Dear Doctor: An Open Letter to My Medical Team

By Kim Dolce

3 min read

If I had a dollar for every moment I wanted to scream at a doctor to please listen to me, well, I wouldn’t be rich enough to beat Elon Musk to Mars, but it might finance a few Uber trips to medical appointments. While it is obvious why screaming at a doctor would not get the result I want, it is not as obvious what WOULD work. So, here’s my latest idea: Write a letter.

Thinking about communication with my MS healthcare team

How best to get started? I wrote out a grocery list of behaviors and attitudes I desire in a healthcare provider. Then I created a tactful, friendly, funny introduction and conclusion. Put them together, and here is a working draft I hope might be worthy of your consideration.

What do I intend to do with this letter? I’m not sure yet. I do know that writing the wish list focused me on what approach to health care works best for me. If you have suggestions, please feel free to mention them in the comments section below. I know I’m not the only one who privately talks to my fairy godmother/favorite deity about such matters, so please DO share!

My wishlist for communication

Dear Dr. _____,

I need the services of a ______ (specialist/PCP) to add to my medical team. You have high patient ratings on Healthgrades, in ways that check many boxes for me. Following is a list of qualities and behaviors I desire in my medical team.

Make eye contact.
Listen with a poker face (as opposed to eye-rolling/judgy face).
Wait until I’m done talking to respond.
Validate what I say by repeating it back to me.
Show compassion, support, and understanding.
Praise me for doing research and asking questions.
Praise me for accomplishments I report, such as: "That's awesome. Keep up the good work!"
Make it clear that you are my consultant and I have the final word on treatment plans.
Ask me if I feel comfortable removing my mask so you can check my face. Seriously. How else will you be able to observe that I have one-sided facial paralysis or a wound that looks suspicious?
Steer clear of blaming symptoms on my being overweight, especially if you are heavier than I am.
Take my complaints of pain in earnest and discuss all options. Hint: I already take a million pills. Can we try something else?
Be prepared to discuss my case by looking at my EMR before you come into the exam room.
If you are going to ask me to recall my entire history from memory, please be so kind as to pull up my EMR and read along just in case I forget something — which I usually do. Relying on my memory about ANYTHING is conducive to neither completeness nor accuracy.

My communication pledge

If you have read this far, thank you so much for hanging in! Please also know that I see this as a two-way street. In kind, I pledge to be a good patient by doing the following:

Come to all appointments prepared with notes and my latest medications list.
Show up on time and cancel in plenty of time whenever possible.
Listen respectfully and attentively to your advice.
Use my inside voice when engaging you in an argument.
Use the F-bomb sparingly. Know that this is not easy for me.
Show good faith by complying with your treatment plan and reporting problems as they arise.
Be courteous and respectful towards your entire staff.
Provide full disclosure about provocative things such as how much I drink and how many sex partners I have. I do not hold back, so if you don’t want to know the answer, please don’t ask.

If we happen to meet, please feel free to give me your own list of patient expectations. I would be more than happy to discuss them.

Kind regards,

Kimberly Dolce

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subnormal Member
A Response from Alberta Health Services (Probably) Dear Kimberly Dolce, Hahahahaha! Good one! As you know, specialists are only available upon referral from your PCP. We do use rigorous criteria to ensure that your specialist is a match though, including such things as geography and ... well that's about it. Given that your first point constitutes a hate crime against autists, I dismiss all your other concerns as an over-zealous fever dream. Sincerely, Alan Smithee Assistant to the Director of the Sub-Committee Charged with the Responsibility of Assigning 46 Standing Members to Determine the Potential Merits of Striking a Research Group With a Mandate to Determine the Best 10 Breeds of Tomato For Inclusion in a Sandwich Designed for an 11 Year Old Boy Who Dislikes Vegetables But Strangely Enjoys Most Fruit Although He Has an Aversion to Green Bananas 
1. subnormal Member
 <inline-mention username="jenniem" user-id="4009132"/> I'm so lucky, and I acknowledge that there's a lot of privilege associated with seeing a private practitioner, especially here in Canada. Interestingly, after being introduced to the potential of recording appointments, I've asked other clinicians and all of them have readily agreed. So yeah, I'm thinking on this side of the Rockies it could be up to the practitioner.
2. jenniem Member
 <inline-mention username="subnormal" user-id="4603676"/>, it's great that you've gotten the go-ahead to record appointments 😀. Yes, could be a provincial thing, or perhaps up to the individual practitioner? Perhaps I should try tossing out the request next time. The worst that can happen is a "no," and perhaps the reason why. My last several neurologist appts have been since COVID, and done by phone. Now THOSE would have been easy to sneak record 😉
jenniem Member
<inline-mention username="subnormal" user-id="4603676"/>, I feel your pain 🙄. I'm another Canadian dealing with our Healthcare system in crisis. British Columbian here - hey neighbour 👋! I do still feel immense gratitude for what Tommy Douglas did for us 😊, and all the benefits a universal health care system has provided me and mine. But the system is in serious need of restructuring in order to meet the needs of patients and Healthcare practitioners. 
1. subnormal Member
 <inline-mention username="jenniem" user-id="4009132"/> Howdy back atcha! I miss BC so much. The long-suffering Mrs. Subnormal and I spent a pile of time, pre-COVID, in Invermere, Golden, Radium - pretty much all the great mountain towns down the 91/93 corridor. I second your gratitude and your frustration. We're sooooo close, and I think we're going to get there eventually, but the restructuring required is not going to be palatable to some. Right now, my immediate concern is how do we make family medicine attractive to professionals again? It's going to take people smarter than me to figure that out, but I hope someone does in my lifetime.
jenniem Member
<inline-mention username="subnormal" user-id="4603676"/>, those mountain areas in Eastern BC are lovely. So postcard worthy. Haven't done much traveling through there since l moved from Alberta. No more summer vacation drives through those mountains to get to the coast. Now I'm just lazily planted in Vancouver. My wandering shoes days are done. Hmm, yes, how DO we rework our Healthcare system? So many stakeholders involved, and so many factors to consider. Yes, here's hoping we see the change happen 🍻! I want a country where my son can have a general practitioner 🇨🇦. Fingers crossed those wise minds can make that legacy happen.
cherip Member
<inline-mention username="Kim Dolce" user-id="4084112"/> It's such a simple idea yet so easy to do!! I've tried to go with a list of small things I'd noticed changing. But when I got in there, my notes made no sense to me. Your idea is a smart way to go about it and I'm grateful for your insight!