Chapter 1: The Most Frequent Procedure
Additional resources:
See the above video from the Johns Hopkins Bayview Aliki program to encourage excellence in the doctor-patient interview - focusing on the inpatient setting.
Questions for discussion:
1. Are there ways in which good physicians can be poor communicators, or vice versa?
2. What are some experiences you have had with health care providers, and how have you matched their communication style with theirs?
Chapter 2: Visit Time and Clock Time
Additional resources: Time spent on the visit has a lot to do with how the doctors and patients get their work done, how the clinic is organized. There is currently a fair bit of work being done on clinic redesign.
Questions for discussion:
1. Have you ever had a visit with a health care provider which was short, but seemed "longer," i.e. focused on your needs and concerns?
2. What is the best way to ensure that the doctor and patient spend enough time together: mandated visit times? required communication practices? criteria for health care outcomes that are "good"?
Chapter 3: What We Want as Patients: Lessons from Communication Science
Additional resources: Check out this article on the relationship between physician personality and doctor-patient communication.
Questions for discussion:
1. What is most important to you in a health care provider? Who has been your "best" (or "worst") doctor, and why?
2. How would you help a loved one or family member choose a health care provider that's appropriate for the
Chapter 4: The Doctor as a Professional - in Our Eyes
Additional resources: When did doctors start thinking about professionalism? Emund Erde compares and contrasts the development of professionalism and ethics, arguing that the two conflict in basic ways.
Questions for discussion:
If you were to draw a figure, similar to those in Figure 4, about what elements of a doctor's professional identity - personality, characteristics - are most important, what would it look like?
Chapter 5: Measuring How Good Our Doctors Are
Additional resources: Recently, a group I headed up conducted a review of the scientific literature examining whether "public reporting" of quality information actually improves outcomes related to patients. The answers might be unexpected.
Questions for discussion:
How do you pick your health care providers? Do you make use of publicly available health care information? What matters most to you about a doctor - how would you tell someone else about how good a doctor is?
Chapter 6: Telling Our Story: Taking the Time to Express Our Health Concerns to Ourselves and Others
Questions for discussion:
After reading this chapter, are there health concerns that you might phrase differently, or shape a narrative around so that your provider understands your problem better?
Chapter 7: Make The Most of the Visit Through Mindfulness
Additional resources: Here is a radio interview with one of the pioneers of mindfulness in the healthcare arena regarding the use of such techniques in the doctor's office.
Questions for discussion:
1. Are there situations outside the visit with your health care provider where you have managed to exercise mindfulness? What advice do you have?
2. What if neither doctor nor patient are concentrating on the visit - how can you get back on track?
Chapter 8: How To Communicate Even While Intimidated, Limited, Uncomfortable, or Under-Educated
Additional resources: [coming soon]
Questions for discussion:
Do you feel empowered to communicate your needs to your doctor? What intimidates you the most? What give you confidence?
Chapter 9: What We’re Talking About: Negotiating The Agenda With the Doctor
Additional resources: [coming soon]
Questions for discussion:
What items do you feel go unaddressed from your agenda?
Chapter 10: Acknowledge - and Use - Emotion and Motivation
Additional resources: coming soon
Questions for discussion:
What behaviors do you need to change? How can addressing motivation help?
Chapter 11: How To Talk to the Doctor
About What Makes You Nervous, Embarrassed, or Grossed Out
Additional resources: coming soon
Questions for discussion:
Are there bodily issues you would never tell your doctor about? Are there people you talk to about issues when you're not comfortable talking to them?
Chapter 12: Making Healthy Communities with Healthy Communication
Additional resources: coming soon
Questions for discussion:
1. What is the relationship between your community, however you define it, and your health care providers? How might it be improved?
2. Do you agree, in your experience, that there is a connection between the relationship betwen you and your doctor and the health of your community?
Chapter 13: Learning How to Want Less: Creating a Resource-Sparing Medical Culture Together with Our Doctors
Additional resources: A paper for the Institute of Medicine by Rita Redberg at the University of California, San Francisco, details the history and goals of the "Less is More" movement mentioned in the book.
Questions for discussion:
1. What happens when you want a test or procedure which your doctor thinks is not a good idea?
2. Are there treatments which you think are underused in our current system?
Chapter 14: Transforming Our Health Care System Through Communication and Collaboration
Additional resources: There are a number of organizations advocating for the central role of a relationship with a primary care provider. Two notable examples among them are the National Physicians Alliance, mentioned in the book, and Primary Care Progress. Recent literature also shows that the care of physicians and nurse practitioners is comparable for many commonly encountered conditions.
Questions for discussion: How would you remake our system? How can we put communication with our primary care provider, and our relationship with them, at the center of our system - or is that the right way to rework it?
