model language for asking medical providers to tell me what they'll do?

November 27, 2019 8:25 PM

I have what I dearly hope is a higher than usual rate of medical providers trying to do the wrong procedure on me. So far, nothing worse than X-raying the wrong body part, or drawing the wrong blood samples. Could the hive mind suggest some polite phrasing for asking medical providers to review their orders with me before they execute them, without getting me labelled a difficult patient?

Things I've tried so far:

1. "Could you tell me what you will do?" tends not to elicit enough information. Maybe they say, "I'm going to take an X-ray" and then give me a super dumbed down explanation of what an X-ray is, complete with 3rd-grader Superman references. They don't say what body parts or which shots. Or they try to reassure me that it's common or painless or quick without answering the question at all.

2. "I'm here for X" gets me "I have it here" but not showing me the paper (not that I would be able to interpret it most of the time) or elaborating further. This one also has the failure mode of not getting people to tell me if they're going to do more than what I said.

3. "I've been having a lot of problems with people getting my procedures mixed up. Could you review with me what you will do?" makes people very defensive. They reassure me that they're always careful and they're going to take good care of me, and then the rest of the interaction is super awkward. These are the ones I'm concerned are going to label me difficult.

A few times, people have asked me for my name, asked me for my date of birth, asked me to spell my name, and then left the room, which I suspect means they had the wrong file. My name is not common in the U.S., is very common among people of my ethnic group, and is not spelled the way an English speaker would guess.

posted by meaty shoe puppet to Human Relations (16 answers total)

Your language for #1 and #3 is a bit focused on something the caregiver needs to do and your expectations for them specifically, so can come across as a bit accusatory. I would try to reframe those questions to be only about YOU and not them. Something like "What should I expect specifically? I feel better if I know some details about the procedure I will be getting". or "Can you remind me exactly what procedure I'm getting done today? Was it x?" That way there's no "wrong" answer they can give so they have no reason to get defensive
posted by JZig at 10:14 PM on November 27, 2019 [7 favorites]

At my latest IRM they asked me what I was there for, which surprised me! (Obviously after confirming personal details etc.)

To me your example phrasings sound unnecessarily coy / like you’re trying to quiz them. If it were me I’d say “I’ve had a few mix ups recently so I wanna make sure we’re on the same page / our info matches. You’ll be doing X today, right?” (Or “what is the procedure you have me down for?” if you really want THEM to say it.)
If you find that makes people defensive, maybe add sth like “so forgive me if I’m overly cautious” (you can say this in a jokey tone to lighten the mood. Turn the whole thing into a “joke”, like “ha ha, you wouldn’t believe the things...”).

I was thinking at my IRM, this guy is fairly highly qualified and probably reasonably well compensated, but BY GOD, his job is boring. So I think your best bet with grumpy health workers is to somehow make their day more interesting, but in a good way.
posted by ClarissaWAM at 11:48 PM on November 27, 2019 [2 favorites]

“Can you confirm what tests / info / procedures / referrals / etc you have listed for me today?” You can also ask for a copy for your own records and they can often print one on site. (And yes, medical models are supposed to move to asking YOU to confirm name, dob, allergies, and procedures but it’s not universal. Confirming your info doesn’t mean they had the wrong file. It could be that they just needed a check mark on the file.)
posted by Crystalinne at 12:03 AM on November 28, 2019 [11 favorites]

I would state what I expect to happen and then ask them if that is right. I'm here for a chest xray today right? Or today the doctor told me I'm getting 3 blood tests x,y, and z. Is that correct?

This way it's not about them doing their jobs but you confirming that everyone is on the same page.
posted by AlexiaSky at 12:57 AM on November 28, 2019 [8 favorites]

Your formulations 1 and 3 sound a bit like a quiz, which they may not appreciate. Perhaps you can adjust 2: "I'm here for X (Y, Z), is there anything else indicated?"
posted by lookoutbelow at 6:29 AM on November 28, 2019 [1 favorite]

I think the phrase “having a lot of problems” in your third example may make people suspect the real problem is you, since they will probably think such a thing is very unusual. I would go very apologetic and cite just one specific example. And when I’m anticipating problems with medical staff, I try to phrase it as if I’m just very over anxious rather than seeming to question their competence. “I’m sorry. Someone x-rayed the wrong leg once, and ever since, I’ve been super paranoid about medical procedures, so it would really help me feel better if you told me what your directions say.”
posted by FencingGal at 6:50 AM on November 28, 2019

You might just want to state there is someone in the medical system who has the same name and very similar birthdates and you've been mixed up before.

