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How to get the right care

Voice your concerns and ask questions

Being a good patient is not about being quiet and obedient. You know yourself, your body and your symptoms better than anyone. Doctors are there to help you, and you can help your doctor by speaking up, expressing concerns and asking questions.

Yet, many patients take a back seat, relying on their doctor to drive the conversation during office visits. Some patients are too embarrassed to ask questions, or simply don’t know what questions to ask.

“Helping patients communicate their symptoms clearly could go a long way toward making an accurate diagnosis,” says Dr. John Ely, professor of family medicine and a retired family physician from the University of Iowa.

“I have been a patient myself recently, and got to thinking about what a good patient would do,” says Ely. “In medical school, professors teach medical students the eight characteristics of a symptom. I think it would help patients to know what they are, in order to be more involved in getting an accurate diagnosis.”

The eight characteristics of a symptom, from Dr. Ely:

  1. Where is your pain or numbness? And where does it radiate? For example, if you have low back pain, does it spread to your abdomen or leg? Or does it just stay in your back? This type of question would not apply to more generalized symptoms, like fatigue or shortness of breath.
  2. How long have you had the symptom? If it’s something random, like a spell of chest pain, how often does it happen and how long does it last each time? Is it gradually getting worse? Getting better? Staying the same?
  3. What were you doing when you first noticed the symptom? Were you just sitting there? Arguing with someone? Running up the stairs?
  4. Are any other symptoms associated with this symptom? For example, with chest pain, did you also have any light-headedness or shortness of breath?
  5. What is the "quality" of the symptom? In other words, what does it feel like? “Patients sometimes say to me, ‘What do you mean? It’s just a pain, doc.’ Well, is it like an elephant stepping on your chest, a fire in your chest, someone stabbing you with an ice pick, or what? I want to stay open-ended as long as possible, so [I usually say] ‘Just tell me what it feels like,’” said Ely.
  6. What is the "quantity" of the symptom? For example, how bad is it on a scale of one to 10?
  7. What makes the symptom worse? Have you noticed anything that makes your symptoms go from bad to worse? For example, with dizziness, is it worse if you roll over in bed or if you stand up quickly?
  8. What makes the symptom better? Have you noticed anything that improves your symptoms? Lying down? Eating a meal? Certain times of day? A heating pad?

4 ways to have a better doctor visit

  1. Get to the point quickly. The typical office visit ranges from 10 to 20 minutes, which may be why your doctor has to interrupt you after only a few seconds. So right away, briefly explain why you’re there. “Physicians want to know a patient’s chief complaint, and then we want a paragraph — not six paragraphs and not a novel — and in that paragraph you need to tell the doctor these eight things,” says Ely.
  2. Bring a medication list. Let your doctor know about any prescription and over-the-counter drugs, supplements and herbs you take regularly.
  3. Know your health history. Being able to talk about any previous medical problems and procedures can make an office visit more efficient. Write it all down if it’s complicated.
  4. Take notes. Jot down key information, so you don’t forget later.

Consumer Reports, On Health, November 2015

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