Talking with your doctor (provider) is not just about what ails you. It’s more. Lot’s more. Let us count the ways:
First, a patient should know his or her health goals, or seek help in defining them, especially as she or he advances in years. For example, if you became severely ill, even mortally ill, how much ‘heroic effort’ would you want your doctor to provide? You should understand your medical options in case a health crisis occurs. Bottom line: What quality of life would you want were you severely ill with questionable chances of recovery?
This relates to a second question: what kind of death would you prefer, if your health were not improving and chances were 50-50 whether you would survive an illness? Would you prefer to spend your final days in a hospital’s ICU or at home with family and friends? Have you expressed these wishes to your doctor? Are they spelled out in your Living Will and Health Care Directive? Besides your spouse and ALL your adult children, does your physician(s) know your health care goals?
Third, care-giving and receiving: How do you feel about aging in place versus in a continuing care retirement community? Have you shared this information with your doctor(s)? Should the time come that you can no longer care for yourself, your doctor needs to know where and what kind of assistance you may require and can afford.
Fourth, tell your doctor who your other providers are. Doctors can become “silo’d,” unaware of the other providers in your ‘health universe.’ This can result in poorly managed medications, because your doctors are ignorant of what their counterparts prescribed.
Fifth, you should determine who is your medical advocate and share this with your doctors. The health care proxy named in your Medical Power of Attorney may live in another part of the country and may not be available to advocate for you in an emergency. You should specify in writing (in accordance with HIPAA) who else (besides those named in your Advance Directive) should be informed if you’re having a forthcoming operation, change in medications, or other developments in your health.
(I recently learned about a doctor who was about to operate on an elderly person and did not know his patient had dementia. Since he had explained to his patient [dozens of times] the procedure he was about to perform, he hadn’t felt it necessary to inform his patient’s spouse of the impending procedure. Imagine the spouse’s consternation when she learned of the procedure minutes before her demented husband was wheeled into the OR!).
Sixth, square with your doctor about your medical background. Especially if you have a history of mental illness or substance abuse. This is essential if a doctor is to intelligently prescribe medications, let alone know how you might deal with unpleasant news about your condition.