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Speak up!

BMJ 2003; 327 doi: (Published 07 August 2003) Cite this as: BMJ 2003;327:303
  1. Andrew Ellner (, assistant medical editor,
  2. Amanda Hoey (, consultant editor,
  3. Lawrence E Frisch (, John S and Doris M Andrews associate professor
  1. BMJ Knowledge, London WC1H 9JR
  2. Northeast Ohio Universities College of Medicine, PO Box 95, Rootstown, OH 44272-0095, USA

    Can patients get better at working with their doctors?

    A mother brings her daughter to the general practitioner with a chest cold. She is mainly seeking reassurance that the infection will go by itself. She hopes to avoid antibiotics unless they are absolutely necessary. Her general practitioner assumes she is there for a prescription and so writes one out for amoxicillin. The mother assumes the prescription means that the infection is serious and so keeps her preferences quiet. After the consultation the general practitioner acknowledged suspecting from the mother's body language that she was unhappy about taking a prescription for antibiotics. He admitted they were unnecessary.

    This consultation would have gone so much better, you might say, if the doctor had simply explained what he was thinking. This is true, but the cliché about communication applies even in medicine—it is a two way street. If the mother had said what was on her mind, things might have turned out differently. “Easier said than done,” say patients. This is a guiding assumption behind “Working with your Doctor,” an online course we have designed for patients to complement BestTreatments, the BMJ Publishing Group's website for US patients and doctors.1 The course teaches patients simple things to do before, during, and after a visit to their doctor to help them get what they want from the …

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