The older we get, the more likely it is we need doctors. Finding the best physician, or other healthcare provider, can become a challenge no matter what your age. It's particularly challenging for midlifers and beyond, however. You may be older than your healthcare provider, have more complex medical issues, or be used to a model of care that is no longer followed today.
Imagine seeing a new health care provider for the first time. Let's say you had a minor accident and required the services of your local hospital's emergency room. As you sit there in a your hospital gown, the hours pass by until someone in uniform finally comes around and starts to assess your injury. Given the time demands on ER personnel, you probably won't have much time to describe your condition in detail. Also, given the age composition of most ER staff, you could possibly be your nurse or physician's parent.
Unlike the healthcare personnel you interacted with in the past, then, you now have an age difference to contend with where you look "old" to this person. Not only that, but unlike health care providers of the past, the current crop tend to refer to patients on a first-name basis (but not suggest this in return). Expecting professionalism and formality, as well as respect for your age, might get your hopes up unrealistically high.
Now you know what it's like when you're treated poorly, if not in an ageist manner. Let's look at a scenario instead in which things are going well. Your physician talks to you in a collaborative manner and explains, perhaps pointing to a tablet screen, what your options are. You may even get to see a closeup of your own X Ray or scan. Discussing your care feels like a process you can get on board with. And because you feel your provider respects you, you'll in turn respect the advice and counsel that he or she provides. Who knows? You may even comply with the treatment plan.
There is a way to objectify the quality of your healthcare provider's bedside manner. In 2004, Dutch researcher Christina M. Van der Feltz-Cornelius and her colleagues developed a 9-item Patient-Doctor Relationship Questionnaire (PDRQ-9) for use in general practice.Wayne State University's John H. Porcerelli and colleagues (2014) not only validated the English version of the PDRQ-9 against similar measures in U.S. patients, but also added a measure of how "difficult" the physician perceived the patient to be (the Hahn Difficult Doctor-Patient Relationship Questionnaire or DDRPQ). Pitting the two perceptions against each other, Porcerelli reasoned, would help partition out the extent to which the patient, vs. the physician contribute to a the quality of a healthcare relationship.
The U.S. sample consisted of 123 women and 57 men averaging 38 years old, being seen in a suburban university-based primary care clinic. Porcerelli et al. found that, as they expected, the doctor-patient relationship measures were negatively related to each other. The more difficult you are as a patient, the less well you'll be treated by your provider. Surprisingly, the PDRQ-9 proved to be insensitive to other factors about a patient, including age.
To do the ratings yourself, answer the 9 items on the PDRQ-9 for your own "PCP" (primary care provider"). Use a 1-5 scale with 5 representing total agreement. Then we'll see what your scores mean:
1 My PCP helps me
2 My PCP has enough time for me
3 I trust my PCP
4 My PCP understands me
5 My PCP is dedicated to help me
6 My PCP and I agree on the nature of my medical symptoms
7 I can talk to my PCP
8 I feel content with my PCP's treatment
9 I find my PCP easily accessible
The average score among the study sample was right about 40. With 45 as the highest possible score and 9 as the lowest, it was clear that most participants felt pretty good about their PCP's. The range was actually 10 to 45, though, so if your score was anywhere below 35, it means that you and your PCP are not particularly well-matched.
For their part, PCP's were pretty accepting of their patients. The total scores on the DPRPQ could range between 10 and 58, but the average provider rated his or her patient at about 20. One caveat is that poorer the patient's health, as rated both by the patient and the PCP, the higher the rating of the patient's tendency to whine or be manipulative.
This last finding points to the control you can have over your own health provider's behavior. The more straightforward you are with your provider, the more positively you'll be regarded, and the more, in turn, you'll get out of the relationship. Good bedside manner may just be a two-way street.
Hahn, S. R. (2000). The Difficult Doctor Patient Relationship Questionnaire. In M. E. Maruish, M. E. Maruish (Eds.) , Handbook of psychological assessment in primary care settings (pp. 653-683). Mahwah, NJ, US: Lawrence Erlbaum Associates Publishers.
Porcerelli, J. H., Murdoch, W., Morris, P., & Fowler, S. (2014). The Patient-Doctor Relationship Questionnaire (PDRQ-9) in primary care: A validity study. Journal of Clinical Psychology In Medical Settings, 21(3), 291-296. doi:10.1007/s10880-014-9407-2
Van der Feltz-Cornelis, C. M., Van Oppen, P., Van Marwijk, H. W. J., De Beurs, E., & Van Dyck, R. (2004). A patient-doctor relationship questionnaire (PDRQ-9) in primary care: Development and psychometric evaluation. General Hospital Psychiatry, 26, 115-120.
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