Better Communication With Health Professionals

Clear communication between patient and their medical professionals is essential for health - but it doesn't come naturally. Unfortunately, that means far too many people don't get the care they need.

Barriers to clear communication include:

    Not Enough Time

The average amount of time spent in an appointment with a primary care doctor in the US is somewhere between 9 and 15 minutes. That  can mean important questions don't get asked, or that answers are incomplete. Since the COVID pandemic, it also takes longer to get an appointment (average wait time in 2022 was 26 days), so questions can pile up, too.

What can we do to get past this barrier?

While patients can't do much to change how appointments are scheduled, we can:

• Come prepared with lists of questions to ask and topics to cover. See the page on Communicating & Being Heard in this collection for strategies.
• Try to schedule appointments earlier in the day, before it's less likely that people running late during the day limit your appointment time even further.

    Different Languages

Obviously, when we're not speaking the same language, it's impossible to communicate clearly - and there are many different languages spoken, written, or signed (like ASL) in Bay Area communities.

Even when both parties are English speakers patients and medical professionals in the U.S. can be speaking two different languages, American English vs. Medical Jargon. 

A different type of language barrier happens when we're too intimidated to speak up. That may be related to factors that are lumped together under the term "health literacy", those who "do not read or write well, has trouble communicating or understanding verbal communications about health, ... or has trouble understanding or using numbers".

What can we do to get past language barriers?

• Read down on this page for more information on interpreters and translation services, and on dealing with medical jargon.
• It's not always easy to ask questions or to ask for clarifications, but it is essential that patients do this. Remember that patient questions help medical professionals do their jobs better!  See the next page on Communication and Being Heard for more on how to speak up.
• Don't hesitate to tell the medical team when someone cannot read printed information, or access online links. Iinformation from your health care team should be provided in a easier-to-understand format.
• In some cases, language barriers are a sign of broader cultural barriers. If you feel those are getting in the way of receiving adequate care, see our webpage on Choosing Your Doctor or Therapist.

   Different Expectations

While we turn to our medical professionals to make our lives better, usually they are looking for specific problems to fix. A mismatch between making life better in general vs being totally focused on one issue to fix can cause misunderstandings and frustrations on both sides.

Or there may be a mismatch between our health issues and our health care team's knowledge. Primary Care providers mostly see patients with common, everyday complaints. If a patient's problem is uncommon or serious, they usually refer patients to a medical specialist. In fact, many health insurance plans require that we get a referral from a Primary Care professional before they will pay the cost of seeing a specialist.

But -- although medical specialists will have been trained on certain diseases or parts of the body, they might not be up-to-date about areas outside their specialty. People with a puzzling medical issue are often referred to more than one medical specialist. When they don't agree, or when they all throw their hands up and say "we don't know", patients get caught in the middle. It can also be particularly upsetting when the patient is concerned about one issue but the medical professional is focused on other areas (this situation can lead to medical gaslighting).

What can we do to get past mismatched expectations, or disagreements between specialists?

• Before going into an appointment, try to be clear on what you want to get from that consult. If this is a referral to a medical specialist, ask why. 
• If the issue has been going on for awhile, document: when it started, whether it changed over time, and what's already been tried to treat it. Bring that history along to each appointment.
• When given a course of treatment, be sure to ask what to expect - specifically, how it is supposed to help your medical concern, its chances of success, and whether there are any adverse reactions to watch out for.  If there are other medical conditions, ask how that treatment might affect those issues. 
• Likewise, ask the health care team what they expect patients to get from each treatment, procedure, or course of action. Use their medical jargon to ask clearly:  "What is the most likely outcome if I take this, or do that?" and "What is the best outcome you expect from this?"
• If intent is to find treatment for one concern, but the professional insists on talking about something else: 
  • a) ask how that is connected to the main concern, and
  • b) unless they can make a convincing case that something else has a direct connection, feel free to insist that they visit focus on that main concern (the "presenting problem").
• If we fear that our concerns will not be taken seriously, we can bring a friend or relative to appointments (even during this COVID pandemic!) for support and to speak on our behalf.

