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Building a Doctor-Patient Relationship (Additional PLUS Reading Materials)
Building a Doctor-Patient Relationship (Additional PLUS Reading Materials)
Building a Doctor-Patient Relationship (Additional PLUS Reading Materials)
Building a Doctor-Patient Relationship (Additional PLUS Reading Materials)
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Building a Doctor-Patient Relationship (Additional PLUS Reading Materials)

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  • 1. EMAIL YOUR QUESTIONS TO www.projectinform.org/questions JANUARY 2010Building a cooperativepatient/doctor relationshipA positive HIV antibody test or an AIDS diagnosis changes many aspects of a per-son’s life, including the kind of relationship they have with their doctor. Many peo-ple develop a more assertive attitude about their health and well-being when they nd out they have HIV. Because HIV disease and its treatment is complicated, mak-ing decisions about when, how and whether to start therapy isn’t always easy. CHOOSE A One great step to take is to become an active participant in your health care RELATIONSHIP STYLEand treatment decisions. is means that both you and your doctor need to learn Choose a relationship style and discusshow to work and communicate with each other. it with your doctor. People have dif- is publication’s intention is to help both patient and doctor establish reason- ferent styles of relating to doctors, and those styles may change at di erentable expectations of each other and to set up a climate of cooperation and joint times or for di erent illnesses. In theresponsibility for healing. Just as there isn’t a “one size ts all” approach to HIV “traditional” doctor-patient relation-care, there’s no one doctor-patient relationship that suits everyone. ship, the doctor leads and the patient follows. For some, this is e ective be- cause they feel secure and cared for.For the patient ... Others may view their relationship as more of a partnership, where both contribute to the decision-makingSHARE YOUR POINT OF properly monitoring through exams process. Some prefer to make decisionsVIEW WITH YOUR DOCTOR and lab tests should be routine. In turn, and use a doctor primarily as a consul-Share your point of view. If something is you should agree to heed reasonable tant. is style requires diplomacy byor isn’t working for you, it’s important warnings suggested by this process. the patient as many doctors have notto let your doctor know. Being hon- If you want certain prescriptions, adjusted to the role of consultant.est about your viewpoint is especially asking in a friendly tone is likely to None of these styles is right orimportant if you want to enroll in a work best. If the doctor opposes it, wrong, but they all make di erent de-study or use experimental treatments. you’re entitled to know why, in clear mands upon the relationship. It’s im- Explain why you’re considering a terms. His or her concerns and knowl- portant that you let your doctor knowparticular decision and listen to what edge should be given due respect, which style you prefer. As you becomeyour doctor has to say. Many doctors whether or not you agree with them. more familiar with HIV andare willing to work with and supportpatients who have clearly put somethought and time into their decisions. FACING NEW DECISIONS? WONDERING WHAT’S THE NEXT STEP? Whether or not agreement isreached on particular treatments, National HIV Treatment Hotline: 1-800-822-7422 (toll-free) 10a–4p, Monday–Friday, Paci c Time © PROJECT INFORM 1375 MISSION STREET SAN FRANCISCO, CA 94103 2621 415 558 8669 WWW.PROJECTINFORM.ORG
  • 2. EMAIL YOUR QUESTIONS TO2 www.projectinform.org/questions JANUARY 2010Building a cooperative patient/doctor relationshipFor the patient, continued ...experience di erent health challenges, the doctor-patientrelationship style that works best for you may change.LEARN THE INFORMATIONKnowledge makes a world of di erence. Generally, themore you know before a medical appointment, the moreyou can bene t from each visit. Obtaining information onyour own doesn’t need to be di cult or over-whelming. Infact, the education process can begin right at home. Many websites, hotlines and community organizationsare dedicated to answering questions about HIV. Realizethat you can’t learn everything at once, so concentrate onthe information that’s most important to your health rightnow. While self-learning is great, it should not substituteusing your doctor as a source of information.PREPARE FOR APPOINTMENTSYou can bene t most when a visit is well-planned. It takes GETTING EMOTIONAL NEWSonly a few minutes to write down key questions ahead of Be prepared for the emotional content of the visit. Mosttime. Get in the habit of writing down items in a journal doctors are sensitive, caring people who respond emotion-about side e ects you’ve experienced, missed doses, or any ally to their patients. Still, there’s only so much support aquestions that come up between visits. Use it to update doctor can give in the short time allotted for most visits.your doctor at the start of the visit. Plan in advance to make use of other support resources. Use the limited time in your doctor’s o ce to focus on If you prefer a more straightforward approach, let yourthe most critical issues, rather than everything that comes doctor know. But don’t expect him or her to also serve asto mind. Maybe bring along treatment literature to discuss your therapist if news is unusually hard to hear. By choos-in the visit. is allows your doctor to know your sources ing a more direct approach, you also choose a path thatof information and how to evaluate them. requires greater inner support. TOLL FREE NATIONAL HIV/AIDS TREATMENT HOTLINE 1 800 822 7422 LOCAL & INTERNATIONAL 415 558 9051 MONDAY FRIDAY 10 4 PACIFIC TIME
