Talking to your doctor about your health can feel quite vulnerable. You might feel queasy and nauseous or feel like you have butterflies in your stomach. Others get very rigid and tense. Whatever your reaction, vulnerability is hard!
It's difficult enough to receive "bad news" about our health, so it's no surprise that most people walk out of an appointment feeling shocked, confused, defeated, dismissed, sad, worried and all the other emotions and feelings that come with receiving a chronic illness diagnosis or being recommended a medication for depression or anxiety.
As a counsellor in Vancouver, I want you to know that your reaction is normal given the circumstance. No one is ever really ready to be informed that our health is not optimal. Even when we know something is off.
When I worked for Parkinson Society British Columbia I was introduced to a wonderful framework that helps clients, like yourself or your loved one, feel more confident at the next doctor's appointment. This framework is called P.A.C.E.. It was developed by Dr. Donald Cegala at the University of Ohio, and later adapted by the University of British Columbia (UBC) department of Patient and Community Partnership for Education to fit different client populations. You can find more information about UBC's use of the framework here.
What exactly is the P.A.C.E. Framework?
The P.A.C.E. framework is an easy, effective way clients can communicate with their doctors (and other allied healthcare professionals, like clinical counsellors) to ensure they are contributing to a strong doctor-client relationship. Clients who use the P.A.C.E. communication skills have gotten more information from their doctors' appointments, and have a stronger partnership with their healthcare team.
P.A.C.E. framework stands for:
P - Presenting detailed information about how you are feeling
A - Asking questions if desired information is not provided
C - Checking your understanding of the information that is given to you
E - Expressing any concerns about the recommended treatments
Presenting
It it so important that doctor and healthcare professional receives accurate information about your health. This information provides the basis from which they must make their diagnosis or assessment, and recommend treatment options. As you prepare for your next appointment, you may find it helpful to write a list of felt or observed symptoms, or start journaling your days to be able to present that information in your appointment.
Asking
Asking questions is so essential for understanding your health. And many of you might shy away from asking important clarifying questions. This is where courage really helps. Ask questions to solicit information from your healthcare professional, such as asking about the side effects of a medication, and to make a request, like obtaining a referral to see a specialist.
Checking
Checking the information you receive with your healthcare professional is just as important as asking a question in the first place. You can clarify the information by asking: “Does this mean I should take only half a tablet per day?”. You can request a repetition of information: “Can you please tell me the name of that test again?”. Or you can summarize something to doctor or healthcare professional has said: “So, what you are saying is that…”. Checking the information allows you to consolidate what has been discussed thus far.
Expressing
After talking with your healthcare professional about their diagnosis or assessment and recommended treatment options, it's normal to feel overwhelmed and concerned about your course of action. It is so important that you check in with yourself about how you are feeling in the moment, and be honest with your healthcare professional about any concerns you may have. By expressing your concerns, you can work with them to find the treatments that suits your needs and values best.
And this is where counselling can be so helpful, too! By working with your counsellor you can learn and practice the P.A.C.E. framework. This can be a great way to prepare for "bigger" conversations with your healthcare team or family and friends. Counselling is a great way to learn easy, effective communication skills that you can apply to your health, your relationships and even workplace.
Stay strong,
Myriame
Reference:
Cegala, Donald (2001). Talking With Your Doctor. Retrieved from https://health.ubc.ca/sites/health.ubc.ca/files/documents/TTYD%20booklet.pdf