The communication between a male doctor and his patient during a routine office visit runs more smoothly if that patient is also male, according to a new study. Failures of doctors to identify the patient's main reason for visit occurred more frequently in female patients, according to a study published by researchers at the Mayo Clinic. The study suggests that physicians should pay more attention to the communication of reasons-for-visits with female patients.

Mayo Clinic Proceedings (1998;73(2):109-117)

COMMENT: This is a huge problem. Not only does traditional medicine not have the slightest clue on how to treat the vast majority of the chronic health conditions that they care for, but it appears that the major reason for the visit is frequently not identified. Admittedly this is partly the responsibility of the patient. My initial patient questionaire makes it very clear that I am interested in the major issues a patient wants to address at their visit and also seeks relevant psyho emotional elements. However, even with this effort a person's true reason for the visit is not uncovered. This happens more frequently on followup visits. Last week I saw a patient for an upper respiratory infection which she was concerned was a sinus infection. That was what she told my nurse. Well, it turns out that was not the reason she was there at all. She was going through a painful divorce and required some guidance on how to address some of the elements of this journey. I have found many people find it difficult to state they are seeing me for emotional reasons. Our culture tends to reinforce the concept that they should be able to cope with nearly any problem and the only legitimate reason to see a doctor is for a physical illlness. I suspect less than optimal encounters with previous physicians when sharing this information may also be a factor in other situations. I find that it is always best to be completely honest in ALL situations, especially when communicating with a health professional. Frequently this will trigger fear which is experinced as a "racy queasy" sensation in the abdominal area. Slow deep breathing with this feeling will help to cope with the emotion.