--that talk about communication with doctors, and shared decision making.

I find most of them lacking, however, in that they not only do not tend to take into account the time pressures that doctors are under (though a lot of this, admittedly, we have brought on ourselves with our tolerance of certain types of medical and insurance systems), but also do not take into account the particular ways medical professionals are trained and tend to share and disseminate information amongst themselves and therefore tend to lapse into with patients.

I am not only talking about medical jargon here, though that is part of it, but about the concept of "presentation". Medical students are all taught how to "present" a case other clinicians, and this involves a specific sequence of information delivered in staccato, "just the facts" tone, with emotionality and descriptive color generally stripped from the narrative. Think "BP 150/80, pulse 84 and tachy, cyanotic". This is not only confined to emergency rooms--it's part and parcel of grand rounds and even case conferences.

Most patients, of course, do not "present" in this manner when asked what is wrong with them. Their descriptions tend to be hazy, and from doctors point of view, lacking in precision. It is the rare physician who feels comfortable with interpreting that sort of recitation, who can probe deeper with meaningful questions, without "cutting off" the patient and asking a series of short, sharp questions designed to elicit information in the manner in which physicians, through their training and socialization, have become used to receiving it. And the problems of communication between health professionals and patients begin there, with the clinicians used to getting and giving information in one style and most patients not versed in that style.

While it's nice to get a professional who can gracefully and easily switch from "clinic mode" to a more personal one, one should not count on it. I have found over the years it behooves most of us with chronic problems who will be seeing a lot of doctors often to not only become well versed with the jargon of our conditions, but to learn this "presentation" mode. I realize this is not easy to learn to do, especially if one does not have great facility with medical terms (or with the first language of the physician). But it does help get relevant info out quickly and often has the paradoxical effect of altering the clinician that here is a knowledgeable, savvy patient, which I find often gets one a little more time and empathy.

In other words, if one can make an attempt to speak their language, many will make a bigger attempt to speak yours.

If one can't reach a communication modus vivendi over time, though, the "dump" option is still on the table, though, again, this can be hard to do, especially in non-urban areas where a certain specialist may be the only game in town (another reason, if one is a complex case, I advocate a visit to a major teaching hospital/clinical/research facility, even if travel is involved--the communication skills are not necessarily better at such places, but more minds are at work that might actually be interested in one's case).

Don't have a lot of time this morning, but I will come back to this thread to talk more about "presenting" at some point.