Why We Forget What the Doctor Told Us

Has your mind ever gone blank after leaving your doctor’s office? You may be trying to remember the specific instructions or the answers to your “what if questions”: “What if I don’t feel better after a couple of days?” “What if I miss a dose of my medication?” “What if I feel worse in the middle of the night?”

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Nine out of 10 Americans don’t fully understand or remember what to do after a visit with their doctor. Four out of 10 individuals don’t fully understand how to take their medication correctly or care for themselves after leaving the hospital.

This has nothing to do with your level of education or intelligence. Medical terminology is a foreign language to most of us. Even those in the healthcare field may not fully process what they hear when they have a health crisis. Being in pain, having surgery and experiencing certain medication side effects can add to the confusion.

“Stress hinders our ability to listen, to process what we hear and to recall it. Research has shown us that only 50% of the instructions and information provided to patients is accurate and only half of that information is remembered correctly,” says Mary Beth Modic, DNP, APRN-CNS, CDE, a clinical nurse specialist in the Office of Advanced Practice.

Getting clarity

“Clear communication is one of the most powerful tools you can use to stay healthy,” says Modic. “How well you understand what you and your doctor have discussed is called ‘health literacy’. It is the best predictor of how prepared you feel to manage your illness or recovery at home.”

Each year, thousands of Americans are injured or die because of unclear communication (in conversation or in writing) about their care — or because they don’t understand the information or its importance.

While hospitals like Cleveland Clinic make every effort to ensure clear communication from healthcare providers, patients play a role in good communication, too.

Listen to your gut

Start by trusting your instincts, and be proactive. “If you’re confused or if something just doesn’t feel right, don’t be embarrassed to ask questions or to voice your concerns,” says Modic.

Remember that the vast majority of patients have been in your shoes. The Joint Commission, an independent and non-profit organization that visits healthcare organizations to assist them in continuously improving their delivery of high quality and safe care, promotes a SPEAK UP TM campaign that provides specific questions patients can use to get the necessary information they want and need when visiting their doctor.

Here are six tips to keep in mind to ensure safe care for you and your loved ones:

1. Speak up, and be heard.

If you have new information (even a minor change in symptoms), tell your doctor. “Your doctor wants to make sure that they address your concerns,” says Modic. “And if you don’t understand, say so. If your doctor appears busy, say: ‘I’m trying to understand, but I feel rushed.’” Your doctor wants to make sure that you comprehend the instructions and recommendations so you will recover more quickly.

2. Don’t trust your memory. Write it down.

Before your doctor’s appointment, write down your questions and concerns, leaving space for the answers. At the office, write down your doctor’s answers. If it will help, ask for a printed diagram or ask the doctor to show you on the computer the part of the body they’re describing. Your doctor will provide you with a printed summary of what was discussed, activities you should perform to prevent complications, a list of worsening symptoms that would require a call to the office or trip to the emergency room and your list of medications. If the summary isn’t offered to you, ask for it.

3. Be truthful.

People often withhold information from their doctor because they worry that they may be judged. You may feel embarrassed to share symptoms or information such as smoking habits, drug or alcohol use, sexual dysfunction or leakage of your bowel or bladder. Valuable time, money and resources may be spent to look for causes for your symptoms. Withholding the truth can affect the accuracy of the diagnosis or delay treatment for a treatable condition. Your doctor wants to help you, not judge you.

4. Bring a second set of ears.

Ask a loved one or trusted friend to go with you to your appointment, to make sure you understand what is being discussed and what activities you need to do to manage your condition. They can advocate for you if you are feeling overwhelmed with all of the information that is being given or if you are having difficulty asking follow-up questions.

Make sure you, or your loved one, understand what you’re supposed to do. Your doctor may ask you for a verbal confirmation of what took place during the visit by asking “I want to make sure that I explained things clearly to you, so can you tell me what you and I discussed today?” If there is a concern, your doctor can offer further instruction in a more personalized manner.

5. Follow directions.

Many people don’t realize how important it is to take medication exactly as prescribed and to follow all the recommendations for their care. If you have questions or believe that you cannot afford the new medication that is prescribed, tell your doctor. Research has suggested that a third of patients never get their prescriptions filled. To paraphrase the esteemed U.S. Surgeon General, Dr. Everett Koop, “Medications don’t work in patients who don’t take them.”

6. Manage your medications.

To make sure you don’t have any medication mishaps, Modic offers these tips:

Learn the names of your medications. Become familiar with the names of your medications and the reasons why you are taking each medication. Bring your medications to your doctor’s appointment.
Read labels. Before you leave the pharmacy, make sure it’s your name on the prescription, and that the drug name and dosage are correct. Human and computer errors can happen, especially if different medications sound or look alike.
Be precise. Know how to take your medicine. For example, a plastic dropper (syringe) is safer than a teaspoon for precisely measuring liquid medicine. Some medications require learning special skills such as giving yourself an injection, using an inhaler or applying a medicated patch. When receiving instruction, be sure to ask that the doctor, nurse or pharmacist watch you practice and give you feedback about your technique.
Make a list. Carry the medication list in your purse or wallet in case of an accident. Give a copy of your medication list to your loved ones so in case of an emergency they can share it with other healthcare providers. Include over-the-counter medicines as well as supplements on the list.
Never double up. Don’t continue taking your old medication if a new medication is supposed to replace it, even if the old medication was expensive! Talk to your pharmacist about any concerns you have with a new medication.
Ask for help with costs. If you can’t afford your medication, tell your doctor about your concerns. There are medication assistance programs for which you may qualify and in which you can be enrolled.