Helping your health care provider to hear you and vice versa

Deborah Herczog is uniquely qualified to discuss communicating with medical professionals, because she is both a person with hearing loss and a medical professional. In this workshop, she provided a wealth of "insider information" that would be good for anyone to keep in mind when visiting a medical professional. And it's indispensable for anyone with hearing loss!

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Finding a new health care provider

Deborah began her presentation by talking about how to find a new provider. She mentioned that one of the best ways is to ask others who are hard of hearing how they are treated by their provider. Once you have identified a potential provider, you should telephone the "gatekeeper", the person who controls access to the provider. The "gatekeeper" is usually the receptionist, who also answers the phone, so she is an easy person to reach. You should make this person your ally.

When you reach the gatekeeper, immediately identify yourself as a hard of hearing person and say that you need her help. Then ask if this is a good time for a few questions. If not, when would be a good time to call back?

During the conversation with the gatekeeper, ask if the provider is familiar with working with patients who are hard of hearing (HOH). If not ask who you should talk to to familiarize the provider with a "care plan" for working with HOH patients.

When you reach that person, tell him that you will be sending a letter of introduction in which you will include information about your hearing loss and also communications tips for the provider and office staff.

If you get a reasonably positive reaction to all this, you've probably found a health care provider that you can work with. If not, and if you have other options open to you, you might want to look for a different provider.

Scheduling the appointment

If you're going to continue with this provider, explain the reason you want an appointment and ask how long the provider usually takes for that kind of appointment. Consider asking for more time to accommodate the additional communications time. The provider may be able to code the extra time as "counseling" or some other indicator that will not increase the cost of the appointment to you.

Schedule your appointment early in the day, if possible, because both of you will be more fresh. Also, the provider won't already be behind schedule and in a big hurry at that time. If you can't get an early morning appointment, an early afternoon appointment should be your next choice. Often a provider has an opportunity to catch up a bit over lunch.

Note that many providers provide no-cost "consultations" by telephone or email, so ask about that. If you intend to communicate by phone, be sure to explain about any telephone accommodations you use.

Deborah also suggested providing the health care practitioner with "Hints for Improved Communications" from the Mayo clinic. She noted that this list isn't really any better than a lot of others, but the fact that the Mayo Clinic distributes such a list might encourage your provider to take the issue more seriously.

And finally, always express warm appreciation at the completion of this and all other interactions.

Appointment Preparation

Begin your preparation by educating yourself about a health care provider's "standard operating procedure". Doing so will enable you to know how to best interact with that person and also to speak their language.

Also, use a health care provider template format (provided at the end of this article) to record as much relevant information as possible. This will reduce the need for spoken communication, which will minimize confusion, frustration, and misunderstandings. Deborah recommends maintaining short and long template forms, and bringing two of the appropriate one to each visit.

Compose a list of questions you have, and leave room on the list for written answers. Also, you may want to bring additional paper and a pen to jot down notes. Bring a laptop, if that works for you.

You can also bring an advocate with you. This is an especially good idea if you are in crisis, or if the appointment is a particularly important one. People under stress have a very difficult time remembering conversations, even if they can hear them perfectly.

At the Appointment

Introduce yourself to the receptionist and remind her that you have communicated via telephone and mail. Ask if she has had a chance to review the communications tips you sent. If not, give her a couple of the key suggestions. Also remind her that you may not hear your name called, so someone may have to come to let you know when the provider can see you.

Take copies of the communications strategy with you and hand them out to staff members you encounter.

Ask if the doctor has a carpeted office that you could use for the pre-examination conversation, and explain that it's much easier for you to understand speech in a carpeted room.

Give the receptionist a copy of your template and ask that she attach it to the front of your chart. That will likely be the script for your appointment.

Always remember that personable people get the best service, so smile and be friendly.

When you meet with the provider, be sure to repeat all instructions and other important things the provider says. At the end of the appointment, summarize the discussion and ask if you have it right. You might also ask him to nod for "Yes" and shake his head for "No", as further insurance that you understand. Whatever else you do, DO NOT BLUFF!

If you are given a prescription, ask if it's ototoxic. You can also discuss this with the pharmacist and do your own research on the Internet. You might also ask if there is a generic or equivalent substitution that could save you some money.

Note that health care providers often use a "start low and go slow" plan. This means that the first treatment they suggest may not work. If that's the case, it's up to you to contact the provider again to seek additional treatment.

If you are not satisfied with your treatment, ask if diagnostic studies or referral to a specialist are indicated. And if you continue to be dissatisfied, you might seek a different provider.

Know your rights, but be appropriately polite and patient.

And work to maintain a strong relationship with your provider.

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Short Template

Name/Date of Birth

PLEASE FACE ME. I READ LIPS.
Hard of hearing; wears hearing aids, cochlear implant, etc.

Date

CC (Chief Complaint)

HPI (History of Present Illness)

Medication Allergies

Current Medications

PMH (Previous significant medical history)

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Long Template

Name/Date of Birth

PLEASE FACE ME. I READ LIPS.
Hard of hearing; wears hearing aids, cochlear implant, etc.

Date

CC (Chief Complaint)

HPI (History of Present Illness)

Medication Allergies

Current Medications

OTC, vitamins, herbs

Habits (smoking, alcohol, caffeine, recreational drugs, sleep, exercise, nutrition, preventative care like immunizations/lab work

Sexually active (alone/partner/both/orientation/contraception/safe sex)

Past Surgeries (type/year)

Past Hospitalizations (reason/year)

Hearing loss (briefly describe cause, R/L/both, hearing aids/CI/both