Doctor-patient relationship

The right information

Around 80 per cent of the information your doctor needs to make a correct diagnosis comes from what you say. The remaining pieces of the puzzle are found when you're examined and from tests.

This verbal information - known as your 'history' - is important and is often obtained in two ways:

• Your answers to their questions
• What you say without being prompted

Never be afraid to give your doctor information as very little of it will be unhelpful. Often it's a little piece of information that you feel is irrelevant that cracks the diagnosis.

Give your doctor as much information as you can. If there's anything you think they need to know - that you're taking supplements or over-the-counter medication, for example - then say so. Doctors are human too and may forget to ask certain things.

Doctors are also used to patients not taking their medicine when they should – often patients are worried about confessing this, but it’s important for the doctor to know that you had side effects or stopped for other reasons, as they will assume you’re still on the medication.

Clarification

In everyday life it's easy to misunderstand something and get the wrong end of the stick. In medicine, it's even easier.

It's assumed that patients and doctors are speaking the same language, but often this isn't the case. Doctors tend to use technical language, three-letter acronyms and words that mean one thing to them and something completely different to you.

That's why you should never be embarrassed to say if you don't understand what your GP is saying. Nobody will think you're stupid; it will make everyone's life easier and avoid potential problems. Likewise, if your GP asks you to explain what you mean, don't be upset, just tell them.

In your medical notes, your GP will often use abbreviations that are universally understood by doctors but may mean something else entirely in normal language. Patients who exercise their right to see their medical records are advised to have someone interpret them, to avoid confusion or worry.

Communication is the basis of good healthcare and GPs are now trying hard to make sure they use patient-friendly language but if you don't understand, say so. That way you'll get the best from your doctor.

Breaking bad news

There's never an easy way to break bad news and it's not something GPs enjoy.

No matter how much a GP might prepare or even rehearse, luck and professional judgement are both involved when trying to give bad news in a sensitive manner. Your GP may know you well enough to gauge how you wish to be told and how you may react. However, even in such cases, it doesn't always go smoothly or to plan.

Your GP may choose to break the news in a direct, almost clinical fashion, believing this is the way you'd wish to hear it. If they're right, you'll appreciate this approach; if they've got it wrong, however, it may come across as if they don't really care. Likewise, a softer, empathetic approach may be spot on or wide of the mark. The way your GP breaks bad news also reflects the approach they're most comfortable with. Often they haven’t been trained in how best to do this, and have to do it as best they can.

Some doctors try to maintain a positive outlook even when all seems negative, which may seem confusing. You may feel your GP hasn't taken the news and the way you're feeling on board and they're making light of the situation. This isn't the case and this approach is just their individual style. In fact, as you get to know your GP you'll be more aware of how they'll react in certain situations.

Patients with a terminal illness may hope to be told how much longer they can expect to live, but this is often impossible for the doctor to guess without giving unrealistic expectations either way.

None of us like to prepare for the worst, but often it's a good idea. It might be helpful to tell your doctor how you'd like to be told such news should the need ever arise. This lessens the chance of them getting it wrong and strengthens your relationship.

When receiving bad news, few people take much else in. For this reason your GP may say very little despite listening to all your questions. Often it's best to take some time to let things sink in, to think about the questions that have arisen and to go back when your mind's a bit clearer.

Your GP will support you in coming to terms with your new situation and share ideas of how others have managed in similar circumstances. They may not have all the answers, but they'll help you to find them.