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A Healthy Relationship

Columnist: James DeVore, M.D.
February, 2016 Issue

James DeVore, M.D.
All articles by columnist

Doctors need to know, as completely as possible, what's going on with you if they're to help you with your health.

A good relationship with your doctor, whether a primary care physician or specialist, is key element to ensuring you get the most benefit from the medical system. Establishing that “good relationship” will be much more likely with attention to a few simple concepts; it’s much like any other relationship. There should be compelling reasons for you to establish care with a physician, and the variety of reasons is pretty wide. Here are some of the most important.

Convenience. A relationship with someone who isn’t available when you need to see them or who is too far away won’t be one you can use to your best advantage, so consider those factors when choosing a physician.

Manner. While your relationship with a physician isn’t a friendship, be sensitive to whether you “click.” I often tell patients that most of what we do together isn’t rocket science, it’s about a personal relationship. If you try to make do with a physician relationship that isn’t comfortable, you may not be able to get the best benefit from your interactions.

Attendance. Just like any other good relationship, showing up is crucial to making it work. One of the most important provisions of the Affordable Care Act was to ensure that regular preventative visits are covered without cost and don’t apply to any deductible. It’s an opportunity to connect, review your history, identify risks to your health, update immunizations and other screening/preventive testing that might be prudent, and make sure you’re doing everything you need to stay—or get—healthy.

While we now sometimes use email and other electronic means to communicate, which can make it easier and more convenient to answer simple questions and resolve simple issues, sometimes there’s no substitute for doing things face-to-face. Please respect the need to come in to the office when we request it.

Honesty. Doctors need to know, as completely as possible, what’s going on with you if they’re to help you with your health. Leaving out any crucial information compromises our ability to make an accurate assessment and provide the best ongoing advice. If things change or don’t seem to be responding as expected, let us know. That starts with scheduling the appointment: Be honest about why you need to come in, so we can allot an appropriate amount of time to deal with the issue.

Organization. Spend a little time thinking about what you want to accomplish before you visit with any physician, and think about the information that will be necessary and useful to paint a clear picture of what’s going on. Just a little planning can make a significant difference between a clear, concise, successful visit and one that ends up feeling scattered and unsatisfying.

It’s also important to keep in mind that, generally, we do our best work when we focus on one issue. The chance that we can assess and accurately do our best with each additional issue gets a little less with each one brought up at any visit. That’s why knowing in advance that there are multiple issues will help us to establish a plan, together, for how to deal with the whole list.

Flexibility and trust. The path isn’t always crystal clear and the diagnosis is not always certain. Medicine in the 21st century is good—better than it’s ever been before—but diagnosis and treatment often involves a certain amount of educated guessing and observation of response to treatment. There isn’t always a definitive test for every diagnostic dilemma.

Part of our role as physicians is to try to explain where certainty ends and that “educated guess” starts. That’s why our mutual relationship is important to establishing a foundation of trust in coming to a definitive diagnosis or finding the right treatment. Even for something as common as high blood pressure, our choice of medication is often a trial and error process. We’re guided by a substantial body of good information, but how a particular treatment will work in a unique individual is always a watch-and-wait process.

That’s why building a strong relationship with your doctor is the best foundation for improving your health.

Dr. Steven Levenberg, a member of Sutter Medical Group of the Redwoods, is board certified in the specialty of family medicine. He’s been in practice for 30 years, in Cotati and Rohnert Park, since 1989, and is a native of Santa Rosa.


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