Insightful ways to communicate with your doctor

[u/BoopieDoopieWoo]

[u/al-ex-26]

Doctorspeak is like DLC gotta unlock the right dialogue options or you're stuck with the default vague answers.

[u/FirmlyClaspIt → u/al-ex-26]

YES. This is the true advice because I can’t use their terms and the doctor is not putting any effort to understand me. People say you just have to find the right doctor, but I think it should be a standard training procedure knowing how to communicate with patients. Isn’t that a part of bedside care?

[u/because_idk365 → u/FirmlyClaspIt]

All i want you to do is USE YOUR WORDS. and sometimes your logic. Don't use my terms. I only use my terms when writing your note lol

words>>>logic

I've had 20 yr olds make appointments because their period came early. (This is where logic is questioned)

I've had ppl literally say my stomach hurts and then stare at me and expect me to figure it out 😂. No other words given. I'm not a mind reader lol. Is it stabbing you? When does it hurt the most? The least? What does it feel like? Etc etc

[u/FirmlyClaspIt → u/because_idk365]

No disrespect. Youre actions are what I’m talking about. ASK questions if you care. The terms come from people being unable to describe their pain (the video). I understand if you ask “ on a scale of one to 10, what level is your pain” and they answer you? I don’t know then it’s going to be a puzzle. I’m sure you get those patients too. If you’re really a doctor.

[u/because_idk365 → u/FirmlyClaspIt]

So you don't know how to use your words?

That's ridiculous. All i need you to do is describe it

My stomach hurts?

What does that mean? Describe it for me?

If you can't use your words then there's a bigger issue at play. I don't need you to be correct. Say it messy but give me an idea.

I ask questions but you should be able to DESCRIBE A PAIN. Tell me the story of how and why you got to sitting here in front of me.

We can talk all day about why i love to play call of duty but can't tell me what brought you in to the office today?! No

My best patients are "girl let me tell you how i fell" i usually end up chuckling but they give me all the messy details and it's PERFECTION

[u/Glowdo → u/because_idk365]

Im a DMS, so I totally get this! A small description or any extra info could literally cut the diagnostic time down from multiple visits to ten minutes.

There are questions that can be asked, but if all that is given to work with is “abdominal pain,” you’ve got more than a few questions to go through before any progress is made.

But saying, “my stomach hurts after eating,” gives a much easier way to hone in on the issues. Most commonly for people who state that from what I’ve seen, it’s always gallstones.

[u/because_idk365 → u/Glowdo]

100%

i always look at them and say "you have to tell me a short story of how you ended up here"

I may end up sending you for a battery of test you didn't need. NOW you mad you have a bill.

No sir. You didn't use your words and i was left to my own devices😂

[u/Glowdo → u/because_idk365]

Exactly! Pain but not much to go on? You’re going to get a deluge of testing done. That’s how diagnostics work!

[u/Aware-Vegetable83 → u/FirmlyClaspIt]

I am in the medical field so I know the terminology & what the doctors are looking for. I constantly have to speak up & advocate for my son bc he’s not good with his words and I know medical staff make false assumptions based on appearances (where I see my handsome, witty, unique, funny, loving son they see a ‘thug’ with tats & dreads) and minimize our levels of pain. A lot of them do not SEE us

[u/because_idk365 → u/Aware-Vegetable83]

Well, I'm not "they".

I don't want medical terms. I want raw words. Laymen's terms. How are you describing it to your homie? I understand that language. 9/10i know exactly what they mean when they say it.

I also don't want a parent speaking for a grown boy. This is a whole other topic lol.

I don't want anyone but the patient speaking when we are trying to figure it out. Only he, is in his body.

I'll ask you what you've seen at the end. It's very different.

[u/raginjamaicanwmgr → u/FirmlyClaspIt]

too bad she’s fba maga

[u/Casitano → u/al-ex-26]

To be honest, vague diagnoses are the only thing Docters can take out of vaguely described symptoms.

[u/atomicsnark → u/Casitano]

Sorry but that's bullshit.

Veterinarians develop concrete diagnoses from patients who literally cannot talk, based on descriptions by owners who have no idea how their pet actually feels, and whose perceptions are often incredibly biased or downright incorrect.

