DEAR DOCTOR,

Is there anything I can do to keep my doctor from interrupting me? He’s a really nice man, and I know he’s busy, but I never get to share all of my concerns or have my questions answered before the visit is over.

— BUT WAIT, THERE’S MORE

DEAR “MORE,”

You’ve brought up an issue that’s getting a lot more attention than it once did, and one that doctors in all specialties are actively working to address. We do have some specific strategies, but first, allow us to nerd out a bit.

A study on this subject with a statistic that often gets cited — that on average, a patient speaks for about 17 seconds before the physician cuts in — was conducted all the way back in 1984. Subsequent studies, which used larger sample sizes, highlighted the same challenge. These days, the amount of time a patient gets to speak uninterrupted has edged up about 50 percent. But considering that’s now in the neighborhood of 25 seconds, it doesn’t seem like much of an improvement.

So what can you do?

Begin your appointment with a mission statement. Politely tell your doctor that, before he or she responds, you would like the chance to lay out all your questions and concerns. This may sound like you’re asking permission for an interminable monologue. However, in studies where patients were allowed to speak without interruption, it took them between 90 seconds and two minutes to present their information.

So you’ve said your piece. Now, it’s your turn to help things move smoothly.

Begin by listing the things you want the doctor to address. Perhaps you have a specific medical issue, and you also want general advice about another topic or two. Make that clear. This will let your doctor mentally prepare for how best to spend the remaining time in your appointment.

If you do have a specific medical issue, be prepared with a concise and fact-filled narrative. Tell him or her when the symptoms began, how and when they changed or escalated, and what they feel like. A burning sensation, a stabbing pain, an ache that occurs when you move a certain way — all is useful diagnostic information.

When you’re finished speaking and are ready to listen, let your doctor know. And when he or she begins to answer, pay attention. Take notes. If something that is said needs follow-up questions, make a note of it. As the visit ends, use your notes to quickly summarize the information and instructions. This way, you both know you’re on the same page.

Sometimes you do wind up with follow-up questions once the appointment ends. Here at UCLA we have an electronic communications portal that our patients can use to reach us. Perhaps your medical provider has something similar. Ask for a few minutes with a nurse or physician’s assistant. And don’t be afraid to make another appointment if you feel that’s what you need.

Life in a doctor’s office moves quickly these days. We understand that speaking up can be uncomfortable for you (and perhaps even for your doctor). But when you do, we believe both of you will come away with a greater sense of satisfaction.

Mindfulness offers benefits

DEAR DOCTOR,

I’m looking for new ways to deal with all the stress I feel these days, and a friend keeps talking about something called “mindfulness.” What is that, exactly? Is there any proof that it actually works?

— MIND, I HAVE DOUBTS

DEAR DOUBTS,

We detect a hint of skepticism in your question, and we understand why it’s there. The word “mindfulness” sounds vague and a bit New Age-y, but the concepts behind the practice date back thousands of years. They have roots in Buddhism and other ancient spiritual traditions, which have been modified and Westernized over time.

As we know it today, mindfulness is an umbrella term for a range of contemplative practices that help the practitioner to become fully present in the here-and-now. Techniques to induce mindfulness can include deep breathing exercises, meditation, hatha yoga, a walk in the woods, losing oneself in a creative project or just sitting and quieting one’s thoughts.

The goal is to silence the cacophony of the outside world in order to find the stillness of the inner one. Rather than letting one’s thoughts race from problem to problem, worrying about things that have not and may not happen, the practice of mindfulness seeks to bring the focus of one’s awareness to this very minute, without judgment, right now.

As anyone who has ever tried meditation probably knows, finding calm amid the turbulence of our thoughts and emotions can be a challenge. That’s why many people find it helpful when the practice is tied to some kind of movement, such as the slow and sustained flow of yoga or tai chi, or the soothing repetition of breathing exercises.

A growing body of recent research suggests that mindfulness techniques can be helpful in relieving stress, depression and anxiety, as well as lessening the physical toll that those emotional states can take on the body. There is also evidence that mindfulness is helpful for people living with chronic pain.

A study published in May 2018 found that participants who engaged in mind-body practices to induce relaxation for eight weeks had a change in gene expression that led to a measurable decrease in blood pressure. Research published in the Journal of the American Medical Association in 2016 reported that mindfulness meditation helped patients with lower back pain find drug-free relief.

Scientists at Georgetown University Medical Center found that mindfulness meditation by individuals with a stress disorder lowered the biomarkers of stress response. And a review of a number of studies into the effects of mindfulness found that the practice can have beneficial psychological effects, including an increase in a sense of well-being and a decrease in anxiety.

It’s important to note that earlier studies often relied on self-reported results from participants, which caused skepticism about how effective mindfulness actually is. This has led to more scientifically rigorous studies that use control groups, which allow researchers to minimize any unintended variables.

As interest into the potential of mindfulness grows, new studies are using advanced imaging techniques, such as functional magnetic resonance imaging, to study the effects of the practice in real time.

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