Doctor-Patient Compatibility

Daily Health Solutions, Power to the Patient
on April 1, 2010
Woman communicating with her doctor.
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We’re all familiar with the stereotype: the hurried, hassled doctor, diagnosing on the fly, leaving stunned, angry patients in his wake. This made-for-TV scene may be a bit exaggerated, but unfortunately, it’s rooted in truth.

Dr. John Castaldo and Dr. Lawrence Levitt, neurologists at Pennsylvania’s Lehigh Valley Hospital, are trying to change all that. Their book, Uncommon Wisdom: True Tales of What Our Lives as Doctors Have Taught Us About Love, Faith, and Healing, sends a clear message to the medical community—and the rest of us—about what good doctoring is. “We think we need to be the teachers and the patients need to be the students,” Castaldo says. “But each patient has a story to tell. The more carefully you listen, the better a doctor you become.”

The book describes cases from the doctors’ 30-plus years in medicine. The pair come across as the real Dr. McDreamys—not hotshots with Patrick Dempsey looks, but doctors who really care. “You have to think of your patients as members of your family,” Castaldo says. “Patients want us to share their sorrow.”

The doctors say compatibility is crucial—otherwise, you may not be comfortable divulging personal information that could be affecting your health. “Patients can’t be afraid that a doctor might turn away, judge them, think of them differently,” Castaldo says.

You can’t change your doctor’s personality—but you can switch doctors if the two of you don’t click. In fact, Castaldo says, he has “fired” patients he feels weren’t straight with him. “If I don’t sense that I have a healthy therapeutic relationship with a patient, I will send them to someone else,” he says.

While the burden of establishing those relationships rests largely with doctors, patients can go a long way toward fostering the kind of communication that Levitt and Castaldo say is the most important in good medicine. “The patient has a responsibility too,” Levitt says. “You need to ask questions, share information.” Amid all the talk of complicated healthcare reform, one simple message—that staying healthy is a two-way street—might just be the best medicine.

The Joint Commission’s Speak Up program offers helpful information on getting better care. Go to JointCommission.org (search for Speak Up).

Be a better patient

  • Ask questions. “Figure out what you want to get out of the appointment, and write it down on an index card to bring with you,” suggests Dr. Lawrence Levitt.
  • Don’t edit yourself. If you’ve tried a supplement, fess up. If you’ve skipped a few pills, speak up. If something is amiss—even if it doesn’t seem relevant—bring it up. If you don’t, your doctor can’t do her job.
  • Check for chemistry. You probably don’t spend time chatting up the biggest jerk at a party. Use that radar to help you figure out if your doc is a good fit.
  • Get guidance. If you want to research your condition on the Internet, ask your doctor what site to go to. “The Internet is both a gold mine and a sewer, and it’s not always easy to know the difference,” Dr. John Castaldo says.