Gruentzig, with patient |
Because this is a complex
disease that is affected by lifestyle choices, stress
and other factors, active participation of the patient
in managing his/her own health can have a profound
impact. Your choices and actions as a patient can be
essential to your recovery; this is an opportunity
for patient and physician to work together as partners.
Your first step as a patient is
to establish comfortable, effective communication
your physician. This is not always easy to do. Most
of us are used to a traditional doctor-patient relationship
where decisions are left to the physician, who
is an authority figure and expert.
your cardiologist is the medical expert. But you are one
of the experts in your own care. Every patient is unique:
physiologically, genetically, emotionally, and intellectually.
vital information about your symptoms, your body, your
needs and your preferences.
Doctors are busy
and patients often feel they are imposing on the physician
by asking questions.
In some cardiology
practices, a nurse educator or other professional will
meet with you to answer many of your questions. When you
with the cardiologist or nurse educator you may be worried
about your condition or nervous about procedures. You
may be concerned about bothering the doctor or sounding
But it's your heart and you're the one undergoing treatment
-- the doctor is there to assist you.
There are a number of tools you can use to facilitate effective
communication so that you understand, choose and receive
the best possible health care.
1) Prepare in advance
usually on a very tight schedule. Sit down before your appointment
and make a list of concerns, symptoms
and/or questions. Think about your
symptoms: when do they occur, how do they start, do they change over time,
are they affected by anything you do. Prepare a concise description of
your symptoms to share with your physician.
Make a list of brief, specific questions. When you go to
your appointment bring along any tests you may have had and
be prepared to report on any treatment that has been given
in the past.
If you have been diagnosed with heart disease, seek out
resources like this web site. Learn appropriate medical
and a bit about standard treatments. You'll feel better
equipped to ask questions.
3) Bring a
support person along
It can help to have a second set of ears, especially when
you are feeling anxious, so it may be a good idea to
bring a spouse, relative or good friend to your appointment. It can also
to tape-record the conversion to review later --
you might bring a recorder and ask if your health provider is comfortable
with your taping the session to help you remember. It's
difficult to absorb a lot of information in a short time,
especially when under stress: a recent study showed that
most patients forget as much as 80 percent of what their
doctors tell them once they leave the office.(source: Journal
of the Royal Society of Medicine, May 2003)
4) Speak up
Mention your most important concerns at the beginning of
the visit. Ask the doctor to explain what you don't understand.
Don't hesitate to ask for clarification if you are confused.
The doctor might
be able to recommend
additional reading or schedule a visit with a health educator.
It can be helpful to summarize briefly the key points from
your discussion -- your understanding of the diagnosis,
prognosis, treatment options, etc. This way the doctor
can clarify any misunderstanding.
6) Make a
Be clear what the next step is. Make sure a plan is in place
to get test results and proceed with whatever decisions
need to be made.
|Seeking a second opinion --
Asking for a second opinion is a routine
and acceptable request. If you feel you would like confirmation, it can
be useful to present the issue in terms of your needs: "I would like to gather
as much information as possible in order to make an educated decision. I'm not
totally comfortable with this treatment. I think it would help me to get another
opinion. Can you suggest someone I could consult?"
Ultimately, you are the healthcare
consumer. The more educated you are, the more choices
you will have.
If your physician
does not offer treatment that you feel might be right
for you, it is your prerogative to seek out alternatives.
medicine there is often no one right answer. Try to partner
with your doctor to examine your options and determine
the approach to treatment that will meet your particular
making your own list of questions we recommend you
read the FAQ's on this site and review some of the
101. These materials should answer
some of your concerns.
We also have compiled a list
of specific questions you might ask your cardiologist
You probably won't
have time in one session to bring up all of your concerns,
but select some questions of particular importance
informed patient is a patient who not only
understands what is being done to him or
her, but is one who can and should participate
in the decision-making process. I mean
not everything we do as physicians is cut
and dried. There are risks and benefits
in many of the decisions we make and I
think most physicians relish the opportunity
to have an informed patient participate
in that decision-making process.".
-- Dr. Gregg
Columbia University Medical Center, New York
"When I first started here, almost
25 years ago, it was, you know, respect
the doctor. Don't ask him questions. He
knows what's right. And that whole process
has changed. And that's the right thing.
It's an informational age. It's appropriate
for patients to know what's going on, and
I don't expect patients to be able to be
their own physician, but they can ask serious
and reasonable questions -- and they demand
and should get reasonable answers."
-- Dr. Stephen