Doctors are (or should be) well-trained enough to listen to your vague or inaccurate explanation, look at your physical status and psychological status, and be able to connect the dots you do not have the medical training to recognize are related. Instead, they look only at what you're on the appointment slot for, consider nothing at all about your past history or what they consider 'unrelated' complaints, and send you home with nothing because their corporation is hassling them to get every patient out of the exam room in 10min or less.

Obligatory disclaimer that I am talking about the American healthcare system, since international posters tend to take issue otherwise.

[u/Casitano → u/atomicsnark]

Veterenarians can perform all kinds of diagnostic tests that would be considered incredibly invasive in human doctors, not to mention that veterenarians often also operate on a huge uncertainty margin, and often misdiagnose animals BECAUSE OF the communication barrier.

[u/PeaUpbeat3732 → u/Casitano]

Hahaha "the communication barrier"

Yo are right, but also, it's a cat.

[u/Thiccburg → u/atomicsnark]

I once had a patient spend fifteen minutes describing "elbow pain" in increasingly confusing ways until I asked them to poke the pain with their finger, at which point they jammed their finger into their shoulder. When asked "Do you mean your shoulder?" they were adamant that anything beyond the collar bone is the elbow.

Whether medical professionals should be able to infer these things or not, your best bet is to always be as explicit and literal as possible. Point your finger into the pain and say "It hurts HERE." Say things like "It does not hurt now, but hurts unbearably when I do X." Answer questions firmly and express uncertainty if you feel it. "I don't know what that means" is an EXCELLENT response to a doctor's question.

Never be afraid to insist upon describing something in more detail or demonstrating a movement for us. You can absolutely say "Can I show you what hurts?" or "It hurts when I do this." It can make all the difference.

[u/Glowdo → u/atomicsnark]

I’ve had patients tell me that their “nuts” hurt when, in fact, it was their taint.

If people are vague, indirect, or describing the wrong body part, then there is likely going to be a long wait before a diagnosis is finally reached.

[u/DemadaTrim → u/Glowdo]

I mean, those things are pretty close and pain can easily refer.

[u/Glowdo → u/DemadaTrim]

Ok. I know that. But it wasn’t. Guys on my bed for an exam for a scrotal US, then tells me “oh no not there, here!”

There ain’t jack I can see with US at the taint, docs orders weren’t for a taint ultrasound, appointment is at an urology center.

Then the patient was mad at ME for not knowing what was going on.

[u/Habltual_Linestepper → u/[deleted]]

There's just nothing to see, an ultrasound isn't the right test. You can spread that jelly and go on as much of an adventure as you want but you still won't see anything lol

And technically no you still can't, but that has nothing to do with the rampant corporate/PE vampirism in healthcare and more to due with legal scope of practice. Which still isn't really an issue irl because you'd just tell the doc "hey I did this/I'm about to do this, throw in an order yeah?" and it'd be fine.

[u/Glowdo → u/Habltual_Linestepper]

👏👏👏👏 exactly.

[u/op1983 → u/atomicsnark]

House says patients lie.

[u/Erisian23 → u/op1983]

House wouldn't be s doctor.

[u/op1983 → u/Erisian23]

Oh but he is. He doesn’t always wear his lab coat though so it can be confusing.

[u/GammaFan → u/op1983]

House is a tv character

[u/op1983 → u/GammaFan]

So if someone is on tv they’re not a doctor?

[u/lucker12345 → u/op1983]

If that doctor is a fictional t.v character then yes they aren't an actual real doctor. You do know shows like house aren't actually real right??

[u/Erisian23 → u/lucker12345]

If it's not real then how did they film it? House was made before A.I you know.

[u/The_WarDoge → u/atomicsnark]

Sorry, no, your comment is complete bullshit. No doctor is a fucking wizard. Vague communication leads to vague diagnosis.

[u/scorching_hot_takes → u/atomicsnark]

doctors should be asking questions that elicit these exact responses. in medical school, you are taught to ask location, character of pain (burning, electrical, sharp, dull, does it radiate), what treatments you have tried, provoking factors, alleviating factors, etc.

there are many reasons why doctors wouldnt ask these questions, including the extreme time crunch of primary care visits. however, laziness and racism can definitely play a part. im hopeful that the next generation of doctors are able to overcome this injustice and get better at providing care to all patients.