When someone is terminally or chronically ill, too often medical professionals cannot shift gears away from fixi-it mode, even if the patient's condition cannot be cured. When more  treatment is offered in that situation, it is good to ask what benefit it would bring vs. the pain, distress, or possible ill effects of that treatment. Helpfull medical jargon to use: "What are the chances of having a better daily life experience with this treatment versus without it?"

    Bureaucratic Errors

Healthcare in the US is a huge business, regulated by many different agencies - it is very easy for important details to get lost in the shuffle, especially when going between one health care system and another. Medical errors are serious! For example, a simple typo in a prescription can result in getting the wrong drug.

Most treatments and procedures need to be prescribed by a medical professional but then also need to be approved by our health insurance company; disputes and denials of service are common. Also, the costs for medical care can be a surprise, even wildly different at different times - if that happens, ask why. You might also get billed for services, tests, or treatments that you didn't receive.

Since medical records are kept both on paper and in electronic form these days, it's even more confusing and difficult to get all the necessary details in one place. See this page for more on accessing your medical records.

What can we do to minimize errors in health care?

• Keep our own records as best we can. Note the names of any medical conditions, names of drugs prescribed, names of specific treatments or tests (and significant test results).
• Regularly review the records kept by our health care teams. If there are errors, ask for them to be corrected ASAP; if that's not possible, insist that a note be added to the medical record pointing out that error.
• Regularly check insurance statements to track medical bills.
• When picking up prescriptions, ask the pharmacists to double-check that it's the correct drug (and ask what that drug is for, if that's not already stated).

  Translators and Interpreters

Health clinics, doctors' and dentists' offices, therapists, urgent care centers, emergency rooms, and hospitals are all required to have some type of interpretation service available for patients. That might be someone on staff who speaks their language, or bringing in medical interpreters, or ir could be a translation service.

If unsure of our ability to speak or understand, let the health care team know in advance so they can have the correct language assistance available at the visit - the I Speak Cards (link below) are a good way to do that.

Translation services must be free to patients in California (there should be no additional bill for these services).

Deaf and hard-of-hearing people in California can turn to the California Telephone Access Program (CTAP) for assistance (including financial aid) with getting the right type of device to communicate over phones with their health care team.

It is not a good idea to ask a friend or family member to translate at a medical appointment. Unless they are health professionals themselves, they might misunderstand what is being said. Or they - or you - might not want to talk about private matters that the health care team needs to know. (Having a friend or family member along might be very helpful as a patient advocate. That's a different job, however.)

     Medical language can look like total nonsense.

For help with translating printed information, handouts, or instructions, these links may be useful:

Patients' Rights

Besides the right to health care services in our language, there are other services required in medicine and health care, under what is sometimes called "Patients' Rights".  (One of those requirements is to receive a written copy of those rights, in our own language, if requested.)

In California, we should expect to:

• Get safe, considerate and respectful care, provided in a manner consistent with our beliefs;
• Get complete information about diagnosis, treatment, and prognosis in terms that are easily understood;
• Be asked for permission to be treated (to give informed consent);
• Get an appointment when we need one ("timely access to care");
• Continue to get care if our doctor or medical group leaves our health plan ("continuity of care");
• See a written diagnosis (description of our health problem);
• Receive treatment for certain mental health conditions ("behavioral care");
• Choose doctors in our health care plan, and change doctors (within our plan) if we are not satisfied;
• Be able to get a second doctor's opinion;
• Receive an explanation if our health plan denies a service or treatment;
• Be able to see our medical records, and add notes to those records;
• Set privacy limits. Patients should decide if health information can be shared with any family member or employer.

To enforce these rights, patients can file a complaint with appropriate agencies, and get an independent review of their grievance.

For a more detailed list of patients' rights, including disability access rights, rights to refuse care, and more, see: