Your IBD Consultation
Getting the most from your consultation
How can I work with my physician to gain maximum benefit from my
consultation? I find it difficult to talk to my doctor about
personal issues - how can I overcome this?
Some people find it difficult to start conversations with their
physician about their symptoms and concerns. If you have been
suffering from the condition for a long time, it may be tempting to
minimise your symptoms for a variety of reasons, such as fear of
requiring surgery, embarrassment or perceived lack of time. Here are
some tips to help you get your points across:
Start the conversation in terms of something you know about and
enjoy. For example, think about what is most important to you in
your life, and how your IBD is affecting it. Then use that as a
starting point in describing how you are doing and also what you
want to be able to do that you can't now. One helpful question
might be: What can't you do now that you used to enjoy doing?
SOAP
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You may find it helpful to approach the conversation the way your
physician has been trained to gather information and develop a
management plan, using the metaphor 'SOAP':
S
=
subjective (focus on the facts, such as what, when, how long and
where in order to help give an idea of what the problem or concern
is about)
O
=
objective (be as descriptive as possible when describing changes or
a problem that is worrying you, and imagine your physician writing
these details into your notes)
A
=
assessment (your physician formulates a list of potential causes and
solutions, weighing the risks and benefits)
P
=
plan (based on the assessment, the physician draws up a plan for
further testing and treatment).
Sometimes, even if you are satisfied with your current treatment,
your IBD may still be affecting your ability to enjoy leisure
activities or work. It is important, therefore, for you and your
doctor to not only discuss your symptoms but also how they are
affecting your quality of life. Working together, you and your
physician can put your quality of life at the centre of your
treatment plan and ensure that these important issues are being
addressed.
This may mean that you will at times need to take the initiative to
start a conversation with your physician about the impact symptoms
are having on your daily life and ask about other treatment options
that may be available to help. Equally important, you will need to
be clear about your willingness to try a new treatment option if one
becomes available.
Likewise, it is important to listen to your physician carefully and
consider that what he or she is saying based on experience and
training. By speaking openly and honestly with each other, you can
work together as a team to solve problems and work out a plan for
managing your IBD, and have the best chance of a positive outcome.
If you have had IBD for a long time, it may be tempting to minimise
your symptoms for a variety of reasons, such as fear of requiring
surgery, but you must be honest with your doctor. It is important,
for you and your doctor to not only discuss your symptoms but also
how they are affecting your quality of life, so you and your
physician can put your quality of life at the centre of your
treatment plan
What makes a good (and bad) consultation?
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You are likely to have a good consultation if:
You are well prepared in advance - bring a list of questions and
the notes about your symptoms, and know what to expect during
the consultation
You and your doctor discuss quality of life as well as symptoms,
including the impact your IBD is having on your daily activities
and how well your treatment is working
All tests and treatments given to you are explained clearly by
your physician in words you can understand
You feel that you are communicating well with your physician and
your questions are answered
Any necessary follow-up is explained clearly to you by your
physician and/or nurse
Together, you and your physician agree on your treatment plan
and how it may be altered if needed
You are given contact information and instructions for what to
do if you need assistance or have questions before your next
visit.
You are likely to have a bad consultation if:
There is too much focus on your symptoms and not enough on
quality of life and impact on daily activities, relationships
and how you are coping
You leave with unanswered questions or are confused about an
answer you were given
You are unsure of what to do if your symptoms worsen or problems
arise
Either you or your physician spends most of the time talking,
rather than the consultation being a partnership with shared
communication
You do not answer your physician's questions honestly, openly
and completely and, as a result, your physician does not get the
full picture of how you are really coping
What if things don't go well?
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If you aren't happy with the way your consultation went, it is
possible to have a follow up appointment with your physician to
clarify on anything that you may feel unsure about. Also remember
that you have a healthcare team, and quite possibly the nurse will
be able to help clarify points or answer any further questions you
may have. Additionally, support groups are available across Europe
that provide services, peer support and information for people with
IBD and their families. When it comes to decisions about treatment
options or surgical procedures, you may find reassurance by asking
for a second opinion. Your physician will understand and support
your wishes.
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