Many patients think they will get better care from doctors if they are nice. Some think it's better to be aggressive. Many just want to get away as soon as possible.
Of the ones who try to be nice, there's a risk that they will not get what they need. That's partly because their politeness leads them not to ask questions, even when they need to.
The power dynamic between doctor and patient is lopsided. The doctor almost certainly knows more, and has the authority to do all sorts of things that a patient can't. (I was always horrified that while covering ICU patients, I had the legal authority to literally paralyze people.) What does that do to open communication?
People respond to power differentials differently. There's a dimension of culture called "power distance" described by organizational behavior expert Geert Hofstede. It can be measured, and the measurement describes the comfort that people have with power being distributed unequally. The U.S. is a low power distance country, but individuals vary quite a bit. And for individuals with this cultural trait, it seems to me that you get a kind of reservedness and formality in addressing people in power. That can lead to poor communication.
Any doctor will tell you that questions are OK. You need to ask questions to build an understanding for yourself. If the doctor winces, or looks annoyed when you ask the questions, you need to ignore that non-verbal behavior, which probably doesn't represent the doctor's final opinion on your questions at all.
What kind of questions to ask, if you're confused? If you really don't know what's going on, say so. If the language the doctor is using is confusing, say so. The doctor may be surprised, but in the end they will be glad you said this.
These three questions offer a nice framework:
- What are my options?
- What are the possible benefits and harms of those options?
- How likely are each of those benefits and harms to happen to me? Including ‘What will happen if I do nothing?'
Nobody gets a class or goes through training about how to interact with doctors. Probably we should have that option somewhere.