What to do if a consultation seems to be going wrong

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What to do if a consultation seems to be going wrong

It is not uncommon to hear that patients are quite dissatisfied with a medical consultation.

What can have gone wrong?

Sometimes the problem is simply one of a clash of personalities. Two people may have such different styles of approach, pace of language and contrasting manner that easy communication is just not possible. This is not in fact very common since doctors meet a wide variety of people as patients and overall just get on with the job in whichever style it takes. Talking to a teenager for example needs a very different vocabulary and choice of tone from the style needed to talk to a widow or a small child.
Doctors usually, given plenty of practice, become very skilled with their ‘communication skills’.

However, when a fundamental clash does occur it is probably best to acknowledge it. If you tell your doctor that you find him or her difficult to talk to they may be very surprised and change their attitude to one which is more forthcoming. It can also help to talk to someone else in the practice such as a nurse, receptionist or even a complaints manager. You may learn that there were extra factors involved such as prior emergencies. If all else fails, it may simply be necessary to arrange to see a different doctor next time.

The commonest complaints after an unsatisfactory consultation are that the doctor was unsympathetic, rushed, rude and uncommunicative. Often a patient reports that the doctor was not listening, was staring at the computer screen, was avoiding eye contact or not even looking at the patient at all or was thinking of something else.

If in the course of a consultation either with a GP or with a specialist, you feel that the doctor is not listening what can you do about it? This is not an easy problem.

First, keep your composure, remain polite. The doctor may seem rude, but responding the same way is not likely to get you what you want.

If the doctor is clearly not listening to your words you might start by saying “I can see you are preoccupied, shall I repeat that?” Try asking politely “Shall I wait until you are ready?” If the doctor simply waves you to carry on and continues to ignore you or block you out, you might try causing a small surprise. You could try causing the doctor a slight startle ……….., drop a book from your lap or your bag onto the floor. The startling sound is likely to fix the doctor’s attention on you rapidly and you can say “As I was saying doctor”. Hopefully this small ruse will attract the doctor’s attention. Alternatively, if the doctor continues to stare at his computer screen, you could surprise him in an unthreatening way by simply standing up and stepping back a little towards the door. You could say “would you like me to wait a bit until you are ready?”

Alternatively, you could be quite direct “Doctor, I don’t think you heard what I said”, “Doctor, I have the impression that you are not listening to me, shall I repeat that?”, “Doctor, would you mind looking at me when you speak to me as I am a little deaf and I need to lip-read!”.
Alternatively, if the consultation is really not going well, you could pause…… or start to hum or whistle. The message here is that you realize the doctor is preoccupied and you are content to wait until he or she is ready!

If you feel you are making no progress, you could ask the doctor if he would like you to make another appointment on another day. Alternatively, you could ask if a familiar nurse or companion could come in to accompany you. The doctor is less likely to ignore you in front of witnesses.

If the problem is irreconcilable, then you may finally have to tell the doctor that you find him or her rather rude and you would prefer to consult someone else. At this point leave promptly and quietly. Report the problem politely to the receptionist and make an appointment with another doctor.

In a hospital outpatient clinic, it may be more difficult, but the nurses are your allies here. Ask their advice about who is in the clinic today and who can best deal with your problem. If you are really dissatisfied and concerned about your health then, more formally, you could ask for a second opinion. The important matter of second opinions forms the subject of a topic below.
In the interim here are some of the types of behaviour on the doctor’s side which annoy patients and frustrate good communication.

Potential problems in communication technique: the patient’s viewpoint:

  1. Doctor is rushed.
  2. Doctor does not listen/does not let you finish.
  3. Doctor interrupts.
  4. Doctor is rude.
  5. Doctor avoids eye-contact or even looking at you.
  6. Doctor does not examine you.
  7. Doctor jumps to premature conclusion.
  8. Doctor writes you unwanted/unexplained prescription.

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