We hire doctors to help diagnose and treat our illnesses, but all too often we expect much more. Those expectations can lead to our saying things that drive a wedge in the doctor-patient relationship rather than creating a collaborative partnership designed to improve our health. Here are 10 things you do NOT want to say to your doctor when you suffer from chronic pain.
1. Don’t expect your doctor to know as much about your condition as you do, unless he/she specializes in that area of medicine. Be gracious and generous about sharing information on your condition in a way that creates a partnership with your doctor. In my case, I’ve printed out the diagnostic criteria for CRPS with notes on how the disease affects me. I share this, along with my current medication list and history of medications and procedures I’ve tried. Every doctor I’ve seen has appreciated my preparation for appointments. You probably will not have time to educate your doctor, but you can give them literature with links where he/she can research and understand your condition better.
2. Don’t rate your pain higher than 10. On a scale of 1 – 10, 10 means that you are out of your mind or unconscious because of your pain, which isn’t the case since you’re sitting in front of a doctor talking about it. Doctors need an objective way to measure things so they ask what seems to be an idiotic question like ‘How bad is it on a scale of 1 – 10?’ Force yourself to be objective, even if this is the worst pain you’ve ever had.
3. Don’t ask for a specific pain medication, it will make you look like you are drug seeking. Ask if he/she thinks that medication would be good for your situation.
4. Don’t say you’ve tried everything, but do tell the doctor exactly what medications and interventions you have tried. Better yet, have it written down with dates and what outcomes you experienced.
5. Don’t tell the doctor that you read about your condition on the internet. Even more, never tell your doctor you heard about it on Dr. Oz. You and I know that the internet is a great resource for learning and connecting, but it is also notorious for bad, misleading information. Doctors are very skeptical about self-diagnosis or interventions that you discovered on the ‘net. Instead, ask questions like, “What is your opinion about ketamine infusion, is it something you think might work for me?” You don’t have to tell the doctor you first heard of ketamine on Facebook.
6. Don’t insist on specific tests or procedures. It is easy to put a doctor on the defensive if you press for a treatment or test that he/she is not familiar. Feel free to ask questions and for their opinions about treatments or therapies. Remember, you want to create collaboration.
7. Don’t minimize or exaggerate your pain or symptoms. I run into more patients who minimize their pain out of fear of not being believed, but it is just as bad as exaggerating it. Do your best to describe your pain specifically: Is it sharp, stabbing, aching, throbbing, spasming, pressing, tingling, biting? Also describe what your pain keeps you from doing: Can you walk, work, do housework, drive, eat, sleep?
8. Don’t refuse to try something you haven’t tried yet. If your doctor suggests physical therapy, you might feel intimidated and worried about exacerbating your pain. Be willing to go once or twice, and be clear about what makes your pain worse and better. If your doctor suggests a drug that you’ve heard negative things about, ask lots of questions and share your concerns. If keeping a pain diary feels like a waste of time because you hurt all the time, ask your doctor what it is he/she is looking for in that journal. The doctor may be trying to track patterns you do not yet see. Give the suggestion a trial and then give the doctor specific feedback about what worked and what did not.
9. Don’t complain about a previous provider. You can tell your doctor about treatments that didn’t work or share that your previous provider lacked expertise. Any doctor who speaks badly about another provider is unprofessional.
10. Don’t expect your doctor to know about or recommend alternative therapies. If you find a doctor who is knowledgeable and willing to collaborate with alternative practitioners, you have found gold. Most doctors are not trained in things like Reiki, essential oils, or cupping. If you find an alternative therapy that is helpful in alleviating your pain, do share it with your doctor with your list of medications and previous interventions.
As someone living with chronic pain, you want to develop a strong relationship with your doctor. You have hired that doctor because of their training and expertise in a certain field of medicine. Be a good consumer and advocate for yourself. Communicate clearly and respectfully and you can expect the best of care.
Dr. Lisa Van Allen is an executive coach and spiritual director living with Complex Regional Pain Syndrome.