Preparedness and organization go a long way in medical appointments, many of which may be shorter in duration. Effective communication about your condition, symptoms, medications, and concerns can help you make the most of your partnership with your healthcare team. What you communicate to your doctor will highly influence what tests are ordered and what medications are prescribed, so it is important to be as detailed and clear as possible. Effective communication is especially important for ensuring proper joint decision making between you and your healthcare professionals (Cegala, 2001).

 

PACE Framework

The PACE framework for effective patient communication was developed by Dr. Donald Cegala at the University of Ohio as an easy way for patients to ensure they are contributing to a strong doctor-patient relationship. Patients who have been trained to use the PACE communication skills have been found to get more information from their doctors and have a stronger partnership with their healthcare team. Effective patient communication involves…

P – presenting detailed information about how you are feeling

A – asking questions if desired information is not provided

C – checking your understanding of information that is given to you

E – expressing any concerns about the recommended treatment

 

Presenting

The information you give to your healthcare team about your symptoms, lifestyle, values, and family history provides the basis from which they must make their diagnosis and recommend treatment options. Before your appointments, prepare to present detailed information. It is important to be clear about the reason(s) for your visit. You may find it helpful to write a list of questions or track your symptoms in a journal. If you are experiencing a new medical condition or changes to an existing one, write these down on a piece of paper that you can bring to the appointment.

Some questions that can help you get started include (Cegala, 2001):

  • Do you have pain? If so, where? Describe the pain (constant, achy, sharp, etc.).
  • When did the symptom(s)/pain first start?
  • How often do the symptom(s)/pain occur?
  • How long do they last?
  • What makes the symptom(s)/pain better? What makes it worse?
  • Are you using any medication, herbal supplements, or over-the-counter medicines to help treat the symptom(s)/pain? If so, what? Did they help?
  • Have you tried alternative therapies, such as massage, vitamins, or physical therapy?
  • Have you seen a doctor about the symptom(s)/pain? If so, what was the outcome of that appointment? Did the doctor prescribe anything, and if so, was it helpful?
  • Are you concerned the symptom(s)/pain indicates a serious condition, like cancer, heart disease, or diabetes?
  • What do you expect from the visit? Would you prefer your doctor prescribe a medication, order a test, or refer you to a specialist?

Always make sure to remind your doctor about any medications, including herbal supplements or over-the-counter medicines, you are taking. These can interact with medications the doctor may wish to prescribe, so it is imperative the doctor be informed. Additionally, your doctor may not remember all of the medications you are taking, even if they prescribed them. You can bring all of your medications to your appointment, though you may prefer to bring a printed list instead. If you choose the latter, make sure to include dose the name, dosage, and how you take each medication, including timing (example: Aspirin, two 50 mg tablets, morning and evening with meals) (Cegala, 2001).

 

Asking

Patients typically don’t ask their healthcare providers very many questions, even though nearly all patients will claim they want as much information as possible. You can ask questions not only to solicit information from your healthcare professional, but also to make a request. For example, you may want to ask about the side effects of a medication, but also for a referral to see a specialist.

Some questions you may consider include (Cegala, 2001):

  • What is the medical condition called?
  • What caused it?
  • How serious is the condition?
  • Can I expect to recover, or will it stay the same or get worse?
  • What is the treatment for the condition?
  • What test(s), if any, are required?
  • Are there any risks to the test(s)?
  • How will I know if I am improving?
  • What medication, if any, should I take for the condition?
  • Can I treat the condition without medication?
  • What will happen if I do not wish to take medication?
  • Will medication interact with any other medications or supplements I am taking? If so, what can I do about this (ie: stop taking another medication, change the dose, take them at different times of day, etc.)?
  • What side effects will the medication for the condition cause? What should I do about the side effects (ie: call the doctor, consult a pharmacist, change the dose, take with more/less food, etc.)?
  • How long until the medication makes me feel better? If I do not get better by then, does this mean the medication is not working? If so, what should I do then?
  • What do I do if I miss a dose accidentally?
  • Where can I get more information about the condition?
  • Are there support groups for this condition? Where can I find more information?

 

Checking

It is important that you verify the information you receive from your healthcare professionals. You can ask for clarification (e.g. “Does this mean I should take only half a tablet per day?”), request repetition of information (e.g. “Can you please tell me the name of that test again?”), or summarize something to doctor has said (e.g. “So, what you are saying is that…”).

Do not be shy to check your understanding of what your doctor has said or ordered. You are more likely to remember and understand the information if you summarize it in your own words (Cegala, 2001). In case you have misunderstood something, getting clarity immediately will save you confusion and unnecessary follow ups with your doctor.

 

Expressing

Sometimes, patients may have concerns or fears about a particular treatment. It is important that you be honest with your healthcare professionals about any concerns you may have. When patients withhold this information, they are more likely to change the treatment themselves or quit entirely. This can cause harm in the long run. Honesty is definitely the best policy around any concerns you may have.

With any condition, there are usually different treatment options. By expressing your concerns, you can work with your healthcare team to find the treatments that best meet your needs and values.

 

Sources

Cegala, Donald (2001). Talking With Your Doctor. https://health.ubc.ca/sites/health.ubc.ca/files/documents/TTYD%20booklet.pdf 


Last updated: January 4, 2024