Doctor Relationship Part 1

Honesty is the Best Policy

There are lots of reasons to work on improving your relationship with your medical providers. A trusting relationship has improved my quality of life and I’m not alone. A meta study found a correlation between trust and patient outcomes - by both subjective and objective measures. I think it’s worth discussing some of the ways I’ve built that trusting relationship and, hopefully, you will find something of value in my experience. 

My first step on the journey of really trusting my providers came at a point of crisis for me. I had been having frightening symptoms for some time and was not making any headway into symptom improvement, despite trying everything asked of me by my doctors. My rheumatologist and immunologist consulted and decided to send me to a pulmonologist for evaluation.

I went to that pulmonologist and it was the single worst appointment of my life. He was curt, blamed everything on my being out of shape, and his bedside manner was really horrible. As soon as I left his office, I had a total emotional meltdown. This guy was supposed to help me, and he left me feeling like I was back at square one, that no one was actually hearing me. I was so determined to improve my situation that I figured I had nothing left to lose, so I did the one thing that seems to be the hardest for a lot of people…

… I told the truth. The unvarnished, complete truth. I cried in my immunologist’s office. I cried in my rheumatologist’s office. I couldn’t help it. I was able to convey to them how upset I was about the visit and how awful my quality of life really was, regardless of how “good” I looked. I told them how scared I was that I was deteriorating and how desperate I was for something to change. They listened. They thought. They looked at my chart again and came up with a game plan that led to significant improvement in my situation. Thank goodness. 

Since that time, through many other difficulties, I’ve stuck with that. I tell every provider the unvarnished truth. I am noncompliant with several of my medications. I don’t do my pulmonary toilet the way I’m supposed to (probably because it takes an hour) and I don’t follow up with all the providers I’m supposed to on the time frames I’m supposed to. I’m 100% honest about not doing it and 100% honest about the why. My immunologist understands that he’s the specialist that has point on my care and is comfortable with me being in more control - because we’ve built trust. He knows that if my situation deteriorates, I will go to my other providers and do my therapy as I’m supposed to. He trusts me to manage my own best interests. He trusts that I am truthful with him. This has radically changed my relationships with providers. They know I’m doing my best, and they know when I’m feeling overwhelmed. I know that if it gets to be too much, I can trust them to guide me to what’s best. 

So much of care is having conversations like this. Hard conversation that, in the end, will yield some new understanding. Honesty is vital to building trust - you have to give honesty to expect honesty from your providers.