The Relationship With Your Healthcare Provider
by James A Zachary MD

Many experts consider a collaborative (two-way) relationship as the optimal type of healthcare interaction.  This collaboration should be friendly, respectful, and professional.  Mutual trust is essential.  Healthcare should not be dictated but rather scientifically guided by your healthcare provider.

I have summarized my recommendations below:

1.  Be totally honest with your healthcare provider.  It is absolutely critical that you are totally open and honest with your healthcare provider.  Without full disclosure a healthcare provider may ask you to do things that you cannot do or ask you to make changes that could harm you.  Trust your healthcare provider to be professional and confidential.  Your healthcare provider is not likely to be shocked by any sort of behaviors.  Your healthcare provider does not represent the legal system, and therefore, unless your behavior is suicidal or homicidal, cannot and does not want to report you to the police or legal system.  Be straight forward about sexual orientation, sexual practices, drug/alcohol/cigarette use, your goals, and your fears.  Also be honest about things that you cannot do and circumstances where you disagree with your provider.  Ask for more time if you feel you need it.  Tell your healthcare provider when you have doubts about their judgment.

2.  Demonstrate that you are doing the best you can to adhere to your appointments and medications.  Adherence helps to build your healthcare provider's trust in your self-care skills.  As in any human relationship, trust is earned and not automatic.  Show your healthcare provider that you are concerned about yourself, and this will help to give you autonomy and more of a voice in decision-making.  Call and cancel appointments that you cannot get to even if it's just a short amount of time before or even afterwards if you forgot.  Humans are not perfect, and they forget things (even healthcare providers do!)

3.  Let your healthcare provider know as soon as possible of medical problems.  Never assume that you are a burden or trouble to your provider or that they are too busy for you.  YOU are their job and therefore, your problems are VERY important to them.  However, sometimes you may be reassured that your concerns will not compromise your health.  However, if you continue to feel poorly, and reassurance is all you get, clearly re-address the issue with your healthcare provider or get a second opinion.  A second opinion is sometimes very important for you and your relationship with your healthcare provider.  If you try to address issues that come up with your healthcare provider and your concerns are repeatedly not satisfactorily answered, it may be time to find another provider.  Get a list of contact numbers and times that the numbers should be used.  Make sure you know what to do after hours and on holidays.  Remember it is mutually beneficial for your healthcare provider to know promptly about any adverse health problems; this information makes it more likely that you will not become even more ill, and prompt information exchange makes it less difficult for your provider to get you back into shape.

4.  Carefully respect the professional relationship boundaries between your healthcare provider and you.  Do not see a healthcare provider who is a friend or a relative.  Similarly if you must have a relationship with your healthcare provider outside of the office, seek healthcare from someone else.  Nonprofessional relationships are much more complex and interwoven than professional ones; the complexity of a nonprofessional relationship can interfere with the judgment of even the best healthcare provider and with the ability of the patient to judge whether the advice of the healthcare provider is appropriate for their health.  Do not invite your healthcare provider to engagements, and do not give them gifts.  Do not provide your healthcare provider with special discounts for the services or goods that you supply.  If a healthcare provider asks for special considerations, consider another healthcare provider.  Do not call your healthcare provider at their home unless you have been told to specifically do so.  Even healthcare providers need some privacy and peace in their lives to maintain their ability to function well.

5.  Educate yourself about your illness.  An educated patient can ask better questions and collaborate more with the provider as opposed to being "directed" by the provider.  An educated patient is more likely to be adherent and to understand diagnostic and therapeutic interventions.  The educated patient is also more efficient for the provider's time.  Once again, as in the case of prompt health updates, the quality of "being informed" is mutually beneficial.  The internet is a good source of information, but because it is uncensored and unedited in many cases, there may be quite a bit of inaccurate information.  Confirm whatever you find to be significant or different from what your provider is teaching you by looking at multiple sources of information (there are recommended links HERE.)  Also take notes at your visits and ask for educational references or handouts.  It is generally impossible for you to just perfectly remember everything that is told you.

6.  Introduce your significant other and/or family to your healthcare provider and keep them updated.  In general your healthcare will be better supported if you involve your close relations with your healthcare and your healthcare provider.  Additionally your healthcare provider can get more information about you and your genetics from family members.  Your family will also feel closer to you and they will feel more secure about your healthcare.  Be sure and let your provider know how much information he can share with your family, and make sure your family knows how to get in touch with your provider in case of emergency.  Bring your family member with you as often as possible to visits.