An important point that patients might like to remember is, “Don’t turn back and ask a question while leaving.”
Here is how things can go badly wrong – a real-life incident narrated by a colleague as a letter to a patient!
You came to me for a consultation. We went through all your problems in detail. You had a list of questions and I answered them. I patiently explained the situation to you and then discussed in detail the treatment plan. When we seemed to be done, I asked you whether you had anything else you wanted to ask. You paused, thought and said no. I closed the file, handed you your papers, picked up the next file and signaled for the next patient to be sent in.
Just as you were walking out the door, you turned back and asked, “Is it OK to have some wine?” I looked at you. I struggled with this sudden interruption, my mind already pre-occupied with the next patient. I looked at you blankly, a little irritated and said “Sure, whatever!”
You went home and started the metronidazole tablets for amebiasis. The next evening, you sat down with a friend and had two glasses of a new Merlot. Suddenly, you felt flushed and thought your face was swelling up. Your wife called me, frantic. From the description, it appeared that you might be in the midst of a reaction caused by a mix of metronidazole and alcohol. While I went through the possibilities quickly, I also checked my notes and asked, “Did he drink any alcohol?” Your wife said, “No, not really, he just had two glasses of wine” and then paused and said, “Doc, but you said it was OK”.”
I could not remember having said so, but did remember that I had told you not to mix alcohol and metronidazole during the consultation. A memory came back…you had turned back and asked me a question that I don’t quite remember. Since the reaction was not too severe, I asked your wife to give you an anti-histaminic while she brought you in. It is only when I start talking to you that I realized you don’t really equate wine with “alcohol”.
A colleague of mine has two doors to his consulting, one for entry and one for exit. The “out” door cannot be opened from outside. He has done this explicitly to prevent the “turn back”. Turn backs not only lead to wrong instructions and misunderstandings, they also create problems with the doctor-patient relationship.
I am happy to give you all the time needed to sort things out during the consultation. But once we are done and I have moved on to the next patient and line of thought, the interruption caused by the “turn back” can make me seem irritable and rude and leave you with the feeling that I didn’t respect our relationship, despite having given you all the time necessary.
As care becomes more patient-centric and doctors learn to spend more time with their patients, patients and their relatives too need to get a little more involved. They need to prepare for the consultation, read up from credible sources and prepare a list of questions, in advance. If they don’t have that list written down and with them, it is very likely that they will forget to ask something important, and remember just when they are leaving and at the door. The answer to that question may not necessarily be the most appropriate one at that point in time.
So, please remember! Avoid “turn-backs” and be well prepared during the medical consultation to avoid confusion at a later date.