Dr. Besser's Notebook: Creating a Doctor-Patient Partnership

Forging honest communication with your physician is often easier said than done.

ByABC News
March 22, 2010, 6:02 PM

March 24, 2010— -- Dr. Besser's Notebook is a regular column that examines public health issues across the nation.

Congress passed health care reform legislation that will eventually increase the number of people with access to basic medical care. The value of this care increases dramatically if patients are able to develop an open relationship with their doctors. Talking about your body isn't easy -- and for many it is nearly impossible.

Ten years ago I was working at the Centers for Disease Control and Prevention on a campaign to promote the appropriate use of antibiotics. Millions of courses of antibiotics are prescribed for colds and flus, viral infections for which antibiotics just don't work. We were holding focus groups with young adults to see what they knew and how we might effectively develop an ad campaign.

I sat beyond a one-way mirror observing the process. "Do antibiotics work for bacteria, viruses, or both?" The facilitator asked.

"Viruses."

"Bacteria."

"I have no clue."

The group was pretty well split.

"Well, they only work against bacteria," she explained.

"What!" an irate participant exclaimed. "I saw my doctor last week. He said I had a chest cold from a bad virus and prescribed antibiotics. I'm really annoyed. "

"Are you going to say anything to your doctor?" she asked him.

"Oh no. ... I'd never do that. He's my doctor. I'm going to look for a new doctor."

And that is the crux of the issue. Rather than challenging his doctor, he would rather go through the hassles of looking for a new provider.

There are data that show the importance of having a regular provider: reduced hospitalizations, better screening, increased satisfaction. So frequently we hear ads on television which say, "Talk to your doctor." But how often do people do that?

There is a power relationship between doctors and patients that can be challenging to overcome. Asking tough questions isn't easy -- even though it's your body.

Yesterday I had my annual physical exam, and I learned how challenging it can be. I'm not your average patient: I'm a doctor, researcher, and former medical school teacher. I talk about health every day on ABC News and read about it constantly. Yet, talking openly and honestly with my own doctor wasn't easy.