Before experiencing life with a chronic illness you likely had less interaction with the healthcare system. You probably only saw a doctor for an occasional check-up or to get a prescription for an acute illness, like antibiotics for a bacterial infection. However, when you or someone you care for was diagnosed with diabetes, your relationship with the healthcare system likely changed quite suddenly and quite drastically; you went from seeing a physician as an occasional acquaintance to managing several long-term relationships throughout a whole healthcare team.
Often times people are not prepared for this shift and are left to navigate these new relationships on their own. Whereas you might have been more passive or neutral in how you related to your doctor prior to your diagnosis (or when you were younger), once you became more involved in managing your diabetes you probably had more questions and concerns that you wanted to discuss. If those questions and concerns end up unanswered or neglected, this can lead to a breakdown in communication and trust with your healthcare providers.
So what can you do you do to create a relationship that feels more balanced with your team? The following points are tips to help you better navigate getting what you need with your doctors, diabetes nurse educators, and dietitians:
1. Write things down.
Think about what you want to say in advance of the appointment and make a list of the issues you would like to discuss. This might seem trivial, but having your thoughts committed to paper means that you won’t have to worry that you will forget something important. Ultimately, this will allow you to be more engaged and active in the conversation with your healthcare provider.
Type 1 Think Tank Network has put together a great Conversation Guide to help you start thinking about what you might want to discuss during your next visit with your endocrinologist and diabetes team.
2. Take a moment to breathe.
Taking a ‘purposeful pause’ before your next doctor’s visit can help you to enter your appointment more mindfully in the present. This will help relax and allow you to centre your attention on the meeting you are about to have with your provider.
A purposeful pause is really a short mindful moment that you take for yourself. A simple and easy exercise you can do anywhere is to focus on and count your breathing:
- Set aside a few minutes before your appointment to sit down, place your feet firmly on the ground, focus your gaze on a spot on the floor in front of you, and bring your attention to your breathing.
- Breathe in slowly for a count of four, exhale for another count of four, and repeat.
- After a few minutes, return to your breathing to a normal pace and set an intention for how you would like to carry out the conversation at your appointment.
3. Co-chair your appointment.
A lot of times we wait for a clinician to set the agenda for our visit and then hope to get our concerns into the conversation after it has started; however, it is often easier to be proactive by explicitly stating what we are hoping to talk about for that visit in addition to what the healthcare provider is hoping to discuss. This is not about creating a power struggle between who gets to speak and about what, but rather about creating a balanced agenda where everyone has a chance to discuss what is important to them for the appointment.
Zackary Berger, author of Talking to Your Doctor: A Patient's Guide to Communication in the Exam Room and Beyond, speaks a lot to the importance of setting a balanced agenda at the beginning of your meeting with your doctor and other healthcare providers. He offers a couple of simple phrases to help you start the conversation about a shared agenda:
- “I have some things I want to discuss.”
- “There are some things bothering me”
- “I brought a list of things to talk about.”
- “Can I go down my list?”
4. Take care of yourself.
Meeting with your diabetes team can feel overwhelming sometimes—even when they go well. Remember to schedule some time for yourself after each visit with your team. Go for a walk, meet up with a friend to talk, get a cup of tea or a coffee.
Note the things that worked for you during the appointment. What did you appreciate about how you handled the visit? What would you like to change? Build from there.
Download Virtue Bajurny's complete Diabetes Appointment Toolkit free here and be prepared for your next diabetes appointment.
Easy for You to Say: Q & As for teens living with chronic illness or disability by Miriam Kaufman, MD
“Making the Most of Your Appointment” by HealthLinkBC
Talking to Your Doctor: A Patient's Guide to Communication in the Exam Room and Beyond by Zackary Berger, MD
Looking for an an endocrinologist’s perspective on healthcare communication? Click here to watch a video of Dr. Alice Cheng’s presentation about what she has learned from listening to people with diabetes’ experiences with their healthcare providers.