Choosing Wisely Australia: The word on the street (extended)

Choosing Wisely Australia: The word on the street (extended)

JULIE McCROSSIN:

Hello, my name's Julie McCrossin and I'm here in Martin Place in Sydney as part of the Choosing Wisely Australia campaign to get good conversations between doctors, nurses, all sorts of clinicians and their patients so we get the right tests, treatment and procedures and we don't have unnecessary ones.
Let's hear what people say.
What sort of health professionals have you been speaking to? Can you just list a few?

SPEAKER:

Yeah, initially it was with the GP.

SPEAKER:

Specialists in regard to my heart.

SPEAKER:

Family doctor, like a JB or something. Sometimes I need the hospital for the emergency.

SPEAKER:

I've been to a specialist for my skin condition too, which I have at the moment.

SPEAKER:

My GP, I've been to see a dermatologist, a dentist.

SPEAKER:

Just my general GP.

SPEAKER:

Last few years I've been seeing specialists for hip replacements and orthodontist.

SPEAKER:

A podiatrist, I've got some problems with my feet. I have had to go to a physio.

SPEAKER:

I don't think I've been to any health professionals in the last, yeah for a long time.

SPEAKER:

I've been to see a doctor, a professor.

SPEAKER:

Osteopath, fair bit for a sore back.

JULIE:

What do you look for in a doctor or a health professional?

SPEAKER:

I think it has to be quite an open relationship where no matter what the issue is there's no judgement.

SPEAKER:

I need someone I can trust and where I feel in good hands.

SPEAKER:

They're not just someone who understands the science of how the body works but actually they're a human being and treat me like a human being.

SPEAKER:

Usually when I do go in he's always asking how I am rather than go straight to the professional questions.

SPEAKER:

Just someone that I feel comfortable talking to.

SPEAKER:

I'd want someone who asked about my medical history because that shows that they care about me and not just about why I'm in the doctors surgery there and then.

SPEAKER:

And also generally just asking about your general health and having a general conversation about how you are at that time.

SPEAKER:

They must be patient, even to the very naughty children. And they are really careful, they're really considerate for your situation.

SPEAKER:

Personally what makes them approachable for me is they don't tell me what I've got, I tell them what's wrong.

SPEAKER:

For someone to take me seriously. Too many times I've been laughed out with trivial complaints and it's quite demeaning.

SPEAKER:

They need to engage with me, talk to me, look at me.

SPEAKER:

Is a good listener, someone who's going to listen to what might be of concern to you and be able to answer any questions. Someone that has the time and will take the time to listen to what you're saying rather than being in too much of a hurry to rush around and get on with seeing the next person.

SPEAKER:

Listen to what my issues are and then work through them in a logical process and do a thorough job.

JULIE:

How approachable have you found the health professionals you've dealt with?

SPEAKER:

Most of them were very approachable, very good. I did see a few of the GPs in my practise before I found the one I like best.

SPEAKER:

My family GP's been very approachable but the specialists just sent me away saying, not very helpful.

SPEAKER:

Really approachable, yeah. I expected them to be a bit awkward because it's like you've got to talk about weird things, like oh, my back kinda hurts in this strange place, like hard to describe, but they're so friendly.

SPEAKER:

Yeah, fine, approachable, no problems.

SPEAKER:

Really good, I've had good help from them.

SPEAKER:

I've been to a lot of doctors where they mutter a lot of Latin at me and I have no idea so I'd like to understand what's wrong with me and have someone that takes the time to tell me.

JULIE:

If they were recommending a test or a procedure would you ask them about risk?

SPEAKER:

Absolutely, I mean just for your own peace of mind, but and also what if I don't get it, because some- they're quite invasive as well so what if you don't get it, what are the complications there so- I'd just be open minded and go in there and just get as much information as possible.

SPEAKER:

Of course I would but actually I would expect that they will tell me by themselves.

SPEAKER:

Course I do, I always worry about my health.

SPEAKER:

Yeah of course, I think that's really important to ask if there's any risk in surgeries.

SPEAKER:

Not really. (laughing) I don't think I've ever really asked about risks and I haven't really been given much information about risks.

SPEAKER:

Not really, I've been told you need it, that's it, no questions asked.

SPEAKER:

Not really, but I've never really had to go through anything that would sound like there's risks. It's generally just stuff like you need orthotics or I'll give you a massage or maybe you should stretch it a bit more or something.

SPEAKER:

Probably, if it was sort of an invasive procedure.

SPEAKER:

I do, I ask about the risks and the risks are the ones which really make me think a lot about what I'm taking.

SPEAKER:

Well things like treatment, the risk of treatment or I guess even the risk of not following through on treatment, yes.