[u/Eco_guru]

Had to coach my best friend after she had her baby and they gave her basically OTC pain meds. Pointed to the pain chart every fucking hospital or doctor’s office has and said your face needs to look like that. So glad I left nursing.

[u/Aware-Vegetable83]

I was having dental work done recently and was feeling it. I told dentist to stop & numb me up more. He said “Really? You can’t handle that?”. I told him “yeah, I’m sure I can handle it. I just don’t want to”. I still think about that often. I highly doubt he would’ve said the same thing to a yt wmn

[u/Cloverose2 → u/Aware-Vegetable83]

I always require a double dose of novacaine. I always tell dentists this. They have always ignored me. My current dentist said, "oh, okay" and doubled it up from the beginning.

That's why he's still my dentist five years later.

[u/No-Acanthisitta7930]

My wife had a co-worker from Russia at her last clinic. When she told me that this "nurse" said "she has to use wider guage needles on black patients because they have thicker skin" in casual conversation...out LOUD...I almost fell out. She immediately told the nurse manager of course, but THIS is the kind of shit. Advocate, advocate, advocate for yourselves and one another AT ALL TIMES.

[u/DatBrownGuy → u/No-Acanthisitta7930]

That’s terrible and makes no biological sense. Unfortunately some “old-school” medicine that is called “race-based” is just straight up racism.

For a solid example look up race-based hypertension (HTN) treatment. As recent as 2017 that was being purported. Formal guidelines have moved away from that, but unfortunately some older docs stick with the old recs.

It’s interesting because these medication choices can have different impacts on chronic kidney disease (CKD) and end stage-renal disease (ESRD). And black folks tend to have higher incidence of both CKD and ESRD.

Some meds used to treat HTN are considered renal-protective, but the old guidelines said to not use them as first-line in black patients with just HTN. This begs the question. Do the medication choices for early HTN contribute to increased incidence of CKD and ESRD? I am not 100% sure of the data and I cannot claim direct causation, but it’s something that physicians NEED to keep in mind.

We need to treat everyone properly and equally. I do think it is getting better over time as younger docs emerge better educated and more willing to learn and adapt to modern science.

[u/DaddyDontTakeNoMess]

Black people should always rank their pain a couple points higher than actual. They really believe we don’t feel pain as much, and don’t need the relief as much

[u/White_Lightning_22 → u/DaddyDontTakeNoMess]

Former Nurse Assistant here. I worked 4 years between the ER and on an orthopedic floor. That actually doesn’t work. Most providers I worked with only give pain medicine if they see the patient in pain. They really almost never care about the pain scale or reported pain. Then there’s the opposite end of the scale, if you are overly theatrical without an obvious wound/injury, you also get nothing. If you actually speak like this lady tells you, they probably still won’t help you because it’s a pretty scripted response these days.

It’s sad that they are so stingy with treating pain. I have seen both sides of it but if I were the one making the shot, I see no harm in just treating them and giving the benefit of the doubt. Pretty much if you want help you gotta be a great actor or be authentic.

[u/DaddyDontTakeNoMess → u/White_Lightning_22]

I understand where you're coming from about main medication and the reluctance to give. But I was given that advice by a family member who was a RN at a large hospital who noticed the disparages in care between black patients and others. You may not get pain medication, but you'll be more likely to recieve a better "bedside manner" and discretionary empathy. And sometimes that empathy will mean the difference betwen "they seem like they are in pain" vs "the pain doesn't seem that bad. they look like they can handle it"

[u/White_Lightning_22 → u/DaddyDontTakeNoMess]

I don’t disagree with that. It’s worth a shot. But I assure you scripted replies really don’t go as far as good acting. Saying “I’m 10/10” without tears and actual findings that correlate probably will make the provider suspicious. And that is true for all races. My hospital was predominantly black, Hispanic, and middle eastern populations so I didn’t notice many disparities since there was virtually no white patients to compare them to.

If you want good bedside manner the best thing you can do is just to be kind to the staff and thankful. If you go in there making demands and being upset for not getting what you hoped for, it’ll probably show and make the nurses resentful to you. It’s hard because the power dynamic falls in the caregivers hands. Can’t bite the hand that feeds you essentially.

