Want a better doctor? Be a better patient

I don’t know anyone who actually likes going to the doctor, especially if you have something we all dread: symptoms. A nagging chest pain. A lousy backache. A screaming headache. Though the symptoms may vary, your goal is always the same: You want your physician to figure out what’s wrong. And you want to get well.

That’s why Dr. Jerome Groopman’s eye-opening best seller “How Doctors Think” (Houghton-Mifflin Company) is so valuable for anyone who wants to live a healthier, happier lifestyle. It teaches us to be a better patient. It recognizes that doctors are far from perfect when it comes to diagnosing our problems. They make mistakes - as many as 15 percent of all diagnoses are inaccurate, according to one study he quotes -- and the majority of errors they make are not technical screw-ups, but rather, errors in thinking. Doctors are under great pressure to perform, and perform quickly. They jump to conclusions they are comfortable with. They ignore facts that don’t fit. They have egos and emotions that can cloud their judgment and lead them astray.

So how can you avoid those problems and improve your chances of getting a proper diagnosis? That’s what Groopman’s book is all about. Here are some of the highlights:

  • Be a partner. To get the best medical care possible and lower your risk of a wrong diagnosis, Groopman says, you can’t be passive or shy or intimidated. You must be involved! “Patients and their loved ones can be true partners with physicians when they know how their doctors think, and why doctors sometimes fail to think.” Doctors who fail to think? It can happen.
  • Trust your instincts. If you sense your doctor is rushing through your exam, not listening to your story, or that he just plain doesn’t like you, pay attention. “Research shows that patients do pick up on a doctor’s negativity but few understand how that affects their care and rarely change doctors.” Groopman’s advice: Change doctors.
  • Don’t be pigeonholed. Doctors think in stereotypes, just like the rest of us: the hysterical housewife, the overworked executive, the kooky hypochondriac. If you think your doctor is pigeonholing you and not paying enough attention to who you really are and what you’re really saying, call him on it. Humor will help.
  • Be informed. It’s OK, even desirable, to learn everything you can about your case “and respectfully question each and every assumption about the diagnosis and treatment.” You do this not because you don’t trust the doctor or hospital, Groopman writes, “but because God did not make people omniscient.”
  • Ask questions. “What we say to a physician and how we say it sculpts his thinking. That includes not only our answers, but our questions.” You can influence your doctor’s thinking - even get it back on track - by asking certain key questions: “What else could it be?” “Is there anything that doesn’t fit?” “Is it possible I have more than one problem?” If your doctor doesn’t have time for your questions and isn’t capable of giving clear answers, say goodbye.
  • Slow down the process. Studies have shown that physicians, on average, only give their patients 18 seconds to tell their story before they interrupt. Oy. If your doctor is distracted - interrupted by staff, looking at the clock or a computer - speak up in a polite way. “The inescapable truth is that good thinking takes time. Working in haste and cutting corners are the quickest routes to cognitive errors.”
  • Beware of corrupt practices. It’s shocking, but true: Some doctors get financial incentives or kickbacks to prescribe certain drugs or perform suspect surgeries. “Spinal fusion may be the radical mastectomy of our time,” he writes. Ask hard questions, pursue second opinions and distrust any doctor who tries to turn the natural aging process into a disorder.

The U.S. Institute of Medicine reports that up to 98,000 people in the U.S. die every year from medical errors. That’s a huge and scary number. The best defense is a good offense. Find a doctor you trust and respect and can partner with. Be involved. Ask questions. And read “How Doctors Think” before your next appointment.
Marilynn Preston is a fitness expert, personal trainer and speaker on healthy lifestyle issues. She welcomes reader questions, which can be sent to