Secrets to a Good Doctor-Patient Relationship
Five people with arthritis share what makes their relationship work.
Your doctor can be a Harvard-educated, Nobel Peace Prize-winning genius, but if he has lousy bedside manner, chances are, your relationship is doomed – and your health may not fare much better.
Dozens of studies show that patients have better health outcomes when their physicians are effective, empathetic communicators. “Being able to talk to your doctor builds trust. And when you trust your doctor, you’re more likely to follow their instructions. That markedly increases your odds of having a good outcome,” says Allan Hamilton, MD, professor of neurosurgery at the University of Arizona in Tucson and author of The Scalpel and the Soul: Encounters with Surgery, the Supernatural, and the Healing Power of Hope (Tarcher/Penguin, 2008).
The Accreditation Council for Graduate Medical Education now lists communication as a core competency skill for residents, and most medical schools now instruct their students on patient communication. The trouble is, it can be difficult for physicians to implement the skills they learn, says Catherine Lucey, MD, professor of internal medicine and vice chair for education at the Ohio State University College of Medicine in Columbus.
“Every doctor goes to medical school with the intent of helping people, and I think almost every doctor wakes up in the morning with that same level of commitment,” says Dr. Lucey. “But unfortunately, our current medical system poses many barriers that prevent physicians from providing the care they intend to.”
Chief among communication barriers, says Dr. Lucey, is a lack of time. “Doctors today have to see dozens of patients in a single day, and if one takes more time than he or she allotted, that cuts down on the face-time the doctor has with her next patients.”
Dr. Lucey notes that patients feel better if doctors aren’t in a rush – and when patients have more time, “they can get to the heart of matters that provide the physician with crucial information that can influence treatment.”
Need proof? We spoke to five inspiring people with arthritis and the amazing physicians who’ve made a difference in their health. Read on to learn what they’ve discovered so you’ll be able to find a great doctor or improve your relationship with your current one.
"Dr. Gaylis isn’t satisfied unless I feel healthy" – Lucille Braha, 57, actress and painter, Plantation, Fla.
“When I was diagnosed with rheumatoid arthritis (RA) in 1987, there were few treatment options, and most of them had side effects that rivaled the disease itself. Because of that, my disease wiped me out, I had to give up my career [as a hairdresser], many of my hobbies, and much of my social life. But when I started seeing Dr. Gaylis, he said, ‘I know we can get you feeling better.’ In 2000, he convinced me to enroll in a clinical trial for the drug that’s now known as Humira, and within a month, my symptoms improved so much that I was able to enroll in acting classes, start painting and go out with my friends again. Today, I live a full, amazing life that I couldn’t have imagined 22 years ago. This isn’t to say that things are always perfect. But when I start to limp, find my hands getting especially stiff or my energy lagging, Dr. Gaylis tells me, ‘Lucille, I know you’re hurting, so don’t pretend. Let’s adjust your treatment and get you feeling better again.’ He’s constantly reminding me that I don’t have to suffer.”
Norman B. Gaylis, MD, Rheumatologist in private practice, Aventura, Fla.
“Not everyone likes a doctor as proactive as I am – but Lucille and I really complement each other. She likes that I’ve made it my mission to help her stay healthy, no matter what it takes. And she’s really a model patient, in that she realizes that RA is a lifelong disease that requires patience and a long-term commitment. Managing RA means many doctor’s visits, blood tests, injections and medications, but patients who understand that and make it a priority and a goal, as Lucille does, tend to have the best outcomes.”
"I can be honest with Dr. Rhea" – Ken Brisbane, 46, hotel catering and conference manager, Nashville, Tenn.
“I was diagnosed with RA at age 19, and have had many rheumatologists since then. Some were complete duds: doctors who whisk you in and out of their offices in three minutes, barely waiting to find out if your meds are working. But I knew from my very first visit with Dr. Rhea that he was a keeper. He doesn’t just want to know if my joints are achy; he’ll ask if the long hours at work – where I’m often on my feet – are getting to me, and whether I can still keep up with my two teenage kids. Best of all, I know I can be honest with him. I don’t hesitate to tell him if I’m frustrated with treatment side effects, or if I’m just down about the fact that I’ve had RA for so long. But Dr. Rhea is always upbeat, and never chastises me. ‘Ken, we have more options,’ he’ll tell me, and before I know it, both my mood – and my health – will be back on track.”
Christian Rhea, DO, Rheumatologist in private practice, Nashville, Tenn.
