What a doctor needs to know about me – including my worries, fears and hopes.

Pre-existing conditions, medication, allergies - but also their worries, fears and hopes: The more information doctors have about their patients, the better they can help them.

Getting the right diagnosis and receiving individualised treatment recommendations significantly depend on the information that patients themselves give to the doctor.

As a patient, you should be like an open book for your trusted doctor. The more he/she knows about you personally and your medical history, the more likely it is that he/she will find a treatment approach that is suitable for you, even if you have complex health problems. This can take time and will probably not happen at the very first appointment.

New patients attending a practice for the first time usually fill out a questionnaire in the waiting room, which asks about general health information. Sometimes these medical history questionnaires are very detailed and can take away the need to provide a full medical history during the consultation, enabling the doctor and patient to set straight to work on tackling the problem at hand. Alternatively, the doctor might use the information as a basis for important follow-up questions, such as family history of particular diseases like diabetes, heart diseases or cancer.

Often, patients are asked to provide information about chronic illnesses, previous operations, current medication and known allergies in advance. These standard questions usually also include whether the patient smokes or might be pregnant. Additionally, the type of medical insurance (where relevant) and contact details – including those of the family doctor – are also recorded. This means that the doctor, and any treatment provider, already has a lot of information about patients before meeting them for the first time in the consulting room.

In the text: “Tips for your conversation with the doctor”, you can read why it’s helpful for your doctor to know a lot about you and your symptoms, and how you can prepare yourself for the conversation. While your family doctor might have known you for many years, a specialist consultant you’re seeing for the first time will obviously know much less about you. There are many details that might initially seem unimportant to you, but which are nevertheless important for your doctor. But the doctor will also ask you many questions, meaning that you should have a lot of information to hand. We provide lots of tips in the section: “How do I prepare for a visit to the doctor?”, and also include aspects such as:

• What questions do you have?
• What worries keep you up at night?
• Is there anything that’s on your mind that you may find hard to talk about?
• Consider in advance how you can still address these topics in a confidential setting.
• Also share any negative experiences you may have had in the past.
• Only if the doctor is aware of your experiences or concerns can he/she understand why you may be frustrated and then address your fears.

In the first conversation, the doctor needs to know as much as possible about the symptoms that have brought you there: How long and how often have they been happening and in what situations? How might you describe, for example, any accompanying pain? Does the discomfort interfere with your everyday life or leisure activities, and is it having a strong psychological burden on you?

To help you get a treatment recommendation that you’re comfortable with, it’s crucial to let your doctor know your views about particular treatments or pharmacological substances, your past experiences with them, and above all, any concerns or doubts that are bothering you. A patient who is sceptical about pharmaceutical drugs in principle, or who simply doesn’t want to add another medication to their regimen, might not take a new prescription at all. Nothing is gained if you, as a patient, inwardly reject the most effective treatment and do not make use of it.

“Only if your doctor is aware of these worries and concerns can he or she address them and explain to you exactly why this treatment is the right course of action for your individual situation. Then, if the treatment is linked to a positive expectation on your part, it can also be more effective”, explains Prof. Ulrike Bingel, who heads the Interdisciplinary Center for Pain Medicine at the University Hospital Essen and has been conducting intensive research on the placebo effect for many years.

You should also tell your doctor if you have already taken something to treat your symptoms on your own initiative, such as regularly taking painkillers or other over-the-counter medications. It’s important for your doctor to know about this so he or she can assess effects and interactions. So don’t be afraid to share this information. “The worst thing is when patients are afraid to tell their doctor the truth, for instance that they’re not taking a medicine at all because they’re afraid of side effects. Therefore, offering to talk about this, in whatever situation, is extremely important”, emphasises medical psychologist Prof. Sven Benson.

More often than not, patients would prefer to avoid telling doctors about personal habits that are harmful to their health, and tend not to want to be asked about them. Being very overweight is hard to overlook, but it’s less obvious if a patient is consuming an unhealthy amount of alcohol or smoking two packs of cigarettes a day. Similarly, the doctor will only find that a patient’s breathing stops and starts in their sleep, or that a patient is having sexual problems, if the patient discusses these issues openly. While some symptoms might seem terribly embarrassing, you should still talk about them openly and honesty. Remember that bodily embarrassments are routine for any doctor and the things that you’re uncomfortable discussing might represent information that is especially important for further treatment planning. And don’t forget that any information you’re embarrassed about is confidential in any case, because all doctors are sworn to confidentiality.

Sven Benson, Professor of Medical Psychology at the University of Duisburg-Essen, also urges his doctor colleagues to listen: “Often, when patients are talking a lot, doctors are quick to interrupt them. This isn’t good, but it’s certainly because time is short. Nevertheless, it’s helpful to be attentive and to ask open questions, because some patients might say a lot of things that are not entirely relevant while having a completely different problem altogether. This communicative warm-up phase is important.”

Very few patients talk about their mental health of their own accord, at least not to their family doctor or another medical specialist.Perhaps you’re like this. It’s understandable if you feel this way as a patient, for instance if it hasn’t even occurred to you that a skin rash, back pain, or heart palpitations might be related to financial worries, stress at work, or a death in the family. Skilled doctors are aware of this and will ask about possible burdens regarding your mental health or family matters.

Open questions can steer medical advice in a completely different and probably better direction. You can help the doctor to help you! Don’t rob yourself of this opportunity. The more trusting your relationship with your doctor, the more positively you will enter into the treatment and recovery process. This applies in particular to your family doctor, who assesses whether you need to see a specialist for further diagnosis and treatment and therefore sets the course for your future health. But even patients with a chronic illness, who may need to receive repeated care and treatment over a number of years, should build this relationship of trust.

You can also read the interview with Prof. Sven Bensen: “Expectations can double the effect of pain medication”

Tell us your personal story involving the placebo effect! Medicine is also shaped by people’s stories. This is why we’re gathering patients’ diverse experiences regarding their own expectations for the Collaborative Research Centre "Treatment Expectation". You can find out more here.