  • 3. EMAIL YOUR QUESTIONS TO www.projectinform.org/questions 3 JANUARY 2010 Building a cooperative patient/doctor relationshipFor the doctor ...SUPPORT YOUR PATIENT’S many sides of medical issues that confront patients, andINTERESTS IN THEIR HEALTH CARE do not feel insulted if your patient chooses something youSupport your patient’s interest in monitoring and treat- don’t recommend.ment. While not every treatment is appropriate, every Today, many people take a strong role in the decision-patient’s opinions and health are. e more uncertainties making process. Of course, that empowerment doesn’ta given treatment raises, the more important it is that you automatically make your patient right. Doctors should helpmonitor its use. Patients may be willing to follow your rec- persuade patients to do what makes sense. Use of well-ommendations if you’re willing to monitor your patient’s phrased questions, reasoning, shared information, respectother choices simultaneously. and patience on both sides best achieve mutually satisfying When someone asks to be monitored in a course of choices.treatment, it doesn’t imply you agree with it—only supportfor your patient’s well-being. ere are no legal precedents RESPOND MEDICALLYin AIDS in which a doctor has been accused of malpracticefor taking blood counts while a patient used a drug against Patients may use a treatment anyway if they’re determinedhis or her recommendation. to and you may not be able to sway them against it. Refus- ing to monitor diminishes your patient’s con dence and may increase the risk of harm.BE FLEXIBLE WITH YOUR RESPONSES Respond in a medical fashion to the uncertainties of un-Recognize that the uncertainties of the epidemic demand a approved treatments or strategies. Perhaps this means more exible response. e expectation that patients will passively frequent visits, other diagnostic tests, or more cautiousfollow orders simply doesn’t work with everyone, certainly reading of lab markers. Added expense may be the pricenot when doctors may not have answers for every question. and the patient must be prepared to heed the outcome of HIV has changed forever the way many people relate to the monitoring process.their doctors. e new assertiveness and knowledge won’tgo away. To cope e ectively, doctors must learn how each DON’T PUSH YOUR PATIENTperson wants to be treated, particularly in regards to degreeand form of collaboration in their healing process. Don’t push patients to begin treatment before s/he is ready to commit. Starting a regimen is a big step and will change many things in a patient’s life.DESCRIBE BOTH SIDES OF THE ISSUES For example, taking pills every day is a constant remind-Doctors have always known that there are two or more er of HIV. Disclosure is o en an issue: your patient may beviewpoints on most issues. Be prepared to describe the reluctant to begin therapy that must be taken around their family or at work. © PROJECT INFORM 1375 MISSION STREET SAN FRANCISCO, CA 94103 2621 415 558 8669 WWW.PROJECTINFORM.ORG
  • 4. EMAIL YOUR QUESTIONS TO4 www.projectinform.org/questions JANUARY 2010Building a cooperative patient/doctor relationshipIf disagreements occur ...When disagreements occur, it’s dif- ion should be sought from doctors A doctor must feel that s/he is prac- cult to know what to do. When an in leading AIDS hospitals, or doctors ticing sound medicine, while patientsactive disease appears, such as a bout could call the WARMline at 1-800- may feel they cannot compromise onof PCP, the doctor’s expertise must 933-3413. treatments they consider essential tolead the way because its treatment is Disagreements about how to treat their health. Both must strive to listenbetter known. Exceptions may occur HIV may occur. When patients have and understand the other’s views.in institutions or areas of the country as much information as the doctor Sometimes, it’s possible to nd newwhere expertise with HIV is not at a about some therapies, each may ar- options that neither party had expect-state-of-the-art level, or when bureau- rive at di erent conclusions based on ed before the discussion began.cratic procedures may hamper the similar data. is presents a challengequality of care. en, a second opin- for both. The patient might ask: The doctor might ask: “What will it take for you to feel “What can I do to help you better un- comfortable with what I want to do? derstand the risks and why I’m con- More careful monitoring? Reviewing cerned with what you want to do?” or the decision in a month or two? More “What other options, if any, have you review of available data? Discussion considered?” or “Will you wait while I with other doctors? A statement re- review the matter more carefully?” leasing you from liability?”However, patients can’t expect their pect patients to “wait and see” inde - Changing doctors should be reacheddoctors to heartily support rem- nitely while the research proceeds. only as a last resort, and only when it’sedies for which there’s no supporting Sometimes doctors and patients clear that you both cannot accept theevidence. Nor can patients realisti- must question whether it’s possible other’s part in the relationship. Eachcally expect their doctors to give the to continue their relationship. It’s of us must ultimately nd the combi-same credence to highly experimental possible to maintain the relationship nation of patient + doctor + approachdrugs as they would to better proven while disagreeing and continuing to that makes a cooperative relationshiptherapies. And doctors shouldn’t ex- communicate over the di erences. possible. TOLL FREE NATIONAL HIV/AIDS TREATMENT HOTLINE 1 800 822 7422 LOCAL & INTERNATIONAL 415 558 9051 MONDAY FRIDAY 10 4 PACIFIC TIME

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