SPEAKER:

I expect the doctor to explain the risk-benefit to me of whatever course they're suggesting I take.

SPEAKER:

Yeah, of course ask them questions. But sometimes you can't get enough answer to what you are asking. Like you needed to spend more time to more explain about your health, about your problem you're coming for.

JULIE:

Do you ask many questions?

SPEAKER:

Absolutely, I mean they're the person in the know. They're the professional. You're there in a private environment to get that information to make yourself feel better at the end of the day.

SPEAKER:

Yeah, I will go there with a very specific thing, like my back hurts in a strange way, I need a refill on a prescription, I don't feel good.

SPEAKER:

Not really, I just go there for my consultation really. So if I have any kind of injury then I'll just tell him straight away.

SPEAKER:

I do if I feel comfortable with the person.

SPEAKER:

Yes, I ask questions when need be.

SPEAKER:

You've got to ask the basic questions. I mean I possibly don't delve deeply into it unless I really have to. Because I've developed that rapport with the doctor then I'll trust him.

SPEAKER:

I do, I do ask quite a lot of questions.

SPEAKER:

I never really know what kind of questions to ask cause you know when you go there it's just like, it's hurts, it doesn't feel right, can you tell me what's wrong?

SPEAKER:

No, not really.

LEANNE:

Why don't you ask questions?

SPEAKER:

I usually don't have anything I want to know. Or Dr. Google I guess usually answers a lot of them.

SPEAKER:

Because I want to know what I'm taking, why I'm diagnosed, what the reason is, what the side effects are.

LEANNE:

Do you do much preparation before you go?

SPEAKER:

No, I don't, no I don't. I go there with a few questions and hoping to get answers.

LEANNE:

And do you recommend research and writing questions before you go?

SPEAKER:

Definitely have your checklist of what you want to ask and what you need to cover before you go in because as soon as you start the interview things go out of your mind.

SPEAKER:

Research a little bit myself on the computer. I make a list of issues that I want to talk to the doctor about so I don't forget anything when I get in there.

LEANNE:

When you go and see a doctor, nurse, physiotherapist, what makes a good conversation, what are you looking for?

SPEAKER:

You want the doctor to be thorough, ask engaging questions and then also follow up with you afterwards, because that's important because you have the issue at the time but also afterwards you want to know that it's taken care of once and for all.

SPEAKER:

Exchanging symptoms, him explaining the reasons for those symptoms and some of the diagnostic issues associated with them.

SPEAKER:

I guess you can just probably tell in their approach and how concerned they are, the advice that they give you.

LEANNE:

You want a sense of caring and trust.

SPEAKER:

Yeah, that's right, exactly.

SPEAKER:

I don't know, like I wasn't really satisfied with the time that I spent with the health professionals. Mainly I noticed that they don't allow you to speak a lot about your issue. Maybe because they are concerned about the number of the patients in the waiting area or maybe because they implement quality assurance programmes so that they should see the patient within 15 minutes.

SPEAKER:

If she asks how long has this been going on, when did you first notice something, has that ever happened before?

LEANNE:

What about you, what are you looking for? You're young, you probably haven't seen too many doctors but what do you look for?

SPEAKER:

I really want an open relationship so information sharing, I want to know why they're doing what they're doing. I want to know information about the sort of treatment that they want me to take.

LEANNE:

If you went to someone and they said, look it's best to do nothing, how do you feel about it if they say that?

SPEAKER:

I'm not fazed by that, I mean I think that there is a bit of a trend of sometimes over-prescribing at times or the idea that somehow preventative measures might be the best course of action. Sometimes doing nothing could be the best course. I think the best thing I learned about going to see an osteopath is look, they can help treat the pain when it happens but it's kind of up to me to adjust my lifestyle to realise that I've got to look after myself the rest of my life.

SPEAKER:

If I went and they did nothing then I’d be a bit peed off and I'd go and get a second opinion.

SPEAKER:

Good if I knew that that's what they felt was the correct thing for me. But I question a lot, I question a lot even if they tell me that wasn't good. For instance if your knee is swollen and they say to you, "It's okay go home." Because I've had a problem where they say, "It's okay, go home." And a day later you've had a problem and you've got to go back.

SPEAKER:

As long as they provide logical reasons for doing so, I'm completely comfortable with that.

SPEAKER:

I'd want my money back, to be honest, to be perfectly honest. I'd be like, well if I came here to get that answer I would have just, I'll stay at home.

SPEAKER:

If I still got the problem, I'm not happy of course. (laughing)

LEANNE:

That's good, thank you so much.

SPEAKER:

It's Allen, oh sorry.

LEANNE:

Well thanks to everyone who spoke to us today and for more information go to the Choosing Wisely Australia website.