Photo: Stuart Fisher

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O: Are there other ways to improve understanding between my doctor and me?

DO: It's effective to say, "I just want to reiterate my top three things: X, Y, and Z. Is there any other information that would be helpful for you?" At the end of the appointment, say, "Okay, let me make sure I've got all of this right." Then repeat back the doctor's advice or treatment plan. This not only ensures accuracy, but also helps jog your memory—and your doctor's—about points you or he forgot to mention. For example, it may prompt him to tell you about a potential side effect of the medication he's prescribed.

O: How do I make extra sure I don't miss anything?

DO: Always have a pen and paper. You can also consider bringing a family member or a friend to your appointment to help fill in the gaps. I recently saw an older patient who'd just been diagnosed with breast cancer, and she was having trouble keeping things straight. On the next visit, she brought her adult daughter with her. We all talked together, and the daughter took notes.

O: Should I ask what my doctor would do if he were in my shoes?

DO: This question comes up a lot. I try to help patients work through their own values using the medical facts I can offer. I once had a patient whose cardiologist had recommended an implantable defibrillator. The patient's general philosophy was to leave everything to God. So when he asked me, "What would you do?" I thought about his past decisions: He was taking blood pressure pills and had done a cardiac catheterization—clearly in this case he seemed okay altering the course set out by God. He also had a lot to live for, including a wife, children, and grandchildren. We discussed the medical evidence and his religious beliefs, and ultimately I recommended that he get the defibrillator. It's so important that your doctor take your values, not his, into consideration, along with the risks and benefits of treatment. So a better way to phrase this might be, "Given my situation, what do you think I should do?"