By Kevin Begos

Relationship Building

What does it take to create a strong patient-doctor partnership?

By Kevin Begos

In retrospect, Schiavone sees some of the possible tension points. “She was young—younger than me—seeing a lot of patients in a high-volume practice. I’m probably a little-bit-difficult patient. But it’s only because I ask a lot of questions, and I do a lot of digging on my own. And that’s very demanding on my physician, and I know that.”

When Schiavone started looking for a new oncologist to monitor her follow-up care, she set some ground rules—for everyone’s benefit. “I said, ‘This is an interview, because this is going to be a 50/50 relationship. This is going to be us working together.’ ” She brought oncologist Yuval Naot all her medical records in chronological order, talked with him for a long time and finished by saying: “You decide if you want me or not as a patient. You have 24 hours.” She says he responded “in his deep, sultry voice: ‘Let’s have a relationship.’ And I just melted.”

Now, “I can ask him anything in the world and he will answer me,” she says. “I actually enjoy going to my appointments with him, and I don’t feel like a sick and dying cancer patient. It’s an exchange.” That exchange includes occasional blunt criticism of some personal research Schiavone brings to her appointments. “He’ll say, ‘This is a bunch of bunk, where’d you get this from?’” she says.

Naot, who practices in Jacksonville, Fla., says doctors face a lot of time pressure—but that’s no excuse for not talking to and listening to patients. “I think you just need to take the time,” he says. “If it’s a new patient, there’s no way around it. You need the full interaction, no matter how long it takes. Just take the time. There’s no shortcut.”

Other issues are more complicated. “For example, for a lot of breast patients, they come to me after surgery, and the cancer is out of their body. Yet they need to go through chemo or radiation,” he says. “It’s a difficult concept to comprehend. I think you have to sit down and really explain [it] to patients, and simplify it. I always try to give patients all the information and explain the rationale behind treatment.”