In Print
Talking to Your Doctor

The Intelligent Patient’s Guide to the Doctor-Patient Relationship: Learning How to Talk So Your Doctor Will Listen
by Barbara M. Korsch, M.D. and Caroline Harding
Oxford University Press, 1997, $25
IN HER EARLIER DAYS as a researcher at Cornell University Medical College, Barbara Korsch found that although many patients received marvelous scientific medical care, they wouldn’t return “or they wouldn’t follow orders,” she says. “I realized something was very wrong.”
Reviewing the interactions from a medical viewpoint, she found no problems. “But when I talked to patients,” she says, “they told me they felt poorly understood or that communication had broken down with the doctor. So patients didn’t feel that what the doctor offered them in terms of treatment or suggestions was relevant.”
Now a USC professor of pediatrics at Childrens Hospital Los Angeles, Korsch put together the first large-scale quantitative research on communicating and, 35 years later, has written a book on doctor-patient communication. The Intelligent Patient’s Guide to the Doctor-Patient Relation-ship: Learning How to Talk So Your Doctor Will Listen is intended to communicate – to both patients and doctors – the message that effective communication is key to every successful health-care relationship.
That is especially true, she adds, in the brave new world of managed care, where patients are seen as “clients” and “health-care partners.”
“To communicate effectively, physicians have to listen to patient concerns, explore their expectations, and be friendly and non-judgmental,” she says. “They have to listen more than talk, find out what the patient has already done, and what they’d like to do.
“Most of all, physicians can’t think of patients as passive victims any more, waiting for the M.D. to decree what they should do. Physicians have to think of patients more as partners now.”
However, Korsch says, not all the responsibility for good communicating falls on the doctor. In fact, effective communication well before engaging a physician can save a lot of time and hassle.
“If you’re searching for a pediatrician, it’s a good idea to interview with the doctor before you have the baby,” she says. “You can ask how they feel about letting the baby cry, about working mothers and other issues. You can find out before you start if you have a conflict.”

IN HER BOOK Korsch stresses the power imbalance in the doctor-patient relationship. “Doctors study this all their lives, so they’re prepared. You as the patient must clarify in your head or on paper the points you want to get across. If you have a clear agenda, you’re more likely to be satisfied.”
Patients must also insist on explanations and speak up if the physician does something offensive. On the other hand, she says, “Don’t expect the impossible from the doctor or blame him for things that are out of his control, like having to wait a long time to be seen.”

– Monika Guttman

Riven Rock
by T.C. Boyle
Viking, $24.95

The newly wed Katherine Dexter – the first female graduate in the sciences of MIT and a leader in the budding Women’s Movement – finds married life quite different than she ever imagined. The groom, who is diagnosed as a schizophrenic sexual maniac, is locked away at Riven Rock, forbidden the company of women. Professor of English T. C. Boyle weaves a tale of a wife who yearns for her husband and visits him yearly, watching him through binoculars as if he were wildlife, hopeful that one day he will be returned to her, sane.

Negrophobia and Reasonable Racism: The Hidden Costs of Being Black in America
by Jody David Armour
New York University Press, $24.95

Jody David Armour, professor in the Law School, writes that race-based mistrust and misunderstanding pose one of the greatest obstacles to racial harmony in contemporary America. As white America comes to grips with the hidden travails of African American life, black citizens still suffer baseless questioning by police and suspicious glances in department stores and at ATM machines, sapping African Ameri-cans of resources, opportunity, time and energy.

Working-Class Hollywood: Silent Film and the Shaping of Class in America
by Steven J. Ross
Princeton University Press, $29.95

The politics of American film and labor history are front and center in this book by professor of history Steven J. Ross. Between 1907 and 1930, makers of films about working men and women clashed with censors, movie industry leaders and federal agencies over the images and subjects that audiences could see. The victors of these battles shaped the meaning of class in 20th-century America. This volume illustrates how silent films helped shape the modern belief that we are a classless nation.
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In Print: Talking to Your Doctor
Photograph by Rick Szczechowski
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