An important part of good health care is a good relationship between you and your doctor. You must be able to communicate well with each other so your needs are met.

Cancer treatment often means that you will have more than one doctor. Sometimes other health specialists are involved, too. You may get facts from many sources. However, it's a good idea to choose one doctor to be your main source of information. You can turn to this doctor with your concerns. This doctor may or may not be the one you see most often. Only you can make that choice, and this information can help.

You should feel at ease with your doctor. A good relationship with your doctor is worth the effort needed to create it. If you and your doctor have similar viewpoints about sharing facts, making choices, or joining self-help groups, you are likely to have a good relationship.

For you, what is the first step in creating good communication with your doctor?

ASK YOURSELF, "HOW MUCH DO I WANT TO KNOW?

You may want a lot of details. Some people feel much better when they know all the facts about what is happening to them. If you are like this, you should ask the doctor for exact details and information.

Or, you may want only the overview. It disturbs some people to be told too many details. They may want simple directions what pill to take or what their treatment will be and when it will be done. They would rather leave most decisions to the doctor. Don't be afraid to tell your doctor how much, or how little, information you want.

SHARING INFORMATION

We each have our own ways to communicate. That's why the perfect doctor for one person may not be a good match for another. You may want your doctor to be business-like. Some people prefer doctors who are direct and to the point. They don't need a warm relationship - just a sharing of needed facts.

Or you might prefer a doctor with a more friendly style. This is often the case when your illness requires long-term treatment.

After you know what you want as a patient, the next step is looking at how you talk with your doctor.

UNDERSTANDING YOUR DOCTOR

Remember, it's hard to listen well and understand when you are anxious or afraid. Even if the doctor is very thorough, you may not hear or remember what is being said. Take notes to help recall what your doctor says. Or ask if you can tape record your talk for later review. You may also want to have a family member or friend there with you. They can remind you of questions you want to ask and help you remember what the doctor said. Having someone there also helps your family know what is happening. You may want their help in making decisions.

Some doctors try to share information with patients but use terms you may not know. If you don't understand something, ask your doctor to explain it to you.

ASKING QUESTIONS

Here are some questions your doctor can usually answer for you:

• What's wrong with me?
• What treatment do you recommend?
• Are there other treatments?
• What are the benefits of these treatments?
• What are the risks?
• What medicines are you giving me?
• What are they for?
• How should I expect to feel during treatment?
• What side effects, if any, can I expect to have?

When you get instructions from your doctor, write them down. Make sure you understand them before you leave the office. Then follow them exactly. Keep written notes and bring them with you, if needed.

Here are some more questions you may want to discuss with your doctor:

• Who else gets information about me? Should anyone else - a spouse, a friend, or another doctor, also get information? Think about the choices and tell your doctor what you want.
• What issues are important to me? For example, will the disease or the treatment keep me from working or caring for my family? Will I have any physical limitations? Again, ask your doctor if you want more information about your treatment. Ask if there is written information you can take with you.
• What is the best time to call you if I have a question? Some doctors have a special time for call backs. Expect your doctor to return your calls, but remember that a quick response may not be possible if another patient is having a crisis.

Above all, your doctor should take your questions seriously. He or she should be interested in your concerns and not make you feel rushed. If your doctor does not respond this way, bring it up at your next visit. If you don't, communication will be blocked and your relationship may suffer.

THE DOCTOR-PATIENT RELATIONSHIP

Here's how to maintain a good doctor-patient relationship:

• Try to state as clearly as you can any changes in body functions, from sleep and bowel habits to other changes such as headaches. Make notes so you can report these to your doctor.
• Talk over your concerns with your doctor. Mention lifestyle habits, even if it's something you're not proud of, such as smoking. Never keep back information. Something you think is minor could affect your treatment. Or, something you think is serious might be easily relieved.
• Make a list of all your questions. Take it with you to your doctor visits. Don't be ashamed or shy about asking these questions. There is no such thing as a "dumb" questions. Refer to the list of questions above for some ideas, and then add your own.

IF YOU HAVE A PROBLEM TALKING WITH YOUR DOCTOR . . .

If you have a problem talking with your doctor, there are ways to improve the situation.

For example, if you need more details after your doctor answers a question, say so. Sometimes it's even helpful to ask the question again in a different way. It will seem as if you understand unless you tell your doctor that you don't.

If you want to take an active role in your cancer treatment, ask your doctor to suggest some reading materials.

If you still have concerns, ask for a special visit to discuss the problem. Go to the meeting with as much knowledge as possible. You can then ask good questions. For example, you might contact your local American Cancer Society for a booklet on the topic. The National Cancer Institute also has information. You can call the Cancer Information Service at 1-800-4-CANCER to get this information. Tell your doctor where you got your information and then ask for his or her opinion.

Being angry or hostile doesn't help improve communication. Don't use questions or statements as an attack. It's normal for people - including doctors - to withdraw or become defensive. Do make it clear that you need answers to your questions.

What should you do if you feel you have done your part but the situation has not improved? Perhaps you could talk to a third party. The head nurse or your family doctor might be willing to discuss the matter with the doctor. Sometimes this is less stressful than facing the doctor directly. It could be a positive turning point. If not, it may be time to find a new doctor. Don't stay with a doctor only to protect his or her feelings. Just because you were referred to the doctor does not mean you can't decide to change on your own. It's your body and you have the right to find the best doctor for you.

CHANGES IN THE RELATIONSHIP

If you are in the hospital, your relationship with your doctor could change. Many people will be involved in your care. Hospitals have rules and policies. Your doctor has to follow these, too. Sometimes all this activity and the need to follow hospital routines can cause stress. There may be times when your doctor can help you solve problems that might come up about hospital rules or practices.

If you have a problem with your doctor while you are in the hospital, there are others there who may be able to help. Speak to someone like a nurse or a social worker. Or ask if the hospital has a patient service representative on staff. They can provide support and help you organize your thoughts before talking with your doctor. With your permission, they might even speak directly with your doctor.

People who have cancer are likely to want to build a good relationship with their doctors. Over the long term, it is helpful to identify one doctor to be your main source of information. Ask the person if that will be OK. Building this relationship doesn't just happen. It takes care and effort on both sides. Chances are, you'll both benefit.

REFERENCE

Talking With Your Doctor, ACS 4638-PS.

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