objective perspective on your situation.
Where youve traveled
Inexpensive airfare has made travel even to formerly remote places in Africa and Asia so common these days that we tend to take it for granted. But especially if you have those notoriously vague "flu-like" symptoms, its essential to tell your doctor about any recent trips. You may have caught something that can be treated and could be disastrous if it isnt. Dr. Peter Braun, a member of the Health Letters editorial board, recalls two such cases. In one, a woman with fever and other flu-like symptoms didnt tell doctors that she had been to Africa to visit her son. She eventually died of an undiagnosed malarial infection. In the other, a man didnt mention that hed been on an archaeological dig in New Mexico. It turned out that he had contracted plague, a bacterial disease that can be treated with antibiotics.
If a family member has been diagnosed with a serious disease
Family history is critical information for any doctor. As genetic and other forms of testing advance, people are getting diagnosed with new conditions or "preconditions" more often. Last years family history may be out of date. Keeping it current will help your doctors make all sorts of decisions, not the least of which is whether you should be tested for a condition.
Over-the-counter pills and supplements you take
Patients often forget to tell doctors about nonprescription medications theyre taking regularly, and theyll deliberately keep them in the dark about herbal medicines because they think a mainstream doctor will be critical, ignorant, or worst of all both. But over-the-counter medications and supplements can have dangerous interactions with conventional medications.
Medications you take prescribed by other doctors
To put it mildly, American health care is not very well coordinated. Especially if youre seeing several specialists, you cant assume that they have conferred (indeed, they probably havent). Medical records are often balkanized, with information collected at one office or institution never reaching another. The form you fill out in the waiting room usually asks you about the medications youre taking, but the doctor might not have had time to look at it carefully. So to be on the safe side, you should tell a doctor about medications that other doctors have prescribed for you. Bring a list or even the pill bottles themselves.
Medications youre supposed to take but dont
More than a few pills never leave the bottle. Sometimes side effects are to blame. Other times ple never really intend to take the medicine. If you discuss the situation with your doctor, maybe the prescription can be changed. If you just dont like taking pills, perhaps theres a perfectly good nonpharmacological approach to your problem. Either way, you wont find out unless you come clean about not taking your medications.
If you smoke or drink heavily
Most smokers know they shouldnt, so theyre sometimes ashamed to tell a doctor about it. If youre asked about smoking, dont lie and if you arent asked, bring it up yourself. The same goes for heavy drinking, although denial is obviously a problem.
If youve been depressed or under stress
The stigma is fading fast, but many people still dont like to admit theyre depressed. Stress isnt considered shameful, but its hard to pin down. And both get channeled into fatigue, insomnia, or irritability, so the root cause may get buried under the symptoms. Broaching the subject with a doctor is a good way to start sorting through these issues. Particularly for depression, it may lead to treatment antidepressants, talk therapy, or some combination that makes you feel a whole lot better.
If youre having incontinence problems
Urinary or fecal incontinence is a prime example of a condition that people learn to live with because theyre embarrassed by it or see it as an unavoidable consequence of old age. There are no guarantees, but these days theyre often manageable conditions but only if you tell your doctor first.
If youre experiencing sexual dysfunction
Everywhere you turn these days, it seems like theres an ad for Viagra or Levitra, the erectile dysfunction drugs. Havent we talked about sexual dysfunction enough? Its different, though, when its you and your problem. Many people clam up when a doctor really could help them with sexual dysfunction.
Of course, youre probably not going to have time to talk about all of these topics in one appointment. So you need to make the most of it by thinking ahead. Writing down some details, like your travel dates and destinations, the over-the-counter medications youre taking, and family history of disease can be a major timesaver. That way you wont be there in the doctors office trying to remember it all. Many people find it helpful to identify the three or four most important issues they want to discuss with a doctor. Make a list of your priorities or have someone do it with you. And then "stay on message".
By Harvard Health Publications
Its easy to suggest that you talk to your doctor. Its much harder to know what to say.
Some of us are fortunate enough to have built up a relationship with a physician over many years, so theres some genuine rapport and trust to bank on. But it can be a difficult exchange to navigate. Often you dont feel great to begin with. The doctor seems hurried and speaks in jargon. Youre intimidated and reluctant to talk about personal issues. Besides, even in the best of circumstances, its hard to know whats important to mention.
