Conversation with an oncologist: rules for a productive dialogue

Why is it so? Because in the complex and painful process of diagnosing and fighting the disease, only a team can win. It consists of a doctor with all the arsenal of modern medicine, and a patient who promptly, clearly and accurately provides information about his condition and responsibly fulfills all the doctor’s instructions.

This truth seems incredibly simple, but in reality it can be very difficult to implement. Instead of fighting a serious illness, the doctor sometimes has to “fight” with the patient himself. With his opinion about the insignificance of some facts. Or, on the contrary, the “importance” of unverified data from the Internet. With banal forgetfulness regarding taking medications, or increased anxiety.

And the patient, instead of focusing on treatment, tries to use Internet surfing, the advice of friends and acquaintances, the study of “alternative” methods of treatment to fill in the gaps in the dialogue with the doctor.

The interaction processes that have long been built and structured in most industries in medicine still remain at the level of a standard “doctor’s appointment” – taking an anamnesis, examination, recommendations, a prescription in illegible handwriting, a bewildered nod of the patient.

But if in the case of a slight runny nose this is not so critical, then for an oncologist gaps in communication with the patient are often a matter of life and death. Today it is important for all of us to learn to communicate. Both doctors and patients. Learn to talk to each other in such a way that from the entire flow of information and emotions, select only what will help solve the problem.

Patients have an avalanche of questions, emotions, doubts, wishes. However, they often do not share all this with the doctor – for many different reasons.

But all this is valuable information that can be decisive in choosing treatment tactics. But people don’t know if it’s okay to share such experiences with a doctor. And every day life puts us in a situation where a failed dialogue becomes the cause of serious consequences. Let’s see what and at what stage of communication between the doctor and the patient begins to “go wrong”.

Bricks in a non-existent wall

It would seem that before the world was simple and clear: the doctor treats, the patient is treated. One is active in solving the problem, the other only passively allows the doctor to work with the problem. The doctor is the leader, the patient is the follower. This model of interaction gave rise to a kind of cult of “people in white coats”.

Remember your feelings from childhood – the atmosphere in the doctor’s office was oppressive, frightening. Smell, instruments, posture and tone of the doctor: “Sick, open your mouth. close. Inhale. Exhalation”. Next to the owner of great knowledge, it is easy to seem like a fool. Only speak if the doctor asks you to. Do not ask again, even if something is not clear. These norms of behavior, instilled in childhood, have remained with us in adulthood.

Unconditional respect for the doctor is one side of the coin. The other is the isolation and confusion of the patient. A wall between two people, through which there is no way to break through a very important element of any treatment – information.

The doctor asked if he had a headache. The head does not hurt, but it hurts in the chest – is it appropriate to say this if the doctor is already asking other questions? And if there is no pain, but there is a strong fear, which sometimes makes you dizzy and darkens in your eyes? Should we talk about this? Are we wasting the doctor’s precious time when we share such revelations? Isn’t it better to remain silent? And if there is any doubt that the recommendations will help? Perhaps the doctor could dispel them, but would the relationship with the doctor deteriorate if they were voiced?

Despite the huge amount of knowledge and practical experience, the doctor simply cannot read minds. And, due to its focus on a medical problem, it does not always feel the patient’s emotions. He can really dispel doubts, it is extremely important for him to know about the fears of the patient, and even more so it is necessary to be aware if something hurts.

And all this he can learn only from you. But he won’t find out… Because between you there is a wall of stereotypes, a ghostly barrier of non-existent, in fact, obstacles – old and useless rules of behavior.

Breaking the wall will not work right away: trust and naturalness in communication are created in the process of communication itself. But three simple principles will help to gradually come to an effective interaction with the doctor: structured information, proper planning and regular analysis.

More information – better communication

Do you know what subject is the chief assistant of an oncologist? Patient’s Notebook! It sounds strange, but it is true: in a situation where any little thing can matter, it is important to write down and structure information.

So you’ve received a referral from your GP to an oncologist. Your state now can hardly be called calm: excitement, confusion, fear are absolutely normal. But the first and most important thing that you must realize and accept is that a visit to an oncologist does not mean that you definitely have an oncological disease. So why were you sent to the doctor?

Take a new notepad. On the first sheet of paper, write down the first task: Rule out or confirm cancer. Now the purpose of the visit is visible and obvious, and smaller, but no less important issues follow from it.

To make a diagnosis, the doctor needs information about the patient. These are certain facts of life related to health and well-being, and the more you state them, the faster and more accurately the doctor will be able to make his verdict.

Therefore, first of all, make a list of medical documents that you will take with you to the appointment. These are all the health reports you have and the results of recent tests. Of course, we are not talking about routine examinations since kindergarten. For an oncologist, research and conclusions of all doctors are important in connection with ailments over the past 3-5 years.

Collect the documents according to the list: it is most convenient to lay out the leaves in transparent files and hem everything into one folder. This will help the doctor quickly navigate the current situation, and you can easily answer questions without wasting time looking for the right sheet in the general stack.

