Author: Dr. Cristy Kessler
Patient and doctor communication should not be contentious. To sustain a meaningful relationship, two- way communication must involve both patient and doctor.
Teamwork is important in medical tourism and necessary for doctors to grow professionally, research, and innovate. Patient must know, without a doubt, they are heard, all of their symptoms are documented and treatment doesn’t stop upon a return home.
Hospital-employed patient advocates advised me to keep a daily journal of feelings and symptoms. However, I wasn’t motivated to follow instructions because my doctors never provided guidelines to follow. I assumed doctors could not be expected to wade through a journal looking for clues to a diagnosis and patient advocates rarely collaborated with them on the value of journaling. This is why patient and doctor communication is so important.
As a result, I developed a system that would serve as a conversation-starter at each doctor’s appointment. If I had been provided a plan like this earlier, I would have avoided six-years of frustrating doctor appointments.
To develop my T-Chart strategy, I threw away my journal and pulled out a sheet of graph paper; although, I now use a computer spreadsheet. I then listed each symptom and issue I had experienced.
I brainstormed through this activity, taking no more than three minutes. By limiting my time, the most important issues were clear. When my stopwatch beeped, I reviewed my list and asked aloud and pondered if it was an honest assumption of symptoms. Honesty is essential. I might have considered my symptom, like swollen hands, a minor issue; but, I kept it on my list because my hands were one of the stimuli that triggered my response — my sensibility. If it was important, then the doctor needed to value that symptom and not dismiss it as minor or irrelevant.
The next step was to review the list again and then, using the right side of the T-Chart, rate each on a pain scale of 1–10. I used the “Faces Pain Scale-Revised,” from the International Association for the Study of Pain (http:// www.iasp-pain.org/Content/NavigationMenu/GeneralResourceLinksFacesPain- ScaleRevised/default.htm).
I assigned an honest number based on the five days prior to my doctor’s appointment. An early mistake was assigning higher numbers to my symptoms in the hope that my doctor would be moved to believe them. However, when my doctor values my sensibility, the level of pain is less important than the fact that I have a symptom at all.
After rating each symptom, I divided the list into urgent and secondary on a new T-Chart that I would take to the doctor. It’s easy to read and gives the doctor a quick summary of what has been happening. At the first office visit, I handed a copy of my T-Chart to my doctor and kept one for myself. I said things in the secondary category meant that during the last five days they had been non-existent. In other words, I had found ways to manage or control them and reduce their effect on daily life. I also said this list was always changing, and just because something had been non-existent in the previous five days, it didn’t mean those symptoms wouldn’t emerge.
When I opened myself to the task of writing down my weekly symptoms, my relationship with my doctors changed. My T-Chart served as a conversation-starter and a way for me to track changes and maintain a record of constant, persistent symptoms. My T-Chart was improving the patient and doctor communication I was experiencing.
By the time I embarked for my transplant procedure, my T-Chart strategy was ready to be easily emailed to my doctor in Turkey prior to phone calls or Skype sessions. This permitted our conversations, via the phone or computer, to be short and direct.
I remained in Turkey for two months following my transplant. When I returned to Hawaii, my doctor and I used the T-Chart strategy for weekly follow-ups, which allowed our monthly Skype sessions during the first year of my recovery to be concise, clear and productive. When it comes to any kind of patient and doctor communication presenting your questions and concerns clearly is key, when you throw in a language barrier due to overseas travel, it is vital. There is no way to know if the T-Chart strategy was responsible for the strong bond I developed with my doctor in Turkey. But, I do know the chart has made my life easier by keeping my thoughts on track and related to my health, body and voice.
About the Author
Dr. Cristy Kessler is alive today because of a medical tourism transplant team in Turkey. She tells her motivational story to audiences worldwide.