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The Importance of Good Doctor-Patient Communication

Good doctor-patient communication is essential to get the most benefit from your doctor visit, yet so often the lines of communication break down or are never adequately established.

Here are some reasons for poor doctor-patient communication:

  • Lack of face time with the doctor.
  • Feelings of intimidation on the patient's part.
  • Lack of comfort with the subject matter. 

Communication is a very important part of getting the best possible treatment. What can you as the patient do to improve this process?

Communication Is a Two-Way Street

You might be surprised to learn that doctors are generally not given any specific training in how to communicate well with patients. A doctor's training concentrates on the skills of diagnosis and treatment, often objectifying the patient as a set of symptoms to be treated. Bedside manner is something learned by doing and some may never become adept at this skill. As the patient, however, there are some things you can do to help the process along.

Be Prepared for the Visit

Doctors today are often pressed for time. It is incumbent upon the patient to be well-prepared prior to office visits in order to accomplish the most in a shorter period of time. Like a good Boy Scout, you should "be prepared". Some steps you can take to get ready for your office visit:

  • Arrange your priorities for the visit ahead of time. Discuss what it is that concerns you the most at the outset of the visit.
  • Prior to your visit, review your answers to the following likely topics: your symptoms, your medical history, what you feel may be causing your symptoms (for example, a stressful event that has recently occurred), your current and past medications and treatments.
  • Make a list of any questions or issues that you have carried over from your last visit.
  • If you don't feel you will remember everything, write it down. This will help you stay focused and get everything accomplished that you desire.
Educate Yourself

Read everything you can get your hands on about your illness and its treatments. Ask questions. There is a plethora of information on the Internet. Just plug the name of your drug or condition into your favorite search engine and read away. Keep a pad and pen handy as you search to write down questions for your doctor. Print out relevant articles and resources for future reference.

Your Needs Matter

Suffering from unbearable side effects? You don't need to suffer in silence. One of the goals of your treatment should be to get you back as close to normal as possible. Although many medications produce undesirable side effects, such as sexual dysfunction or weight gain, the good news is that many of the newer medications coming down the pipeline do not. If side effects are a concern, have a frank discussion with your doctor about trying an alternate medication.

Provide Feedback

Doctors are not mind readers. If a treatment isn't working, they won't know if you don't tell them. Nor can they help with side effects. One of the primary means a doctor uses to determine if a treatment is helping you is your feedback. Providing your doctor with complete, timely and honest information is crucial in getting you on the best medication for your needs.

This Is Just Too Embarrassing!

Have a problem that you feel ashamed to discuss? I'm going to let you in on a little secret. You are not the first person to face this issue and your doctor will not be shocked or upset with you for mentioning it. Remember, your doctor is there to help. There's no reason you have to suffer in silence with sexual dysfunction or any other embarrassing problem you may have.

The solution may be quite simple compared to how difficult the problem may feel. To get your best care, you must be honest. Also, keep in mind that doctors have an ethical obligation to keep your case confidential. If you just can't bring yourself to say something, however, try these tips:

  • If you don't feel comfortable talking aloud about the problem, write it down. How you communicate the problem is not as important as if you communicate it.
  • Don't put off talking about it. Bring it up at the beginning of the session and get it out of the way first thing.
  • Talk to the nurse ahead of time. Sometimes patients feel less intimidated by a nurse or other office personnel. The nurse can then bring up your problem to the doctor allowing him to broach the subject with you in a less threatening manner.
  • Remember that your doctor is just another human being like yourself. Having an advanced degree does not mean that he is immune to the same conditions that you yourself are experiencing. My first psychiatrist got into the field of psychiatry because he was suffering from panic attacks during medical school.

But They Just Won't Listen!

Let's say you've done all your homework, but your doctor interrupts you or says not to worry and dismisses your concerns? You just don't feel like you're being heard. What should you do?

At this point, it's very important to remember that you are paying for a service. You are the customer and you deserve to have your needs dealt with. Speak calmly, but assertively. Let your doctor know that you value his time, but you do not feel confident that your questions have been addressed. Then ask your questions again politely and don't back down until you feel satisfied that you have been answered. Avoid taking a confrontational stance, but do make certain that you are really being listened to. In all likelihood, this will be enough. Oftentimes, doctors become accustomed to making decisions for patients because most patients are used to turning all the decision making power over to their physicians. A patient who wants to become involved in his own treatment is a novelty. If, however, you simply are not getting the service that you desire don't be afraid to seek out another doctor. Your health and well-being are at stake. You deserve to get the service you are paying for.


'Guru' doctor of mood-stabilizing drugs suspended for second time

A doctor who described himself in an Orange County Register investigation as the “guru” of mood-stabilizing drugs has been suspended for the second time by state medical regulators.

The Medical Board of California put Laguna Niguel physician Paul Corona on a five-year suspension Friday for gross negligence in treating five patients and failing to maintain adequate medical records. He was also suspended in 2009 after suffering a psychotic breakdown.

Corona, who described himself to the Register as the most prolific prescriber of mood-stabilizing drugs anywhere, is prohibited from supervising physician assistants during his suspension.

His attorney, Ronald Talmo, declined comment Monday.

Jodi Barber, whose son, Jarrod, overdosed in 2010 on a mixture of drugs, some prescribed by Corona, said the state was too lenient.

“This is ridiculous. Remove his license permanently. How many slaps on the hand is he going to be given?” said Barber of Laguna Niguel.

Her son did not appear to be one of the victims in the state complaint.

Corona was the subject of a 2011 investigation by the Register into how doctors overprescribed to teens, fueling a rise in Orange County overdoses. Coroner records show accidental fatal overdoses have risen steadily from 130 in 2003 to 291 in 2013.

Corona preached the use of psychotropic drugs to remove the mental traumas that feed drug addiction.

“I am the top prescriber of psychotropic medications around,” Corona said. “Ninety-five percent of my patients are very happy.”

But drug addiction experts questioned Corona’s tactics, saying it didn’t make sense to use drugs to fight drugs.

Dr. Harry Haroutunian, physician director at the famed Betty Ford Center in Rancho Mirage, told the Register in 2011 it is especially dangerous to prescribe drugs with sedative qualities when treating addicts in an outpatient setting, where they might score more drugs on the street.

“If he is telling you he is the highest prescriber,” Haroutunian said, “that would be a dubious distinction by my measuring stick.”

Corona first came under the state’s attention after Orange County sheriff’s deputies were sent to his Laguna Niguel home in 2007 to investigate reports of a man having a psychotic breakdown and threatening suicide, according to a medical board accusation.

“Respondent was acting bizarre and was very aggressive, yelling and screaming incoherently. The officers had to taser respondent several times in order to subdue him,” said the report by the medical board. Corona was hospitalized for nearly a month for psychological observation.

It was the same year that he published a book about treating mood disorders, entitled “Healing the Mind and Body.”

In a 2008 interview with the medical board, Corona said he suffered an episode of hypomania three years prior. State documents say that he was prescribed Seroquel by his psychiatrist, but he admitted to self-medicating from his sample drugs after his psychiatrist moved away.

“His disorder has impacted his ability to practice safely and led to his hospitalization for a psychotic breakdown,” the state complaint said. He was put under suspension for five years in June 2009.

Under the latest suspension, Corona must take courses in prescribing practices, medical record keeping, medical ethics and clinical education. He must also find another physician to monitor him, according to medical board documents.

Source: OCRegister