Can you understand your doctor?

By Richard Fleming, MD

Sometimes it seems doctors and their patients do not speak the same language. I am not referring to cases where the doctor only speaks English and the patient only speaks Spanish. Interpreters and telephone “language lines” can help in those situations. No, I am talking about times when both doctor and patient speak English, but they do not understand what each other is saying.

Maybe you know what I mean. You go see your doctor. You spend 10 minutes talking about several problems. At the end of the visit, your doctor rattles off a bunch of things for you to do, telling you to get a few lab tests and pick up some prescriptions, and ushers you out the door. You might remember one or two things the doctor advised, but you did not really understand what he or she thought was going on. Why does this happen? I put most of the responsibility on doctors. But I do have a few ideas for patients which may help.

There are two main reasons doctors may not communicate well. One, we are often rushed. There are only so many minutes in the day and we often have more patients to see than would be ideal. We do not mean to hurry, but our schedule is packed, our waiting room is filled, and we are running behind. This is a recipe for rushing.

Two, we often use complicated medical terminology rather than plain English words. Instead of saying “walk,” we say “ambulate.” Instead of asking about “chest pain,” we ask about “chest constriction.” Instead of talking about your “blood count,” we refer to your “hemoglobin.” When we speak in full sentences, we often sprinkle in a lot of two-bit phrases instead of down-to-earth language that normal humans can understand. We do not intend to confuse, but we learned medical-speak in school and it becomes a habit to use those words and phrases.

So what can patients do to help? One thing is to understand your doctor is probably going to be rushed. Prepare ahead of time to focus on your one or two most important concerns. If you bring up five different issues, your doctor will probably not be able to give adequate attention to all of them. Sometimes writing down your concerns ahead of time can help.

Next, if your doctor does go through a bunch of information too quickly, or at too high a level for you to understand, tell your doctor you do not understand. Tell him or her to repeat things and say them more simply. Most of the time, the doctor will do so, since they do want you to understand their advice. Asking for a written hand-out, which many doctors have available, can be helpful also.

Seeing a doctor can be intimidating. It can be hard to question a doctor on what he is saying. But most doctors would prefer you ask questions when you do not understand. You may both be speaking English, but if you do not follow what your doctor is saying, your health may suffer.

— Dr. Fleming is a Regional Medical Director of Partnership HealthPlan of California


PHC is a nonprofit community-based health care organization that contracts with the State to administer Medi-Cal benefits through local care providers, to ensure Medi-Cal recipients have access to comprehensive, cost-effective health care. PHC provides quality health care to nearly 465,000 Medi-Cal members. Beginning in Solano County in 1994 PHC now provides services to 14 Northern California counties — Del Norte, Humboldt, Lake, Lassen, Marin, Mendocino, Modoc, Napa, Shasta, Siskiyou, Solano, Sonoma, Trinity and Yolo.

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