What to expect from your doctor

By Elizabeth Cohen
CNN
http://www.cnn.com/2008/HEALTH/02/28...ref=rss_health

Empowered Patient, a regular feature from CNN Medical News correspondent Elizabeth Cohen, helps put you in the driver's seat when it comes to health care.

ATLANTA, Georgia (CNN) -- Dr. Joan Harrold once had to tell a relative that he should fire his doctor.

The relative was on a new medication to control high blood pressure. He started to feel lightheaded. Then vertigo set in. He couldn't stand up. He started to vomit.

A neighbor who's a nurse took his blood pressure; it had fallen drastically.

"He called his doctor, who said, 'I don't think it's your medicine. I'll see you in the office next week,' " Harrold says. "My relative fired the physician and went to another practice."

Harrold, an internist and co-author of "Handbook for Mortals: Guidance for People Facing Serious Illness," has a lot of thoughts on the basic requirements for a doctor.

So do the people at the National Patient Safety Foundation and Consumer Reports. Doctors don't have to be perfect, they say, but there is a short list of the minimum you should expect from your physician.

1. You should be seen in a timely manner when you're sick

This seems obvious, but Harrold's relative's experience shows it doesn't always happen.

If you call the office saying you're not well, you should expect a phone call back from the doctor or a nurse within 90 minutes, Harrold says.

What happens from there depends on how sick you are. You may not need to come in at all. (For example, an adult with cold symptoms, no high fever, no rash and no signs of a sinus infection might be better off staying home.) But if it's more complicated than that -- let's say you need new tests or might need a new prescription -- Harrold says it's usually reasonable to expect to be seen that day.

2. You should get test results in a timely manner

Harrold says you should hear about test results within 48 hours of when the results come into your doctor's office, or sooner if it's urgent. When you get the test, ask when results will be back. Simple lab work is often done in a day. More complicated tests can take a week or more.

3. Your doctor -- not the staff -- should call you with bad results

Dr. Julia Hallisy, author of "The Empowered Patient," thinks doctors should even call you with good results. "Many times, test results lead to changes in the treatment plan," she says.

4. Your doctor should tell you what medicines you're getting and their side effects

Dr. Jonathan Fine says that on a recent visit, an eye doctor put drops in his eyes. "I asked what they were, and he said, 'they're eye drops.' I thought to myself, 'well, obviously you're not giving me an enema.' "

Fine, executive director of Bedside Advocates, a patient advocacy group, says he had to specifically ask what kind of eye drops (they were anesthetic drops).

The experts we talked to said your doctor should clearly state what you're getting and any significant side effects, even ones that aren't dangerous, but could be annoying, like a dry mouth.

5. Your doctor should explain everything in terms you can understand

"Patients should have a basic expectation that they're going to be provided information they need in terms they understand," says Diane Pinakiewicz, president of the National Patient Safety Foundation.

Adds Dr. Orly Avitzur, a neurologist and associate medical editor of Consumer Reports: "If you ask questions and you still don't get it, that's not good enough."

Harrold says to look at it like this: Expect the same service from your doctor that she got recently from the man at AAA.

"My car was stuck one day last week, and it was snowy and cold," she says. "A lovely gentleman got on the phone and said to me, 'What can I do? I'm here for you.' If I can get that from AAA, I should get that from my physician's office."