“For most seniors, preparing for a doctor appointment means taking a bath and wearing clean underwear,” says Vicki Rackner, MD, a surgeon who now focuses on improving the health of the doctor-patient relationship through her company Medical Bridges. “It's no secret that patients should bring a written list of questions, talk with their doctors about embarrassing medical topics and ask for explanations they understand. Yet, few do so.”

Face-to-face coaching is the key to helping seniors speak up, according to a review from the Cochrane Library. Seniors given brochures or written handouts rarely alter the way they work with their doctors. Coaching, a process in which the office visit is rehearsed, makes the difference.

Rackner says, “Most patients know what they should do; the problem is that they don’t know what to say or how to do it. Coaching offers this missing piece. Working with your doctor in new ways means developing new skill sets. It also requires overcoming deeply ingrained beliefs about what it means to be a ‘good patient’ and conventional notions of proper etiquette at the doctor’s office.”

“Many seniors were taught it was impolite or disrespectful to question a doctor. Compared to 50 or even 10 years ago, doctors use more powerful medical interventions, manage an explosion of medical knowledge and act in the face of more moment-to-moment distractions. Patients who are unwilling to help their doctors by speaking up can literally put their lives at risk,” she said.

“Who doesn’t know that patients need second medical opinions before subjecting themselves to an operation?” she asks “Still, even the most empowered patients skip this step because they’re worried about offending their doctors. Coached patients learn that the primary care doctor, not the surgeon, generates the referral; the surgeon does not need to know that they are seeking a second opinion! Further, coached patients are more likely to arrive at the consultation armed with the right medical records, a second set of listening ears and a written list of questions. They also know to bring the x-rays and pathology slides instead of the reports.”

“As a physician I always appreciated the patients who came to their appointments prepared,” she said. “Coaching is nothing more than an action-oriented, rehearsed preparation. While the patients in this review were coached by medical students, any lay person can serve as an effective coach. The worksheets in my Personal Health Journal, for example, walk through the physical, intellectual and emotional preparation for doctor appointments. Seniors can complete the worksheets, or their adult children or caregivers can serve as the coach with the worksheets as a guide. Any way it’s done, coached seniors are more likely to speak up and get the medical care they want, need and deserve.”

Medical Bridges offers products and services that tell patients and their caregivers exactly what to say and what to do so that patients get the health care they want, need and deserve. Dr. Vicki Rackner’s media appearances, talks, articles and books all contain practical tips that help ordinary patients to get extraordinary health care.

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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