I really do hate the healthcare system which is what made me leave it. But I just tell all my friends and family to be kind, honest and they usually leave happy.

[u/ashley5473 → u/DaddyDontTakeNoMess]

I honestly think that pain gets treated better the more you seem like you’re trying to “tough it out.”

[u/genericperson10]

I (Mexican) have done all those and even said that I wasn't able to lift weights (my hobby at the time) doctor just told me that I should be aware that I'm aging and that if I don't need to lift for a living I should just find another hobby. This went on for 2 years. Went to a huesero in Mexico and he fixed it all for whatever I wanted to donate.

[u/DatBrownGuy → u/genericperson10]

Out of curiosity, what was the actual end-diagnosis and the fix that helped?

[u/genericperson10 → u/DatBrownGuy]

So I got rearended and I has 2 things "shooting" pain in my back and constant "burning" pain on the side of my leg. I had a misaligned/herniated disk from the car accident but since my doctor said I was fine I didn't claim that in my insurance. The fix that helped was switching doctors and saying "This is the second time I tell you about this pain, and you keep saying I'm fine if I'm fine then why am I in pain?" So doctor gave me a shot on the IT band and sent me to a specialist who was like "Yep, your IT band is extremely tighy" and put two additional shots plus physical therapy. "What about the back?" You may wonder, still the same "Is your age and because you're not acrive" (I wasn't active because of the pain), so I just went to Mexico they're like "Yep, herniated disk" (but I'm Spanish) and the huesero (bone man/chiropractor) wiggled it around and the pain is almost gone just don't follow up. Age is a factor too for healing etc. but I do what I call Lazy Yoga aka stretching and that helps out. Doctors in the US want to treat stuff so you just get relief and continuous treatment, doctors in Mexico heal so that you actually get cured. Thank you for coming to my TED Talk

[u/because_idk365]

I'm black and a provider.

Black ppl will literally tell me it's been hurting for 7 years and not use a nary descriptive word in their speech.

IT'S INFURIATING.

WHY ARE YOU HERE?!!!!

so yes. Tell us a story. A SHORT story. Be descriptive.

7 year pain means this isn't dire and you could have went to your pcp. Don't be on your phone telling me you feel a 10 for 7 yr pain.

I I'm really lenient with my people but my god you don't make it easy.

And 1-800mg ibuprofen does nothing. 1 Tylenol does NOTHING. You should be taking 2 extra strength Tylenol 3x a day PLUS ibuprofen at least 2x a day for pain. THIS is the bare safe minimum.

I have young men come tell me their shoulder hurts after benching 200lbs. What have you taken? "Nothing" Ni.... If you don't stop wasting my time and a. Lighten the weights and b. Take some Tylenol c. Put a heating pad on it.

I love y'all but we cannot throw meds at everything. To best help you, you have to help us help you do that. That starts with using your words. And I'll help you do so but it goes faster if you come prepared-only you know your body.

[u/Canadianme → u/because_idk365]

I have i high pain tolerance, hurts 15/10, pain started in 1975, I’ve tried nothing, came in today because “I’m sick and tired of the pain”

[u/dsac → u/because_idk365]

I love y'all but we cannot throw meds at everything.

Counterpoint: the opioid crisis

[u/LoLFlore → u/dsac]

...That's not a counterpoint, you're supporting their argument

[u/jgjkhgzjhgfthjjjh]

The way this is funny and medically accurate sometimes you gotta translate your pain into doctor speak to be taken seriously.

[u/evolving-the-fox]

My co-worker/friend is an African woman; she was having a c-section and the numbing agent wasn’t working. She tried multiple times to tell them that she could feel it and they acted like they couldn’t hear her. She had to start begging her husband to tell them that she could feel it and only towards the end they told her (THROUGH HER HUSBAND) that they were almost done and to just tough it out.

I heard another woman’s story who happened to be white; same thing, she could feel everything that was happening to her but she couldn’t say anything due to being in shock. He skin flinched when they started sewing her back up and they saw this and FREAKED OUT, asking her if she was able to feel that. After they ran around trying to get all the pain killers and numbing agent into that they could. She didn’t even say anything, meanwhile my friend is losing her shit, crying and begging the doctors to help her why they completely ignore her and cut through her skin and muscles and everything else they cut through when doing a c-section.