First of all, compose:

1. “Risk List” – a list of past diseases, foods and drugs to which you are allergic.
2. “Help List” – a list of medications and dietary supplements taken with dosage and schedule of administration.

Now you have the basic data from which the doctor can begin work on taking an anamnesis and making a diagnosis. Great news: this step saved 10 to 20 minutes of taking. The doctor will definitely appreciate this, because in fact you have shown respect for his (and your) time and demonstrated an attitude towards productive cooperation – and this means a lot.

In addition, you will have the opportunity to discuss your complaints with your doctor in more detail. Speaking of them, prepare two more lists that you will write in a notebook:

1. Pain. This is a very important factor, so it is necessary to describe in detail:

• localization of pain;
• its intensity, the conditions under which the intensity of pain changes;
• Does the pain restrict mobility, interfere with normal activities and clear thinking?
• medications you take to relieve pain, and how you take them.

2. Your complaints. Here it is important not only to list, but also to note the intensity of the symptoms, to try to fix the frequency and time of their manifestations. Here is a sample list of what is important not to miss:

• shortness of breath or cough;
• problems with the gastrointestinal tract (constipation / diarrhea, hiccups, nausea, vomiting, etc.);
• fever or chills;
• lack of appetite, sudden changes in weight;
• drowsiness, fatigue, apathy;
• hot flashes, sexual dysfunction or lack of libido;
• feeling lethargic or hallucinating;
• insomnia;
• vision problems (double vision, loss of focus, etc.);
• tingling and loss of sensation in the extremities, convulsions;
• confusion of consciousness.

Thus, in your notebook there will be three main points on which the doctor will build a conversation: medical documents, important health nuances and complaints. When everything is in front of your eyes, there is less risk of missing something significant.

The next thing to do is to make a list of questions to ask the doctor. It is better to write each question on a separate sheet so that there is room for answers. Already at the reception, leafing through your notebook, you will remember important points and will not lose the thread of the conversation. And if a new question arises during the conversation, it should also be written down along with the answer.

Punctuality is more than just politeness

Do you plan to come to the appointment with the doctor strictly on time? Most likely, you will enter the office 10-15 minutes late. The system of medical care includes not only your conversation with the doctor in the office.

In order for the doctor to always have information about you at hand, so that your data is quickly sent to narrow specialists, and the research results are promptly entered into your medical record, the clinic needs about 15 minutes of your time to complete the documents and enter information into the database. And it’s very disappointing to subtract this time from your communication with the doctor.

In addition, the cherished 15 minutes before the appointment will help you, in a calm atmosphere, once again think over the questions with which you came to the doctor, remember the fundamental points for you that are important to talk about.

Also pay attention to your plans after the visit. It would seem that if a doctor’s appointment lasts 40 minutes, then why not make an appointment, for example, after it, or go to work to complete some project? But it is better to free the day of the visit completely. And here’s why: diagnosing cancer is a complex, multi-stage process. A visit to an oncologist is just the starting point. The doctor determines further studies, on the basis of which he will already make a diagnosis. So, you will need to take tests and undergo diagnostic procedures.

The sooner your doctor gets the results, the sooner they can prescribe treatment. Therefore, you will be offered to complete at least part of the research on the same day. In addition, the visit to the doctor itself can be delayed, especially if you have chronic diseases: there are many questions about them, and answers take time.

And, even if everything went quickly and there was a lot of time left after visiting the doctor, it is better to devote it to the next important thing – analysis.

Analyze. Write it down. Help the doctor

A visit to an oncologist is a difficult step from a psychological point of view: the situation itself unbalances, no matter how well you prepare for the meeting. To return thoughts to rationality and switch to solving the current problem (remember what we wrote in the notebook on the first sheet), pick up the pen again and get ready to write.

Confusion, shock, loss of orientation is a normal reaction of a person who is faced with oncology. But you need to move on to solving the problem, and here again the right notepad will help you.

First of all, you need to remember everything that is important, in your opinion, what the doctor said during the appointment. It is very likely that in a calm home environment you will have new questions – write them down, they will become markers for assessing your own condition before the appointment, they can be discussed with the doctor during the next visit.

Read the answers to pre-prepared questions to see if they require clarification. Any questions? Something is not clear? Write down difficult moments again. Such work helps to calm down, focus on a constructive approach. If any questions cause strong emotions, it is better to call the doctor right away and find out everything.

Try not to succumb to emotions, try to understand what caused them. Are you scared? What exactly is scary? Uncertainty? This means that a rational decision may be to call the doctor with a question or read literature on the topic. If you feel that the emotion is uncontrollable, then this is a good reason to contact an oncologist – most likely, he will help resolve the issue with psychological support.

These simple principles apply to the first, second, and subsequent visits to the doctor. The fight against a malignant neoplasm (if this diagnosis is confirmed) is a long way along which you will go side by side with an oncologist. And your assistance is as important for him as his experience and knowledge are for you.