Chapter 43
How to Make the Most of Your Doctor

from the book How to Have a Baby: Overcoming Infertility
by Dr. Aniruddha Malpani, MD and Dr. Anjali Malpani, MD.

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Remember that just finding a good doctor is not enough. For an infertile couple, the doctor-patient relationship is the ultimate one-to-one relationship, in which you confide fully in your doctor and trust him to help you to conceive. You need to form a partnership with your doctor, so that you can make the most of his skills and abilities.

In order to foster and nurture the relationship with your doctor treat it with great care and respect. Don't forget to say ‘thank you’ to your doctor – after all, he gets fed up of attending to droves of patients with complaints all day long , and would be delighted to hear a patient appreciate his efforts! This simple expression of gratitude by you would make the doctor remember you as a person and treat you as a special patient; getting VIP attention from him helps improve your medical care a good deal! As in a marriage, the doctor-patient relationship depends on good communication and trust built up over time. It is definitely worth spending time and taking trouble to maintain such a beneficial relationship.

Remember that the doctor's staff plays a key role, and you need to learn how the clinic functions. It's very helpful to build up a rapport with the staff (the receptionist, a nurse or an assistant), which can prove very useful when you need to talk to the doctor on a priority basis. The simple rule is that if you treat the staff well, you will be treated well too! A small ‘thank-you’ gift for the staff can help ensure that you get personalized attention. It's useful to learn which days are the busiest and what times are the best to consult the doctor. You should also find out what steps to take if there is an emergency, or when the clinic is closed.

Your visits to the doctor can be expensive, despite being very short. Many doctors have perfected the technique of flying into the examination room, shooting off questions, and rattling off advice. And, before you know it, you're shoved out of the door, worrying about those crucial matters you forgot to ask and the directions you forgot to write down. So, what's the solution? Is there really a secret to getting your money's worth from a doctor's visit? Yes, there is, and it's a simple one: Do your ‘homework’ thoroughly before visiting the doctor! In order to make the best use of your doctor's time, you need to ‘prepare’ for your visit, very much like you prepare for an examination. Time spent in getting organized before you go to the doctor can help immensely! A well-organized patient not only makes efficient use of the doctor's time but he is also likely to get better medical care, as he can help the doctor to make an accurate diagnoses. A conscientious patient makes sure that he has all the records with him as well as the vital questions to which he needs answers (preferably, in writing). Patients who value the doctor's time will do their best to get answers to their queries by tapping external sources such as books, libraries and the Internet, before going to the doctor’s clinic. This procedure will allow them and their doctor to focus on what is important to them, so that they can make the best use of the limited ‘quality time’ that they have with the doctor.

Your doctor is definitely not a mind-reader; you must tell him everything you know, think, and feel about your problem if you want an accurate diagnosis and the best treatment plan. (There is no need to be shy or embarrassed about sensitive subjects such as sexual problems or sexually transmitted diseases as far as your doctor is concerned. Rest assured that doctors have ‘seen it all’ and ‘heard it all’. They're not there to pass moral or ethical judgement on your conduct.)

Do not hesitate to share your thoughts with your doctor. If you think what he is recommending does not make sense, say so, and specify your reasons. If you're worried, do express your anxieties and find out how you can get more information and support to dispel them. If you sit on your chair and listen meekly, your doctor will either assume that you are uninterested in a full explanation --- or that you are too stupid to understand! Remember: the more you ask, the more you will be told!

Do keep in mind that doctors are also human, and they may also be burdened by their own problems. On certain days they may seem rude or curt; on such days, give them a little leeway and a lot of understanding!

Since it is your head on the block,’ so to say, you are entitled to raise all relevant questions and seek satisfactory answers to them. If you cannot understand your doctor's explanations, ask him to repeat everything in simpler language. Ask him to show you illustrations; also, ask for written material that explains the medical issues in greater detail, so that you can study this later at leisure.

The following terms can be very helpful when you talk to your doctor:

• Please tell me more about that.
• What does that mean in simple English?
• Could you explain that to me again?
• Could you write that down for me?
• Where can I find more information about this subject?
• You seem rushed. When can I call you to talk about this in more detail?

Try to schedule your next visit at the end of the consultation. If the succeeding question-answer session is something which can be managed on the telephone, then try to do so. You could save both time and money by avoiding an unnecessary visit to the doctor’s clinic.

However, you need to learn to make intelligent use of the phone to get appropriate help from the doctor. The following routine may help you to help the doctor give you the care you need over the telephone:

• Keep a pen and paper ready so that you can write down the relevant instructions.
   
• Make sure all your medical records are at hand, so that you can answer questions about your medical problem intelligently and accurately.
   
• Identify yourself properly, giving your full name as well as your diagnosis ( try not to tax your doctor's memory!).
   