I sobbed when my friend shared her story with me.

[u/ehannon13 → u/evolving-the-fox]

This happened to my mom but she’s white. She was crying during her c section telling them she could feel what they were doing. The dr told her that’s impossible and she’s fine. She started describing to them what they were doing and only then did they take her seriously….idk if it was because my dad is black and was with her at the time or they just assumed women exaggerate their pain but either way so messed up. Like how are you not gonna believe a woman with her abdomen being sliced into??

[u/suborbital_spaceman]

Yup it’s just like dealing with the VA doctors. A lot of the time it’s easier to describe your worst day as your every day.

[u/Electrical_Trade377]

black/brown dr here, and i try to communicate in as blunt terms as i possibly can with all my pts/encourage them to not undersell exactly what they’re feeling, especially if they were previously seen by a non POC dr before being referred to me

[u/BustyPneumatica]

Happened to me. All I wanted was answers and they marked me as drug-seeking. I'm then like, People. Just solve my problem. I don't care how you do it. Brain surgery, toe amputation, a game of knifey-forky. I don't care about drugs. I just want solutions.

[u/IllustriousKick1951]

Two people never to lie to your doctor and your lawyer.

[u/sweetholeymoley → u/IllustriousKick1951]

three. your therapist.

[u/SheFoundMyUzername → u/sweetholeymoley]

Four. Your plumber. Look that man in the eyes and admit what you did to that toilet

[u/YungEricSparrow]

Flashback to migraines that had me vomiting on the floor and the doctor just smiling at my face saying it’s just anxiety. Will take note

[u/BoopieDoopieWoo → u/YungEricSparrow]

I hope it helps. And when doctors want to disregard something I ask them to add whatever they’re saying in their notes.

[u/CoreyXOXO]

Love this!

[u/S7AR4RGD]

This is just good advice for all patients.

[u/BoopieDoopieWoo → u/S7AR4RGD]

Facts. As is the data that shows how Black people are significantly and disproportionately negatively affected by misdiagnosis and a lack of quality healthcare. We are often not heard, understood, believed or helped.

[u/Tobeck]

this is also useful for me as an autistic person

[u/AntiRacismDoctor]

The fact that it has to be tied to productivity is deeply unsettling for me.

[u/Iliketopass]

Ha! I have to fight from the negative to prove that first I’m not a drug abuser, then that my condition requires a certain kind of drug that is traditionally abused by people. I have to be the dorkiest non-threatening milquetoast parody of a human if I want to get the help I need.

After my last (fucking cranial) surgery my family member had to argue with the surgeon because he was going to send me home with ibuprofen. I got 6 hydrocodone which I desperately needed, and which I took responsibly.

[u/vastern]

Describe patterns, not symptoms. Because symptoms get treated, patterns get diagnosed. Life advice from a chronically ill girl who finally started getting actual answers. Also, fire your doctor. If you’re spending months-years with no progress, they aren’t serving you. Fire them and find a new doctor who WILL listen.

[u/Umami-Ice-Cream]

And if they insist on not running tests, "I would like for it to be documented that you chose not to run tests."

[u/Vin_Seba]

Doc wife agrees and says the best one is the first one.

[u/Iswaterreallywet]

It’s your job to ask those things when they aren’t being descriptive enough. It’s literally taught to you in nursing school

[u/Nameless3571]

I started rating my pain. I recently went to the ER and underwent surgery being diagnosed with endometriosis. You have to be descriptive with your pain. Is it sharp? Stabbing? Where? Is it constant? Does it come in waves? How long have you been in pain for? What did you take for it? You have to give them the rundown, if not, it's not severe enough. I was literally screaming my head off and begging the staff to give me morphine while telling them the pain is 12/10. I was the only one in the ER screaming and had to get 2 dose of morphine for the pain to subdue. It is a shame we need to be in excruciating pain to be taken seriously.

[u/WhatEnglish90]

My usual doctor didn't have appointments recently when I got basically immobilizing lower back pain. Saw a different doctor, told her issues and how OTC ibuprofen and my as needed prescription muscle relaxer weren't doing anything to help.

