Here are some tips to strengthening this partnership:

Identify health goals. What do you hope to achieve with the plan you and your doctor develop? You may want to lower your risk of heart attack or prevent cancer or be freed from pain. Effective goals are:

• Measurable “Get my blood pressure to 120/79” rather than “Lower blood pressure”
• Realistic “Go out for a ten-minute walk five days each week for the next month” rather than “Loose 45 pounds”
• Positive, stating what you want, rather than what you don’t want “Get 6 hours of uninterrupted sleep” rather “Feel less tired”

Understand the plan. Before you leave your doctor’s office, make sure you understand the plan. If you have a medication change, how will you know it’s working or not working? When is your next appointment and with whom? Under what conditions should you call earlier? And always ask what lifestyle choices support the therapeutic action of the medicine.

Measure your progress Discuss with your doctor how you know you are moving closer to your health goals. Some things, like lowering blood pressure or weight are easy to follow. Other goals, like “more time with less pain” can be measured with creative scoring systems.

Gather resources Ask your doctor to point you in the direction of information or community resources that support your efforts. You two don’t have to do it alone.

Be honest with your doctor and with yourself, even if you have news that you would rather not admit to yourself or others. For example, if money is so tight you can’t afford the news medication, say, “I’m embarrassed to admit this, but I can’t afford this medication.” Then you and your doctor can work towards a solution.

Keep your word The plan you and your doctor make is an informal contract, and sometimes you need to renegotiate. If you experience unacceptable side effects from a new medication, tell your doctor so you can try another instead of just stopping the medication.

State your needs clearly, even if it feels uncomfortable. If you don’t understand what your doctor told you, say, “Could you please explain that with different words or draw a picture.”

You can strengthen your partnership with your doctor. You will be rewarded with better health care. And better health. Copyright Vicki Rackner MD 2005

Phrase, “I invest in my partnership with my doctor”

Scene: Your doctor recommends a procedure.. You say, “How will the results of this test move us closer to my health goals?”

Take this quiz to asses the health of your partnership with your doctor.

• Do you your doctor trust and respect each other?
• Do you and your doctor communicate honestly, understand each other and do what you say you will do?
• Do you understand your medical options and make choices that lead to health?
• Do you notice changes in your body like a new mole or an alteration of bowel habits or a new ache and act on them?
• Do you know how to keep yourself and your family healthy?
• Are you moving closer to your health goals?

Vicki Rackner M.D. president of Medical Bridges, is a surgeon who left the operating room to help patients partner more effectively with their doctors. She's a speaker, author and consultant.

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