• Ask if you can take a few minutes of the doctor's time now, or whether you should call back again — this is common courtesy!
   
• Report specific symptoms. For example, rather than just saying, ‘I don't feel well, or I've got the flu,’ which can be interpreted in different ways, be prepared to describe your symptoms precisely; for instance, fever, sore throat, cough, and/or bodyache.
   
• When you don't know what you need (for example, you may not be sure how serious the illness is, i.e., if you require a visit to the clinic), tell the staff you're uncertain and request that you speak to a nurse or the doctor's assistant over the phone. Don't be hesitant; if you're feeling concerned or anxious, let the clinic staff know.
   
• Don't insist on talking only to the doctor every time you call. For example, if you just need to make an appointment, or merely clarify a doubt, the nursing staff or receptionist may be able to help you. To put it differently: respect your doctor's time!
   
• Don't misuse the phone by trying to wangle a free consultation. Not only is this act unfair to the doctor, but also such a consultation is likely to be very unreliable!

Today, many physicians make themselves, an assistant or other staff member available to their patients over the phone. Pre-visit questions and routine follow-up on the phone can save you — and your doctor — both time and money. Before making a call, you need to certain relevant information in advance:

• When is the best time to call?
• What is the doctor's rule for returning calls?
• Whom should you speak with (e.g., assistant, nurse) if the doctor can't come to the phone?
• What is the phone number for making emergency calls or for calls when the office is closed?
• Whom can you call if your doctor is out of town?

Making effective use of the telephone can help to save both you and your doctor considerable time, effort and money! learn to use this instrument wisely and well.

Many doctors today are happy to answer your queries by email – and this can be very helpful if your doctor is in a different city. Please find out from your doctor what his policy about email queries is !

It’s a good idea to carry written checklists with you during every visit. You may have a wide range of questions you would like to ask the doctor, but as a result of the stress generated by the consultation you often forget most of them. Such a situation is very frustrating, and you kick yourself when you get home. To prevent such an adverse outcome, it is prudent to, write down all the questions you need to ask, in order of priority. It is also helpful to write down the doctor's answers. Studies have shown that patients forget about 50 per cent of what the doctor tells them during a visit! Writing down the doctor’s answers will prevent such a ‘disaster’! Moreover, your doctor also stands to benefit because you need not pester him with your queries all over again!

Try to make sure you go for your consultation as a couple. The presence of your spouse can help reduce your anxiety, give you courage to ask the relevant questions, and also ensure that you have someone to interpret the doctor’s statements. As mentioned earlier, do not hesitate to ask questions (and more questions); never mind how many other patients are waiting outside the doctor's clinic, or how stupid the questions may seem to you. When you are with the doctor, his only focus of interest should be you, and it's his job to provide answers. Remember, the only stupid question is the one you didn't ask. Be courteous but assertive while asking questions and obtaining information, but don't turn aggressive or antagonistic. Listen carefully to what your doctor says, and in case of doubt and ambiguity, do not leave till these have been dispelled. Remember, the word doctor is derived from the Latin root docere, which means 'to teach'. Therefore, look for a doctor who is willing to share his knowledge with you!

The most common complaint patients have is that they are made to wait for ages before the doctor sees them! It is only because patients put up with such a situation that doctors get away with this unpardonable behavior. After all, no doctor would remain very busy if all his patients decide to refuse to wait for him! Some patients seem to believe that the longer they have to wait outside the doctor's clinic, the better he must be, since he has so many patients clamoring for his attention. This is simply not true! No matter how hard-pressed a doctor may be, he can always space out his appointments, so that you never have to wait for more than an hour to see him.

In order to ensure that you don't lose your patience while waiting in the clinic, it would be a prudent idea to carry a paperback novel or a Walkman. Nowadays, many doctors keep patient educational leaflets and brochures in their clinics. You could read them in order to use your time constructively! Some clinics are also ‘blessed with TV sets, so that patients do not get totally fed up.

While an occasional delay is unavoidable (since a medical emergency could require your doctor's immediate attention), if you are made to wait for an eternity each time, something is seriously wrong with the doctor's attitude towards patients. For any inordinate delay, the clinic staff should be courteous enough to provide an explanation, and, if needed, an alternative appointment. As an example of efficient patient management, if a doctor at the famous Mayo Clinic in the USA makes you wait for more than 30 minutes without an explanation, you can complain to the hospital manager who will rectify matters.

Make sure you carry photocopies of all your medical records and tests. You can give them to the doctor for his files, if needed. You should have a clear understanding of your medical records so that you can explain the details to another doctor if needed.

Try to do your best to become an ideal patient, and learn to take an active interest in your medical care – it’s a simple fact of life that infertile patients who know how to make the most of their doctor get better medical care !

by Dr. Aniruddha Malpani, MD and Dr. Anjali Malpani, MD.

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