4 Questions You Should Ask Your Doctor

4 Questions You Should Ask Your Doctor

Why you should initiate advance care planning with your doctor.

Medicare’s recent decision to reimburse physicians for end-of-life conversations beginning in 2016 is a clear victory for advance care planning. Insurance will soon cover the cost for you to speak with your doctor about your preferences for end-of-life healthcare decisions. However, given the reality that most healthcare providers have little to no experience in the art of advance care planning and are reluctant participants at best, we—that’s YOU and ME—need to initiate these important conversations with our doctors. We have to own the responsibility of defining our own treatment preferences in a medical emergency if unable to speak for ourselves. (click to tweet)

Doctor patient conversation

Photo courtesy: Shutterstock / Monkey Business Images

Focus on four key questions with your doctor.

A conversation framework developed by two prominent Harvard physicians—Dr. Atul Gawande, author of Being Mortal, and Dr. Angelo Volandes, author of The Conversation—offers both patients and physicians a place to start by focusing on four key questions. Each question has been reframed below so you can do the asking in a conversation with your provider. Don’t wait for him or her to initiate; own this for yourself, and for the benefit of your family. Ask your doctor:

  1. Are you willing to honor what is most important to me if I am faced with a life-or-death medical emergency? Share your feelings about what makes life worth living for you—how you define an acceptable quality of life even within the context of the limitations of a disease, condition or advanced age.
  1. Will you help me to understand my medical future? Explore the possibilities with your physician of a given disease or condition with which you are living. Ask questions. Share your concerns. You might have to push to honestly reach an understanding of your medical future instead of allowing a doctor to spout medical terminology while talking at you.
  1. Will you do your best to ensure I receive all of the care—but only the care—I desire? If you want a more peaceful passing, if you want to die at home, you can help your doctor understand where the boundary is that crosses from attempting to stave off death versus focusing on your comfort. Or, if you want to receive all possible life-sustaining treatment, your doctor needs to know that as well. This is deeply personal. Only you can convey your wishes. As hard as this is for you, recognize it will be infinitely more difficult for those left to make decisions in a crisis.
  1. Will you please honor my beliefs? Talk with your doctor about the values—whether spiritual beliefs, cultural norms or family traditions—that would guide your decisions about treatment options if you were able to speak for yourself.

The medical system default is not a peaceful passing.

You should know that the hospital default would always be to do everything possible. Without setting limits to your care, you will receive all types of treatments, some of which can be brutal on a frail body. If you want a more peaceful passing, you need to ensure your doctor understands your desire for less invasive care in a crisis.

Why wait?

Waiting for your doctor to ask the questions or waiting for the crisis … neither approach serves you nor protects your family from the painful conflict of arguing over the treatment choices presented by the medical team in the emergency room. You can be the hero of your family by proactively discussing your wishes before the emergency happens.

How can you get started?

I’ve created a one-page checklist with these questions so you’ll have a tool to take with you to your next doctor’s visit. You can start the conversation. Download it now!

Need help sorting through your wishes?

If you aren’t quite sure of your preferences for future medical care or who should be your decision-makers, you can explore Healthcare Choices from the Heart, an online healthcare directive system and coaching program I have just released this month. Then, plan a meeting with your healthcare provider so you can ask your doctor these important questions.

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