The Intelligent Patient's Guide to the Doctor-Patient Relationship: Learning How to Talk So Your Doctor Will Listen PDF
Preview The Intelligent Patient's Guide to the Doctor-Patient Relationship: Learning How to Talk So Your Doctor Will Listen
THE INTELLIGENT PATIENT'S GUIDE TO THE DOCTOR-PATIENT RELATIONSHIP This page intentionally left blank THE INTELLIGENT PATIENT'S GUIDE TO THE DOCTOR-PATIENT RELATIONSHIP Learning How to Talk So Your Doctor Will Listen BARBARA M. KORSCH, M.D. & CAROLINE HARDING OXFORD UNIVERSITY PRESS NEW YORK OXFORD Oxford University Press Oxford New York Athens Auckland Bangkok Bogota Buenos Aires Calcutta Cape Town Chennai Dar es Salaam Delhi Florence Hong Kong Istanbul Karachi Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi Paris Sao Paulo Singapore Taipei Tokyo Toronto Warsaw and associated companies in Berlin Ibadan Copyright © 1997 by Barbara M. Korsch and Caroline Harding First published by Oxford University Press, Inc., 1997 First issued as an Oxford University Press paperback, 1998 Oxford is a registered trademark of Oxford University Press All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press. Library of Congress Cataloging-in-Publication Data Korsch, Barbara M. The intelligent patient's guide to the doctor-patient relationship: learning how to talk so your doctor will listen/ Barbara M. Korsch and Caroline Harding, p. cm. Includes bibliographical references and index. ISBN 0-19-512657-2 (pbk.) \. Physician and patient. 2. Consumer education. 3. Interpersonal communication. I. Harding, Caroline. H. Title. R727.3.K67 1997 610.69'6—dc21 97-373 1 3 5 7 9 10 8 6 4 2 Printed in the United States of America CONTENTS ACKNOWLEDGMENTS, vii POINT COUNTERPOINT Listening to Both Sides, 3 SO, WHAT DID THE DOCTOR SAY?, 11 WHAT WENT WRONG? Derailed Encounters, 34 WHY DON'T I FOLLOW MY DOCTOR'S ADVICE?, 69 WHERE IS THE TRUTH? Secrets and Lies in the Doctor-Patient Relationship, 92 DOES YOUR DOCTOR SEEM UNFEELING?, 125 HOW DO DOCTORS GET THAT WAY? The Conspiracy of Silence, 145 DO I HAVE TO GO TO THE DOCTOR?, 165 WHEN YOUR CHILD IS SICK, 195 THE HOSPITAL, 230 GETTING THE MOST OUT OF MANAGED CARE, 261 NOTES, 283 SELECTED READINGS, 287 INDEX, 289 This page intentionally left blank ACKNOWLEDGMENTS This book is based on fifty years of experience in medicine. Patients, their families, colleagues, and friends have all been my teachers. A large amount of what I know and what I experience comes from reading—science, but also important world literature, including fiction. It is not possible for me to trace the sources and influences that have actually shaped my own thinking. Giving credit to selected individuals who have been significant in my professional life would mean omitting others who have been equally influ- ential. But I wish to pay homage to the late Loren Stephens, a wise and sensitive teacher who inspired my interest and understanding of what "doctoring" is all about and who is responsible for many of the ideas in this book. My colleagues at the Bayer Institute for Health Communication, es- pecially Greg Carroll and Vaughn Keller, have been an invaluable resource. I owe the reader an explanation regarding the case illustrations used viii ACKNOWLEDGMENTS I in this work. The long dialogues come from literal transcripts of recorded medical visits. Shorter quotes are gleaned from medical practice, mostly my own, and sometimes that of colleagues as well as from the files of the Bayer Institute for Health Communication. We have had to review a great many publications and wish to thank Doreen Keough, Health Sciences Librarian at Childrens Hospital Los Angeles. There has been no reference, no matter how old or how obscure, that she was not able to produce quickly. There have been thousands of publications on the doctor-patient relationship since the 1940s. We will not attempt to review the literature, and cite original sources only in relation to specific research projects. For the interested reader we have suggested a few from the many excellent books that deal with the doctor-patient relationship in general. (See the Selected Readings at the end of the book.) Most of all, we owe special gratitude to our editor, Joan Bossert. She has been a valuable collaborator throughout the preparation of this manu- script. Her support, contributions, and constructive criticisms have been invaluable. To our families and friends, especially Robert Ward III and Harding B. Michel, Ph.D., we are grateful for their having encouraged and sustained us during this work. December 1996 B. K. Los Angeles, California C. H. THE INTELLIGENT PATIENT'S GUIDE TO THE DOCTOR-PATIENT RELATIONSHIP
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