Your Healthcare Provider and You

Your Healthcare Provider and You

Having the right healthcare provider and a strong relationship with that individual is one of the most important relationships you’ll make during your lifetime.  Selecting a healthcare provider in your teens when you begin your annual visits and building a connection of open communication and trust, can be the foundation for how you build your healthcare team – whether you’re healthy or have been diagnosed with breast cancer.  The right doctor will listen to you, teach you how to be your best advocate, and advocate for you, if and when needed. The right provider also will have a network of other specialists he/she trusts, if you need specialized care.

• Selecting: When choosing a doctor, such as a general practitioner, OB/GYN, surgeon, radiation oncologist or a medical oncologist, you may combine information from the sources mentioned below to help you make an informed decision. A good starting point is directories from hospitals and health insurance plans. These directories often list doctors by medical specialty and gender, and may include personal biographies details such as education, training, certification and personal interests. To find the best doctor for you, you may also consider referrals from a trusted source such as your primary care provider, family members, friends or other breast cancer survivors. A good provider is board certified, which means that the doctor has the training and knowledge to practice a medical specialty and have passed a certification exam. The American Board of Medical Specialties (ABMS) oversees the certification of specialists and has an online directory. In addition to being board certified, a doctor’s malpractice records a good indication of the quality of care that they provide. In general, little or no malpractice payouts are a good indication that they offer the best quality care possible. However, doctors may be sued for malpractice when, in fact, they did nothing wrong. State medical boards often have malpractice records available to the public.

Your doctor should be someone you feel comfortable with on a personal level and someone who you can talk to openly. A doctor should be open to you getting more than one or two opinions before selecting the one that is best for you.   This is a good way to learn about their abilities and to see whether or not you have a personal connection with the healthcare provider. Here are some questions that may help you interview a doctor:

• How long have you been practicing?
• Are you open to questions or other opinions?
• Are you comfortable with me sharing my opinion and having a conversation about what we both think is right for me?
• Do you only see people diagnosed with breast cancer?
• How many people with breast cancer do you see (or operate on) in a year?
• What breast cancer treatment guidelines do you follow?
• What is your area(s) of special interest or research?
• Which hospitals are you affiliated with?
• Are you board-certified in the area of specialization?
• Have you completed any fellowships completed in cancer care (surgery, radiation therapy, medical oncology)?
• Building and Sustaining the Relationship: Finding a doctor with whom you feel comfortable and can talk openly is one of the best ways to feel good about your breast cancer treatment decisions. During your initial visits with your doctor, it may be a good idea to bring a friend or loved one with you who can help ask questions and discuss the answers later as you may feel overwhelmed by all of the new information.

After additional visits with your doctor, you should continue to feel even more comfortable talking with your doctor. Whether you continue to go alone or with someone, it is always a good idea to prepare a list of questions ahead of time for your doctor. This can help you remember everything you want to ask and keep the discussion focused on the issues that are most important to you. In keeping abreast of new and available treatment, be sure to ask your doctor whether they take part in clinical trials. A doctor who participates in clinical trials is likely to know about new therapies and may be more open to future medical treatments, which could make a big difference in managing your breast cancer.

In general, the best relationship you can have with your doctor is one where you are open and do not feel shy about speaking frankly. Be sure to update your doctor about how you are feeling and about your full family history of breast and other cancers. This information helps your doctor understand your risk of breast cancer and your risk of breast cancer returning.

• Talking with your Provider: An open line of communication between you and your doctor can make a big difference in both quality of life and a sense of empowerment over the care received. Being your own advocate will help you better understand your treatment. It will also help you be actively involved in your care. Keeping the lines of communication open reduces the chances for misunderstandings between you and your doctor. Here are a few tips:
• Ask questions. Ask questions about anything that you do not understand, and do not be afraid to ask the question again if you don’t understand the answer.
• Take notes. Make notes about what you discuss so that you can refer to them as needed.
• Ask for what you need. It is almost always better to ask a question as soon as you think about it rather than put it off for a later date.
• Speak up if you feel there may be a misunderstanding.Most misunderstandings are much easier to resolve right away. If you find it difficult to speak up, ask a friend to speak for you. Do not let miscommunication linger and become an even greater issue.
• Be patient.During your appointments, bring something to read or keep you busy while you are in the waiting room. This will make the time flow more easily and reduce your irritation. Having a physician who is there for you when you need it and who takes the time to answer all of your questions means that they are likely to get backed up at times.

To clarify details about coordinating your care generally or in an emergency, here are some questions to ask your doctor:

• Who should I call if I have any symptoms on weekends or after hours?
• If I need emergency care, where should an ambulance take me?
• What symptoms might suggest an emergency?
• What types of emergencies may occur with cancer like mine?
• Who should I call if I have any side effects?
• Who is ultimately in charge of my care?
• When should I call the clinical trial investigator and when should I call another member of my healthcare team?

Basically, you should feel as if your physician is competent, professional and that he/she really cares about you.  Start building this relationship as a healthy young woman; and know that it will benefit you throughout your life journey.