How to help your doctor give you the best care
By Debbie Gardner
debbieg@thereminder.com
As both Chief of Baystate Medical Center’s Geriatrics and Postacute Medicine Division and a Professor of Medicine for Tufts University School of Medicine, Dr. Maura Brennan has dedicated herself to teaching the core principles of palliative medicine – a multidisciplinary approach to specialized medical care for people with serious illnesses – to future internists and geriatricians training at the hospital.
Originally headed for a career in political science – she received a master’s degree in the field from Columbia University in 1974 before turning to medicine a decade later and earning her medical degree from Yale – Brennan first came to Baystate in 1989 as an intern. Following several fellowship awards, including research in Japan and work in geriatrics at Mount Sinai School of Medicine, she was appointed the inaugural director of the Geriatric Consultation Program at Baystate in 1997, and has been influential in the care of mature patients from that time forward.
PRIME recently approached Brennan for advice on how a patient – of any age – can get the best possible information and care from their doctor, especially when facing a new or more severe diagnosis.
Here is what she had to say:
Q: The diagnosis of a new condition presents a patient with a lot to absorb. How can a he, she or a caregiver best get the information needed to understand treatment options?
“This is a challenge especially if the information is frightening. Bring someone with you if possible to help keep track and ask questions. Make notes and ask the doctor to write down important points or spell unusual words. If the information is very complicated, you may need to discuss it on more than one visit.
“Most importantly, ask questions, especially the really critical ones about what this information means for you and your future. Ask for potential alternatives. For example: ‘If I go for this procedure, how will it help me?’ ‘What are the best and worst outcomes I might expect?’ ‘What happens for most patients like me who go for the test?’ ‘What is likely to occur if I don’t go for the test,’ etc.”
Q: Doctors understand the instructions that they give to patients. How can a patient tell a doctor that he or she is confused about medicines, doses or instructions?
“Good doctors often use a ‘teach back’ method. The physician explains the new content to the patient and then asks if he can report back the important points in his own words. If the doctor forgets or doesn’t routinely do this, the patient could prompt the process. For example: ‘Let’s see if I have this straight. You want me to go for a CAT scan because there is something that might be worrisome on that X Ray, right? Honestly, I’m not sure I caught the word you used – did you call it a lesion? What does that mean?’”
Q: Caregiving is a two-way street. What do doctors need from their patients so they can provide the best care possible?
“Be honest and open with us. If you don’t understand or would rather not follow our suggestions tell us! Don’t try to spare our feelings by pretending you have taken the medications we prescribed if you haven’t.
“If you think you are having side effects or are worried about what a new problem may mean, please let us know. We want to serve and help you as best we can.
“This is a partnership – we are the experts on the medical problems and treatments but you are the experts on you! Only you know how you feel, what is most important right now for your health and what you are able to do to try to achieve your health goals. Together we can make a strong team to devise a plan of care that is right for you.”
