By Kevin Begos
What does it take to create a strong patient-doctor partnership?
By Kevin Begos
Naot says the note-taking need and style “depend on the personality. A lot of patients feel very secure with their pad. I’ve had patients come in with a tape recorder—it’s a little eerie, but I’ve let it go. I think you kind of just have to go with the patient and accommodate.”
Some doctors take the note-taking idea into their own hands. P.J. Hamel of Hanover, N.H., sent an e-mail to CR about her oncologist, Gary Schwartz, of Lebanon, N.H., who “carefully writes down everything he says on a lined pad. At the end of the appointment, he rips off the piece of paper and hands it to you. I’m still referring to that same ragged piece of paper six years later.” Schwartz, she adds, “will bring something personal into the discussion—we both like to bake pie, so that’s a common topic—and his simple ‘human-ness’ makes it easy to develop a relaxed, communicative relationship.”
Cutting-edge therapy could be as simple as chicken soup, notes Dana Adkins, a stage II breast cancer survivor who nominated her doctor for an award. “Knowing that one of my fears was being able to cook or shop for groceries after a major operation, she sent me an order of chicken noodle soup and rice pudding from the local Jewish deli the day I got home from the hospital. She also has a wicked sense of humor and we have been known to e-mail a lot of funny (and some pretty awful) jokes to each other,” Adkins wrote to CR.
According to Kazin, the ultimate goal of good communication is building trust. At some point, the patient may have to accept that endlessly questioning a doctor’s decisions can go too far, she says. Kazin did get a second opinion but told her primary oncologist everything she was doing. “I think more than anything it just reassured me,” she says. Eventually she said to herself, “I can’t keep second-guessing. I got on the roller coaster, and OK, it will stop, I will get off.”
Others suggest a trust-but-verify attitude. Debbie Collinsworth of Huron, Ohio, has a rare form of breast cancer, Paget’s disease of the nipple. For more than two years she had a crusty lesion on her breast. She first tried different creams, and then after she went to a routine checkup, her primary care doctor prescribed another cream. Collinsworth continued to try new creams, after two or three more doctor’s visits, with no progress. Then, in the spring of 2006, a friend sent her an e-mail about Paget’s.