We asked several members of the Health Letters editorial board to suggest topics and issues that patients should discuss with their doctors. We were particularly interested in things that patients should bring up, but usually dont. Here are 11 of their suggestions for things you should tell your doctor:
What you want to do or used to do but cant do any longer
Either out of stoicism, denial, accommodation, or some combination of all three, people often come to accept a certain level of disability, especially if its the result of a condition that has come on slowly or involves something private like sex. Lab tests or a physical examination arent going to reveal the compromises youve made along the way. If you dont tell your doctor about them, you may be missing out on treatments that would ease the problem, or even solve it.
What youre afraid of
Particularly after the diagnosis of a serious disease, many people dwell on the worst. Even without a diagnosis, some people carry around pretty wild fears about medical conditions. Your doctor cant become your psychotherapist. But a thoughtful, attentive doctor (not all of them are, of course) might reassure you by giving you some facts or a calmer, more objective perspective on your situation.
Where youve traveled
Inexpensive airfare has made travel even to formerly remote places in Africa and Asia so common these days that we tend to take it for granted. But especially if you have those notoriously vague "flu-like" symptoms, its essential to tell your doctor about any recent trips. You may have caught something that can be treated and could be disastrous if it isnt. Dr. Peter Braun, a member of the Health Letters editorial board, recalls two such cases. In one, a woman with fever and other flu-like symptoms didnt tell doctors that she had been to Africa to visit her son. She eventually died of an undiagnosed malarial infection. In the other, a man didnt mention that hed been on an archaeological dig in New Mexico. It turned out that he had contracted plague, a bacterial disease that can be treated with antibiotics.
If a family member has been diagnosed with a serious disease
Family history is critical information for any doctor. As genetic and other forms of testing advance, people are getting diagnosed with new conditions or "preconditions" more often. Last years family history may be out of date. Keeping it current will help your doctors make all sorts of decisions, not the least of which is whether you should be tested for a condition.
Over-the-counter pills and supplements you take
Patients often forget to tell doctors about nonprescription medications theyre taking regularly, and theyll deliberately keep them in the dark about herbal medicines because they think a mainstream doctor will be critical, ignorant, or worst of all both. But over-the-counter medications and supplements can have dangerous interactions with conventional medications.
Medications you take prescribed by other doctors
To put it mildly, American health care is not very well coordinated. Especially if youre seeing several specialists, you cant assume that they have conferred (indeed, they probably havent). Medical records are often balkanized, with information collected at one office or institution never reaching another. The form you fill out in the waiting room usually asks you about the medications youre taking, but the doctor might not have had time to look at it carefully. So to be on the safe side, you should tell a doctor about medications that other doctors have prescribed for you. Bring a list or even the pill bottles themselves.
Medications youre supposed to take but dont
More than a few pills never leave the bottle. Sometimes side effects are to blame. Other times ple never really intend to take the medicine. If you discuss the situation with your doctor, maybe the prescription can be changed. If you just dont like taking pills, perhaps theres a perfectly good nonpharmacological approach to your problem. Either way, you wont find out unless you come clean about not taking your medications.
If you smoke or drink heavily
Most smokers know they shouldnt, so theyre sometimes ashamed to tell a doctor about it. If youre asked about smoking, dont lie and if you arent asked, bring it up yourself. The same goes for heavy drinking, although denial is obviously a problem.
If youve been depressed or under stress
The stigma is fading fast, but many people still dont like to admit theyre depressed. Stress isnt considered shameful, but its hard to pin down. And both get channeled into fatigue, insomnia, or irritability, so the root cause may get buried under the symptoms. Broaching the subject with a doctor is a good way to start sorting through these issues. Particularly for depression, it may lead to treatment antidepressants, talk therapy, or some combination that makes you feel a whole lot better.
If youre having incontinence problems
Urinary or fecal incontinence is a prime example of a condition that people learn to live with because theyre embarrassed by it or see it as an unavoidable consequence of old age. There are no guarantees, but these days theyre often manageable conditions but only if you tell your doctor first.
If youre experiencing sexual dysfunction
Everywhere you turn these days, it seems like theres an ad for Viagra or Levitra, the erectile dysfunction drugs. Havent we talked about sexual dysfunction enough? Its different, though, when its you and your problem. Many people clam up when a doctor really could help them with sexual dysfunction.
Of course, youre probably not going to have time to talk about all of these topics in one appointment. So you need to make the most of it by thinking ahead. Writing down some details, like your travel dates and destinations, the over-the-counter medications youre taking, and family history of disease can be a major timesaver. That way you wont be there in the doctors office trying to remember it all. Many people find it helpful to identify the three or four most important issues they want to discuss with a doctor. Make a list of your priorities or have someone do it with you. And then "stay on message".
