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How To Talk to Your Doctor

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Leander R. McDonald, PhD, Richard Ludtke, PhD, Twyla Baker-Demaray, MA, Kim Ruliffson, BA, Ann Miller, Jim LaBelle, MA, George Charles, PhD, Cheryl Easley, PhD,

Noreen Mokuau, DSW, Colette Browne, PhD

Prior Lake, MN April 30, 2008

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Center for Rural Health

• Established in 1980, at the University of North Dakota School of Medicine and Health Sciences in Grand Forks, ND

• Focuses on:

– Education, Training, & Resource Awareness

– Community Development & Technical Assistance

– Native American Health

– Rural Health Workforce

– Rural Health Research

– Rural Health Policy

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National Resource Center

on Native American Aging

• Established in 1994, at the Center for Rural Health, University of North Dakota School of Medicine and Health Sciences

• Focuses on:

– Education, Training, and Research – Community Development & Technical

Assistance

– Native Elder Health, W orkforce, & Policy • W eb site: www.nrcnaa.org

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Health Care Coverage: Cycle III

57% 54% 27% 20% 14% 8% 6% 5% 2% 0% 10% 20% 30% 40% 50% 60% Cycle III

Medicare IHS Medicaid Private Health Tribal Veterans ANHO Other Private LTC

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Barriers to Medical Care: Cycle III

15% 14% 12% 12% 12% 9% 3% 1% 1% 1% 0% 5% 10% 15% 20% Cycle III

Waiting Room Wait Appointment Wait Distance Transportation Cost Other

Office not Open Language Barrier Disability Access Child Care

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Health Advice: Cycle III

64% 32% 18% 16% 9% 6% 4% 2% 2% 0% 10% 20% 30% 40% 50% 60% 70% Cycle III

Clinic Physician's Office Emergency Outpatient CHA/CHR Traditional Healer Urgent Care Other No Usual

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Do you have a personal doctor?

47% 29% 19% 4% 0% 10% 20% 30% 40% 50% 60% Cycle III

One More than one No Not Sure

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Indian Health Service Concerns

Funding reduction

Physician turnover

Lack of primary provider

Diagnostic and treatment delays

Contract care unavailable

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Provider concerns

1)

Understand community attitudes such as

mistrust, bias, and stereotyping

2)

Gain knowledge of health disparities,

causes, and solutions

3)

Acquire the skills to improve

communicate and negotiate across

cultures, languages, and literacy levels.

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Take responsibility for your health

• Know when and how to seek medical care. • Follow your doctor's

advice for taking care of yourself.

• Work with your doctor in making decisions about your health.

• Build a relationship with your doctor; foster good communication and trust.

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Best Use of Your Time

Rank your list of concerns and

questions by importance.

–Talk about the 3-4 most important concerns or questions first.

–If you have time, you can talk about the other things on your list.

–Your doctor may not have a lot of time to talk with you. Therefore, it is important for you to stay focused on what you planned to talk about.

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If you have a choice, choose a

doctor you can talk to

• Decide what you are looking for in a doctor • Identify several doctors

• Consult reference resources such as Internet

• Talk to office staff about doctors you are considering

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Getting ready for the appointment

• Be prepared: make a list of concerns

• Take information with you

• Make sure you can see and hear

• Consider bringing a family member or friend

• Find an interpreter if you think you’ll need one

• Plan to update doctor on what happened since last time

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Giving Information

Share any symptoms

Give information about your

medications

Tell the doctor about your habits

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Getting information

Learn about medical tests

Discuss your diagnosis and what to

expect

Find about your medications

Understand your prescriptions

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Making decisions with your doctor

Ask about different treatments:

–Are there risks associated with the treatment?

–How soon should treatment start?

–How long will it last?

–Are other treatments available?

–How much will the treatment cost?

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Making decisions with your doctor

Ask about prevention:

–Is there any way to prevent a condition that runs in my family?

–Are there ways to keep my condition from getting worse?

–How will making a change in habits help me?

–Are there any risks in making this change?

–Are there support groups or community services that might help me?

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Talking to doctors in special situations

Asks questions if you are unclear

Try to write down as much as possible

Tell your primary doctor if you have

seen a specialist, need surgery, or have

gone to an emergency room

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Practical matters

• Don’t hesitate to bring up concerns even if they don’t seem to be medically related

• You and the doctor can make better

decisions if the doctors knows about troubling non-medical concerns

• If the doctor can’t help solve medical concerns, they may know of available resources

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Sensitive topics

Don’t hesitate to discuss sensitive

topics

Use brochures or props to introduce

topics that feel awkward

If your doctor doesn’t take your

concerns seriously, it might be time to

change doctors

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Remembering the answers

Ask about anything that seems unclear

Additional resources for health conditions:

DVDs, CDS, cassettes, or videotapes

Websites

Take notes

Telephone or email doctor

or staff for clarification

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Provider scenarios

Questionable interaction

Appropriate interaction

Discussion

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References

¾ Talking with Your Doctor: A Guide for Older People, National Institute on Aging, National Institute of Health, NIA Information Center, PO Box 8057, Gaithersburg, MD, 20898-8057

¾ National Institute of Health

¾ http://nihseniorhealth.gov/talkingwithyourdoctor/toc.html, last accessed 4.28.08

¾ Becoming a Partner in Your Healthcare,AARP

http://www.aarp.org/health/staying_healthy/prevention/becoming _a_partner_in_your_healthcare.html, last accessed 4.28.08 ¾ Maintaining a Good Relationship With Your Doctor,

http://www.healthcarecoach.org/resources/index.php?view=deta il&id=123&node=63

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For more information contact: Leander “Russ” McDonald, Ph.D.

Center for Rural Health University of North Dakota

School of Medicine and Health Sciences Grand Forks, ND 58202-9037

Tel: (800) 896-7628 Fax: (701) 777-6779 http://ruralhealth.und.edu

References

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