Anybody who works in a medical system had been trained about these mistakes happening, and has heard about this. Say something like I just am extra careful because we've gotten mixed up before.
posted by AlexiaSky at 7:06 AM on November 28, 2019 [4 favorites]

I wouldn't worry about being labeled a "difficult patient." Think or yourself as assertive and taking charge of your own care. It's your body; no one is going to care about your health as much as you are.

Be polite and civil, of course, as you'd be with any service professional, but remember, these medical providers are ultimately there to take care of you. If they get defensive over basic questions, maybe they're in the wrong profession. In any case, their feelings are not your concern, and I wouldn't spend a lot of effort on how to phrase things perfectly.

The American health care system is fractured, indifferent, and focused on the bottom line. To get even the possibility of quality care, you need to ask questions and stick up for yourself.
posted by Leontine at 8:16 AM on November 28, 2019 [4 favorites]

If you are in the doctors office as in for an appointment there would be some language pre-scheduling that might allude to your symptoms and they generally tell what tests they are going to use to diagnose you. Or sometimes in ER visits theres kind of a rush to get to the root of a symptom and rule out life threatening pathology so they may not have time to specifically discuss what and when and how but in terms of doing the wrong thing were talking about an x ray machine that is clearly or not directed toward the area of your concern and a blood draw which is sent in lab format to diagnose elevations of somethings or low counts of another. Generally the blood drawn is drawn as it always is and it's what the diagnosis may come up with that determines how the lab orders it. You may need to just focus on being more clear on what is failing you so they dont ask for one test when it's not where you are having problems. Perhaps it's just how much you're telling them that's insufficient.
posted by The_imp_inimpossible at 10:49 AM on November 28, 2019

The standard of care is to ask you for your name and date of birth before every procedure. If they ask you if means they are doing something right, not that something is wrong.
posted by SyraCarol at 11:00 AM on November 28, 2019 [8 favorites]

Just say you've recently apparently had mix ups with a patient with a similar name in the system and they need to confirm date of birth and address as well as the procedure with you. They are supposed to do that anyway and they know it so shouldn't be a problem.

Dont joke or beat around the bush or try to be appeasing. Just say: I want to make sure you're holding my file because of a mix up last month and stick to your guns on it. You are paying them, remember
posted by fshgrl at 12:03 PM on November 28, 2019 [1 favorite]

Instead of quizzing them to see if they know what you’re there for, “Could you tell me what you’re doing?” which is pretty vague, why not tell them why you’re there yourself, “My name is Inigo Montoya and I’m here for a chest X-ray. Can you confirm that’s all I’m down for?” They’ll check paperwork, ask for your date of birth and go from there.
posted by Jubey at 12:29 PM on November 28, 2019 [1 favorite]

At my hospital, a doctor is supposed to do a "time out" before any procedure. Here's an article that I haven't read: https://pssjournal.biomedcentral.com/articles/10.1186/1754-9493-3-14

You might say, "Will you perform a 'time out' before doing the thing?".
posted by neuron at 8:56 PM on November 28, 2019

I suspect means they had the wrong file. My name is not common in the U.S., is very common among people of my ethnic group, and is not spelled the way an English speaker would guess

I don't know if they actually are mixing up your file or not. For myself, I've had a file mixed up with another family member living at the same address, I would not have realized if they medical provider had not remarked in surprise on my having a medical issue that is very uncommon in people my age.

In your situation, maybe something like "There's a lot of us folks in , it's like being named (Jones, or whatever is an extremely common last name where you live) -- I know the date of birth matches, but I want to be absolutely certain you've got the file for the right , can you verify ____?"

Another thing you can do, if your medical treatment is happening in the same large system, find out what your medical record number, or whatever they call it in-house there, actually is. When you are at the point where someone is just about to start asking for the information they need to look you up, ask if they would like the in-house term number.
posted by yohko at 7:41 PM on December 2, 2019

Re: x-raying the wrong body part, is it obvious to you that they're doing that (e.g., they're x-raying the left foot instead of the right foot, as opposed to the abdomen instead of the chest, which may be more difficult for you to realize in the moment)?

If it's clear to you that they're x-raying the wrong body part, do you bring it up in the moment? "Oh, actually my issue is with my right foot."

Also, generally, I think it would be fine to say, "Just double-checking - I'm here for X today, right?"
posted by mingodingo at 1:38 PM on December 4, 2019

Response by poster: Interesting twist: I appear to have had a technician straight-up lie to me about what tests she was drawing blood to do.

My notes indicate I asked her to confirm that I was getting X. She said, "Yes." I then asked her to confirm I was also getting Y. She said, "Yes, I have it right here," gesturing with her written orders. It turns out I did not get Y.

I guess I should have insisted on reading the paper she waved at me?
posted by meaty shoe puppet at 6:33 PM on March 6, 2020