Does your doctor CARE?

Doc lacks empathy? Try asking different questions!

Interesting article in the Washington Post today that shows patients may actually get better quicker if they have doctors who rate high on the CARE scale. ET patients have a chronic illness that doesn't get "cured," but how might understanding the scale improve communication with your doctor?

Let's take a closer look.

The CARE scale asks patients to rate their doctors from 0 to 5 (5 being best) on these 10 questions:

1. Did the doctor make you feel at ease?
2. Did the doctor allow you to "tell your story"?
3. Did the doctor really listen?
4. Was the doctor interested in you as a whole person?
5. Did the doctor fully understand your concerns?
6. Did the doctor show care and compassion?
7. Was the doctor positive?
8. Did the doctor explain things clearly to you?
9. Did the doctor help you take control of your illness?
10. Did the doctor help you create a plan of action?

Using this scale and other factors in 2009, a small study showed that those who rated their doctors 50 out of 50 on the scale (a perfect score), recovered from the common cold up to 24 hours quicker than their counterparts who visited a doctor with a lower CARE score.

Without expecting to be cured of my ET, I think that the 10-point CARE score might be useful to us patients with ET by helping us understand where our doctors might be less engaged than we would like, and to gently nudge doctors toward more compassionate care.

Try this: Take a few minutes to think about your visits to your hematologist. Then try rating your doc on the CARE scale above. (I'd rate my hematologist about a 35, not bad, but room for improvement.) Some questions I might ask to improve communication, if not actual empathy might be in order.

For instance, you might say things like, "I really want you to understand my reservations about taking the chemo you want to prescribe." Or, "Help me understand what the CALR mutation means in terms of my prognosis." Or, "I'm sorry, I don't understand this term you are using." Or, "So what is my care plan between now and my next visit?"

Working against more empathetic care, according to the Post article is the fact that

... doctors and patients alike have lamented that fully booked appointment schedules, the laptop’s intrusion during history-taking, billing pressures and edicts from insurance companies are squeezing the kindness out of the exam room. 

At my last appointment, my hematologist, who is a woman roughly my age, apologized while she tried to get her laptop to connect to my test results. She was also trying to type in my questions so she would have a note of what we discussed. The laptop cut out part way through our conversation, and she laughingly said, "We need scribes to come in and take our notes for us and put it all in the chart so we can talk more." But she was only half joking. The appointment was less productive because of the electronic chart, something that allows all my other doctors to see how the visit went, but, for now, is more time consuming for the doctor to input.

Perhaps a good way to show empathy for your doctor is to have your questions written out ahead of time so the appointment goes quicker. Other suggestions?

You may be dealing with your hematologist for most of your life. Think now about how to improve your relationship!

Be well!

Related: Need questions for your doc?

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