“I find it satisfying to engage in my patients’ lives. More importantly, as Ken points out, learning whether someone can do things like pick up his grandchild, play a round of golf or work out gives me crucial information about whether the treatment is working. Plus, there’s nothing to be gained by scolding patients if they’re not taking their meds or making other healthy changes; I’m a physician, not a babysitter. The doctor and patient have to work together as a team, and Ken and I do just that.”
"Dr. Bodenstab gave me the straight story" – Marian Shelton, 68, retired, Wilmington, Del.
“My osteoarthritis was pretty severe for several years, and I knew in my heart that I’d have to have knee replacements. Of course, I didn’t want to go through surgery, and when I went to see Dr. Bodenstab for the first time, I told him so. He took X-rays of my knees and showed me how bad the damage was. ‘You need joint replacements,’ he told me, point-blank. But he added that there were other alternatives, and although he didn’t think they would be particularly effective, he was willing to try them if that’s what I wanted. The fact that he gave me the straight story without being pushy actually made it easier for me to accept the truth, and I ended up having both knees replaced over the course of two years. Today, I have absolutely no pain in either knee and can get around more easily than I’ve been able to in years. I credit not only Dr. Bodenstab’s surgical skills, but his excellent bedside manner, which made me a calmer, more informed patient.”
Alex B. Bodenstab, MD, Orthopaedic surgeon at First State Orthopaedics, Newark, Del.
“Much of Marian’s success with her knee replacements is thanks to her patience. Her replacements took a little longer than average to heal, and there were times during her post-op recovery that she felt frustrated – and rightfully so; even though we’ve come a long way in joint replacement surgery, it’s still hard on the body and can be painful. And yet Marian was willing to persevere. She worked tirelessly with her physical therapists and me to get to a good, functioning level and in the end she had the best outcome possible.”
"Dr. Zito likes that I’m an informed patient" – LaRita B. Jacobs, 48, educator, Indian Shores, Fla.
“As an arthritis educator and someone who likes to be up-to-date on the latest research, I need a physician who wants me to be a willing participant in the management of my psoriatic arthritis and Sjögren’s syndrome. It doesn’t sound like a tall order – but I can’t tell you how many physicians have been patronizing or downright insulted when I came in with a list of questions or asked for more information before agreeing to take a medication. That’s why Dr. Zito is my dream doctor. Not only is she extremely knowledgeable and an excellent diagnostician, she actually encourages me to ask questions and do my own research. And she’s as thorough as I am: My first visit with her was an hour-and-a-half long, and my regular checkups often come in close to that. I never feel rushed or like I’m just another patient to check off her list of the day.”
Susan Zito, DO, MPH, Rheumatologist in private practice, Largo, Fla.
“If only more patients were like LaRita. Each time she comes to my office, we sit and have an intelligent, thoughtful conversation about her condition. That’s wonderful, because the more you know about your disease, the easier it is to understand how treatment works, which means you’re much more likely to stick with it. I really believe that informed patients do better overall. They feel like partners, rather than passive participants in their disease, so they ask questions, notice and tell their doctors when something’s amiss, and take more action to improve their health.”
"Dr. Matteson is a pro at navigating treatment options" – Lori Stoltz, 49, English professor, Rochester, Minn.
“I’ve been Dr. Matteson’s patient since I was diagnosed with RA in 1991. I’ve tried many treatments, with varying degrees of success. But I have complete confidence in Dr. Matteson. He’s on the cutting edge of arthritis research – but he’s also realistic and never pushes anything I’m not comfortable with. For example, when my last medication stopped working, Dr. Matteson suggested a fairly new injection [Enbrel]. He saw that I was hesitant about giving myself shots, so he said, ‘Listen, we can have a nurse do it for you if that might help, and you can see if it’s effective enough to make it worth it.’ That helped me get over the fear, and now I can do the shots myself, and my symptoms are under control again. I also like that Dr. Matteson is completely open to alternative therapies. For example, I take supplements, exercise and meditate regularly in order to improve my health. I never hesitate to tell Dr. Matteson about anything I’m considering, and he’ll evaluate it with an open mind and see if we can work it into my treatment plan.”
Eric L. Matteson, MD, Chair, Department of Rheumatology, Mayo Clinic, Rochester, Minn.
“Lori is a wonderful person with a severe disease, and I really admire her willingness to make her health a priority. Our doctor-patient relationship works well because from day one, we’ve both been very open to ideas about her treatment. Lori has a lot of interest in alternative therapies. Some physicians have a jaundiced view of things like herbal supplements and acupuncture, but it’s called ‘complementary medicine’ for a reason – research shows that it can work alongside and even improve a traditional regime.”