How to Navigate 6 Common Healthcare Issues
These strategies can help you get better care from your doctor
By Hallie Levine
Adults in the U.S. are living longer. But that doesn’t always mean they’re healthier—almost 61 percent of older Americans are dealing with multiple chronic conditions.
This makes solid medical care essential as we age. Also, for older people errors “are much more likely to have consequences—their physiology is just not as adaptable,” says Los Angeles internist Michael Hochman, MD, MPH, chief executive officer of Healthcare in Action, which provides care for people experiencing homelessness. Plus, almost 20 percent of Americans 50 or older say doctors have made assumptions about them based on their age, which can lead to inappropriate care.
All this means it’s key to speak up if you have concerns or questions, says Terry Fulmer, PhD, RN, president of The John A. Hartford Foundation, which focuses on improving healthcare for older adults. Here is how to best fix six healthcare issues. And remember: If your doctor doesn’t respond, you may ultimately want to switch providers.
1. The Doctor Talks Too Much
Doctors interrupt patients’ opening statements after about 18 seconds, on average, according to a review of studies published in the journal Patient Education and Counseling this year.
One solution: Create a written agenda of the issues you want to talk about and hand a copy to the doctor at the beginning of each appointment. “This really refocuses the conversation on you and what you need,” says Jake Harwood, PhD, a professor of communication at the University of Arizona in Tucson.
2. The Doctor Uses Medical Jargon
Receiving complicated explanations or instructions from a doctor can be challenging in the best of situations. In fact, up to 80 percent of the medical info patients are given during office appointments is forgotten immediately, according to the Agency for Healthcare Research and Quality.
If your doctor uses a lot of medical jargon or is otherwise unclear, you can bring a trusted friend or family member to take notes during appointments. Harwood also suggests the teach-back technique, where you repeat the doctor’s explanations in your own words. This allows the doctor to see whether you’ve gotten anything wrong and, if so, to go over what they’ve told you again.
3. The Doctor Dismisses Your Pain
Almost 31 percent of older adults have chronic pain, and about half of those report that this makes daily tasks, socializing, and physical activity challenging, according to a study published in the journal Frontiers in Pain Research this year. Ageism and the subjective nature of pain may lead doctors to discount discomfort, Hochman says. “There’s no lab test that quantifies a person’s pain with an exact number, such as 7 out of 10,” he says. “There’s an attitude now that pain is one of those things people, especially the elderly, just need to deal with.”
Bring written questions and concerns, and a list of treatments you’ve tried, to your next appointment. Consider having a family member or close friend with you to back up your concerns. Raise the topic right away, and be specific: Tell the doctor exactly where and when it hurts.
It’s also key to set expectations. “Let your doctor know that you assume that your treatment and overall approach to healthcare will be with the goal of bringing your health back to baseline,” says Annette Ticoras, MD, a patient advocate in Columbus, Ohio, area. In addition, give your doctor a snapshot of what you want. Perhaps it’s important to you, for instance, to still be able to travel independently and play tennis.
4. You're Not Getting Better
If a treatment isn’t helping, your doctor may need time to get to the bottom of the problem. That could take weeks or longer.
But if your provider doesn’t seem to listen or you’re too uncomfortable or ill to wait, get a second opinion. “It’s a good idea to get a fresh pair of eyes on the situation, as another doctor may see it from a different angle,” Hochman says.
A study published in 2021 in the journal Mayo Clinic Proceedings, for instance, found that a second opinion cut the chance of misdiagnosis in half. If you seek a second opinion, Hochman recommends doing so with a doctor at another medical center, who may be more likely to approach your condition with a different perspective.
Your doctor should be open to you getting a second opinion. “A good primary care provider won’t be offended that you are seeing someone else, and may even welcome the input,” Hochman says.
5. The Doctor Doesn't Respond Quickly
“It’s reasonable to give a medical provider 48 hours to get back to you for non-urgent questions,” says James S. Powers, MD, a geriatrician at Vanderbilt University Medical Center in Nashville, Tenn. You should get a same-day response to an urgent request. One of the best—and fastest—ways to get a response is to send your doctor a message through your patient portal; most practices now have one. You can also use the portal to keep track of appointments, check test results, and read after-visit summaries from your provider.
“Office staff, and physicians themselves, check these portals frequently, so if you send a message, they’re more likely to see it and respond than to pick up the phone and call you back,” Powers says. In fact, physician-patient communication through these sorts of portals rose 25 percent from 2018 to 2020, according to the 2020 Deloitte Survey of US Physicians.
6. The Doctor Doesn't Consult Your Other Providers
More than 30 percent of Medicare recipients see at least five specialists a year, according to data from 2000 to 2019. So “your primary care provider should be the quarterback of your healthcare team,” Powers says. But with multiple specialists each running their own show, doctor-to-doctor communication might not be ideal.
So make sure your primary care doctor has the names and contact information for all the providers you see, and a list of your medications (including over-the-counter drugs and supplements)—and who instructed you to take each one.
Ask your internist to go over your electronic health history with you to make sure it’s correct; it should list all your meds and health conditions. “Sometimes, there’s so much information in it that their primary can miss something,” Powers says.
If you use a patient portal, print out the notes and after-visit summary for recent specialist appointments, and go through these with your internist to check for duplicated treatments and gaps in your care.
Editor’s Note: This article also appeared in the August 2022 issue of Consumer Reports On Health.
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