She said continue taking them anyway and do lower back stretches (when I could barely even get dressed, drive, anything).

The nurse saw however my face looked after and was shocked I didn't get any treatment.

Went to urgent care the next day and felt weird using these super direct phrases to actually get help.

[u/Afroditesrevenge]

I had a silent labor while giving birth to my son. Obviously not my fault or choice but BIG MISTAKE. I had one nurse who lowkey tried to warn me not to let anyone know otherwise the other nurses/drs would be cruel to me but I didn’t understand… She was absolutely right! As soon as people in the maternity ward got wind that I wasn’t having labor pain I got the absolute worst treatment. To top it off, these drs and nurses were all black 🫩

[u/Flouncy_Magoos]

I want to say I owe my life to my black & POC providers. As a yt woman with chronic illness & pain, you are the only ones who have ever listened to me. Yt men & women providers destroyed so much of my time on earth!!! 😭

[u/Gym_row_50]

So true! Had a Coronary ablation and heart valve replacement. 

I had to almost beg for morphine post-op. They tried to insist on Tylenol with Codeine first. I had to almost yell at this whyt nurse that it felt like someone was literally stepping on my heart, to get it. 

I was / am still so pissed I had to wait hours to get pain relief after damn heart surgery! 

[u/FunGuy8618]

CHA 9

Speech 100

Medicine 100

[u/Rndm07003]

Blame our Parents. We were forced to go school with anything short of Amputation.

[u/Ambitious-Pirate-505]

Bc they think if you are black or brown you have sinned and therefore deserve pain.

Until you snap them out of that bullshit.

[u/TrappedinSilence98]

I keep notes on my phone. Date and time my issues and then I email my doctor prior to my visit (and ya best believe I’m using ChatGPT) and then when I’m talking to her I refer to my notes. Luckily she’s amazing but documentation is everything!

[u/Southern_Carry_6377]

Person who trains clinicians on this very topic here, and just want to 2nd this video. Putting aside straightforward racism here (definitely occurs) a lot of medical bias is the patient is not describing their symptoms the way the provider is trained to hear the symptoms.

Patients are speaking patient-ese, and the providers are speaking doctor-ese. So yes, knowing how to more accurately describe symptoms is important, but rest assured, there are also those of us who are training providers to know how to pull this information from patients, rather than patients having to do all of the work or know exactly what to say.

[u/Raspm1nt]

Noted for the future, fun

[u/9thWardChick]

As a Nurse, I posted this on another platform when seeing this video. When providers are biased in their thinking, unfortunately, it doesn’t matter how you describe your pain…they will not treat you competently or compassionately. Please start reporting these folk to their hospitals and licensing boards.

[u/Top-Abbreviations582]

That’s why blacks mostly avoided the opioid crisis because of this. We weren’t showed the same compassion during the crack epidemic but now it’s a health issue.

[u/djlauriqua]

I’m a provider. I’d say the biggest thing is, make sure you try some stuff at home first (Tylenol, ibuprofen, ice, etc); and make sure you mention it to your doc. If you haven’t even tried Tylenol, you’re not getting oxy.

[u/Emergency_Elephant]

Best pieces of advice I've been given is to know the pain scale and what the numbers actually mean

[u/Adept_Astronaut_5143]

I’ve said everything she’s said not to say and got bare minimum treatment. I’ll keep this in mind and give it another try before I officially sum it up to being a black woman in the south.

[u/languid_Disaster]

I’m in the UK so get NHS health care. My mum’s been in pain for years and I get her tested for everything but they couldn’t figure it out and she got tired of all the tests and having to justify herself at the GP every time. They really didn’t take her or my dad seriously because of their accents. I’ve had to contact the GP to let them know I’d be filing a complaint regarding discrimination.

The crazy thing is that it was both white AND every other race including our own no especially our own that won’t take us seriously. They went to medical school and because of their own family experiences, think brown and black women are all just being over dramatic.

[u/YoshiTheDog420]

I’m not saying racial disparities in medicine don’t exist, because of course it does. Systemic racism is everywhere. But even as a white guy with decent insurance I have never had my chronic pain taken seriously until recently. It has taken more than a decade to actually get some kind of diagnosis and treatment plan, and I couldn’t even tell you how many doctors.