Questions to ask your Doctor

Dr. Lisa Ryan is the president of the Maine Medical Association. She is a pediatrician at Bridgton Hospital, and mother of two. Dr. Ryan champions the idea of more open communication between patients and their health care providers, and believes this will positively impact the future health of us all.

What keeps you excited about medicine, and motivated to be a leader?
Years ago there was an article published in the Annals of Internal Medicine called “Medical Professionalism in the New Millennium.” I found this article recently, and it has re- energized me and caused me to say, “This is why I’m doing what I’m doing. This is what brings me passion.” The article suggests that doctors remember three basic principles. The first is patient welfare. That’s really what we all went into medicine for—we wanted to take good care of our patients. The second is patient autonomy. That’s a relatively new priority in medicine. We want to engage patients in their own healthcare, and take the time to ask, “What are you worried about? What’s really bothering you?” We need to talk with patients about their disease process, how to maintain wellness, and what options there are. The third principle is social justice. We need to make sure that everyone has access to high-quality health care.

How can patients and family members tell they are working with the right health care providers?
Patients and families need to feel that they can talk to their providers. The provider should not be simply a doctor, who tells them what to do. When you meet a new provider, you should trust your gut. We’ve all had experiences where something doesn’t sit well, and later wish that we had trusted ourselves. You should also have a level of ease with the office setting and the staff. Ask yourself, “Do I feel welcome? Do I feel safe? Do I feel comfortable?”

What about cost? When I was in private practice ten years ago, I knew how much we charged for a patient visit and how much it would cost to order a cholesterol test or an x-ray. It has gotten more difficult to tell how much things actually cost. This can negatively impact the trust between patients and their providers.
In this country our healthcare costs are astronomical. It really can’t continue the way it has been going. Many families have very high-deductible insurance plans and money is a huge issue. When patients come in the office, it’s my job to steer them to the places that they could get the answers to those questions about cost—even if I don’t have those answers myself. The health improvement organization Maine Quality Counts has worked with Consumer Reports on a program called “Choosing Wisely in Maine.” There are five questions patients should ask their healthcare providers related to cost: Do I really need a test or a procedure? Are there other alternatives, other options? What happens if I don’t do that test, or take that medicine, or do that procedure? What are complications and side effects if I do? How much does that cost? Those are important questions.

When I’m with a patient, I want to be part of a positive, collaborative relationship—to see where we can start as human beings, rather than simply doctor and patient. It sounds like this is something that you feel the same way about.
The nice thing about being a pediatrician, and especially with newborns, is that I have had the opportunity to build relationships from the beginning. I’ve been doing this long enough that I’m starting to see the children of the children I once had as patients. It’s great to have those relationships and great to be part of the community.