Additional resources:
See the above video from the Johns Hopkins Bayview Aliki program to encourage excellence in the doctor-patient interview - focusing on the inpatient setting.
Questions for discussion:
1. Are there ways in which good physicians can be poor communicators, or vice versa?
2. What are some experiences you have had with health care providers, and how have you matched their communication style with theirs?
Chapter 2: Visit Time and Clock Time
Additional resources: Time spent on the visit has a lot to do with how the doctors and patients get their work done, how the clinic is organized. There is currently a fair bit of work being done on clinic redesign.
Questions for discussion:
1. Have you ever had a visit with a health care provider which was short, but seemed "longer," i.e. focused on your needs and concerns?
2. What is the best way to ensure that the doctor and patient spend enough time together: mandated visit times? required communication practices? criteria for health care outcomes that are "good"?
Chapter 3: What We Want as Patients: Lessons from Communication Science
Additional resources: Check out this article on the relationship between physician personality and doctor-patient communication.
Questions for discussion:
1. What is most important to you in a health care provider? Who has been your "best" (or "worst") doctor, and why?
2. How would you help a loved one or family member choose a health care provider that's appropriate for the
Chapter 4: The Doctor as a Professional - in Our Eyes
Additional resources: When did doctors start thinking about professionalism? Emund Erde compares and contrasts the development of professionalism and ethics, arguing that the two conflict in basic ways.
Questions for discussion:
If you were to draw a figure, similar to those in Figure 4, about what elements of a doctor's professional identity - personality, characteristics - are most important, what would it look like?
Chapter 5: Measuring How Good Our Doctors Are
Additional resources: Recently, a group I headed up conducted a review of the scientific literature examining whether "public reporting" of quality information actually improves outcomes related to patients. The answers might be unexpected.
Questions for discussion:
How do you pick your health care providers? Do you make use of publicly available health care information? What matters most to you about a doctor - how would you tell someone else about how good a doctor is?
Chapter 6: Telling Our Story: Taking the Time to Express Our Health Concerns to Ourselves and Others
Questions for discussion:
After reading this chapter, are there health concerns that you might phrase differently, or shape a narrative around so that your provider understands your problem better?
Chapter 7: Make The Most of the Visit Through Mindfulness
Additional resources: Here is a radio interview with one of the pioneers of mindfulness in the healthcare arena regarding the use of such techniques in the doctor's office.
Questions for discussion:
1. Are there situations outside the visit with your health care provider where you have managed to exercise mindfulness? What advice do you have?
2. What if neither doctor nor patient are concentrating on the visit - how can you get back on track?
Chapter 8: How To Communicate Even While Intimidated, Limited, Uncomfortable, or Under-Educated
Additional resources: [coming soon]
Questions for discussion:
Do you feel empowered to communicate your needs to your doctor? What intimidates you the most? What give you confidence?
Chapter 9: What We’re Talking About: Negotiating The Agenda With the Doctor
Additional resources: [coming soon]
Questions for discussion:
What items do you feel go unaddressed from your agenda?
Chapter 10: Acknowledge - and Use - Emotion and Motivation
Additional resources: coming soon
Questions for discussion:
What behaviors do you need to change? How can addressing motivation help?
Chapter 11: How To Talk to the Doctor
About What Makes You Nervous, Embarrassed, or Grossed Out
Additional resources: coming soon
Questions for discussion:
Are there bodily issues you would never tell your doctor about? Are there people you talk to about issues when you're not comfortable talking to them?
Chapter 12: Making Healthy Communities with Healthy Communication
Additional resources: coming soon
Questions for discussion:
1. What is the relationship between your community, however you define it, and your health care providers? How might it be improved?
2. Do you agree, in your experience, that there is a connection between the relationship betwen you and your doctor and the health of your community?
Chapter 13: Learning How to Want Less: Creating a Resource-Sparing Medical Culture Together with Our Doctors
Additional resources: A paper for the Institute of Medicine by Rita Redberg at the University of California, San Francisco, details the history and goals of the "Less is More" movement mentioned in the book.
Questions for discussion:
1. What happens when you want a test or procedure which your doctor thinks is not a good idea?
2. Are there treatments which you think are underused in our current system?
Chapter 14: Transforming Our Health Care System Through Communication and Collaboration
Additional resources: There are a number of organizations advocating for the central role of a relationship with a primary care provider. Two notable examples among them are the National Physicians Alliance, mentioned in the book, and Primary Care Progress. Recent literature also shows that the care of physicians and nurse practitioners is comparable for many commonly encountered conditions.
Questions for discussion: How would you remake our system? How can we put communication with our primary care provider, and our relationship with them, at the center of our system - or is that the right way to rework it?
