I was fortunate that a friend told me about Dr. Leana Wen’s presentation at a local library so I could hear her speak in person.
She began by telling us the stories of two people. Jerry was a car mechanic in his late 40’s who went to the ER with chest pain. Actually, the rest of his body ached, too, because he’s been helping his brother move over the weekend, but the doctors focused on the chest pain so he underwent numerous tests, and was kept in hospital overnight before he was told he could go home. The problem was that Jerry was discharged without ever finding out what caused the chest pain and what he should do from that point on.
Sandy went to see her doctor because she wasn’t feeling well. The doctor did some tests but couldn’t diagnosis her condition. She continued to feel unwell despite several trips to the doctors who over the course of 18 months prescribed medications for depression and anxiety. In the telling of the story, it was clear to the audience that Sandy wasn’t depressed or anxious, but more likely was upset because she continued to feel unwell and the doctors weren’t helping her. Sadly, by the time she did receive a diagnosis, it was for breast cancer and it had metastasized.
Dr. Wen stressed that our history, or our story, will give the answer at least 80% of the time; far more than technology and data will on their own or with a few yes or no answers. Doctors need to go back to relying less on technology, and more on listening to their patients. She also talked about how we have about 10 seconds before the doctor is interrupted or distracted to get our main point across. Based on the 8 Pillars to a Better Diagnosis in her book, When Doctors Don’t Listen: How to Avoid Misdiagnosis and Unnecessary Tests, she had four tips for us:
1) Talk about your story instead of only your symptoms. Put it in context and use your own words. Practice your story before going to see your doctor so you feel comfortable with it. Perhaps you could practice it with a family member or friend so you can get their feedback.
2) Ask your doctor for a partnership. You know your body better than anyone and your doctor knows medicine so you can suggest that you work together and share the decision making. Don’t assume your doctor already knows you want to participate.
3) Before proceeding with testing, ask the following questions:
• What is your diagnosis?
• What are the doctors looking for?
• What are the risks?
• What is the time link – can you wait?
• How will having the test change how your condition is managed?
• What happens if the test is negative?
4) Speak up! Ask questions like why do you need a particular test or what are the prescribed medications for?
Patients Are People, Too!
You can read more about Dr. Wen on her website: http://drleanawen.com
And her blog: http://whendoctorsdontlisten.blogspot.com/
A new campaign Dr. Wen is starting: Who’s My Doctor? The Total Transparency Manifesto