Working with your health care team

When you have a complex condition like chronic pain, you need good relationships with your doctor and the rest of your health care team.

This is especially true when you are going to make changes in your health care, like stopping long-term opioids. Research shows that the quality of the relationship between patient and provider can affect a patient’s health outcomes, both positively and negatively.

In our research, we interviewed 101 people who have chronic pain. We learned that some of the most important things people with chronic pain need from their health care providers are:

Hearing and believing the patient’s story
Understanding the impact of pain on the patient’s life
Customizing care to the patient

The goal of this module is to share some strategies you can use to have better conversations with your doctor and others on your health care team. This will help you get the information you need to make choices about how best to manage your pain.

In this module we will say “doctor” since most people get their opioid prescriptions from a doctor. But the information in this module also applies to conversations you may have with others on your care team, including clinical pharmacists, physical therapists, counselors, and others.

Check Your Understanding

Here are a few questions for you to try answering. You won’t be graded on your answers. These are just for you to see what you already know about this topic.

Learn/Refresh

Here are some strategies you can use to have better conversations with your doctor and others on your health care team.

Speak up (advocate) for yourself

1

Be a partner in the relationship.

It can be helpful to think of your relationship with your doctor as a partnership. Their role in the partnership is to share their professional knowledge. Your role is to share what’s going on with you and your body, what your goals are, and what your values are — the beliefs, preferences, and priorities that shape your decisions. Sharing this information with your doctor can help you get the most out of their professional knowledge.

2

Ask questions.

Health care visits can feel intimidating — for example, if your doctor uses words you don’t understand. But it’s important to remember that this is your health care! You are allowed to ask questions. You can interrupt if you need to. You can ask your doctor to explain something in words you understand. You can also ask about other options for managing your pain.

3

Bring someone with you to the appointment.

It can be helpful to have a trusted friend or family member come to an appointment with you to support you and advocate for you, ask questions, and speak to your needs and goals. This person can also help you remember what your doctor said.

4

Decide if you want to continue a relationship.

If you aren’t happy with your doctor, ask yourself: do they offer something you really need and can’t get anywhere else, like a special expertise? If yes, work to improve the relationship with the ideas in this module. If no, you may want to find a different doctor.

Gloria, age 77, back and neck pain

William, age 75, osteoarthritis

“My daughter and I were discussing that, and I said ‘You helped me learn to ask questions.’ She said ‘It’s our generations.’ She doesn’t know what I went through as far as education, but she goes ‘We had computers, we have cell phones, we can Google information.’ That generation is farther ahead than what we were taught, which is like you do what you’ve been told, no questions asked. You weren't allowed to ask your parents, you weren’t allowed to ask your doctors.”

“[My doctor] talked to me all the time, she knew what was going on, and she knew how she could help me, and it was comfortable to have somebody to talk to that really seemed to care and really knew what [I was] going through. She was able to tell [me] what might help, what wouldn’t help, and that was great. I hope they do that with more people because I think that it is the way to go, instead of cutting people off.”

2) Prepare for appointments

Health care visits are short and can feel rushed. It can be helpful to take some time ahead of each visit to write out the main things you want to talk about, so you don’t forget to share important information or ask questions. The American Chronic Pain Association has a tool you can use to prepare for appointments. You can also use the “Telling your story” exercise from Module 2 to help you decide what’s most important to talk about in visits.

It can be hard to tell your story and know that you’ve been heard when you only have 5 to 10 minutes with your doctor. But most patients who take opioids for chronic pain are required to visit their doctor regularly. If this is true for you, you can tell your doctor about the things that are important to you over time, in more than one visit.

Linda, age 45, back pain

“I know everybody is busy, everybody’s shorthanded, and I don’t think doctors and medical people have the time that maybe they would like to spend with patients either. It’s a challenging situation for everybody and I’m not blaming them, but the system doesn’t make that time allowance to have those conversations.”

Letty, age 45, rheumatoid arthritis

“It was good. They would do the drug screening and stuff like that, to make sure I wasn’t doing anything bad, that I had the opioids in my system. I regularly see my rheumatologist every 3 months, so we would have conversations.

3) Educate yourself

Understanding chronic pain can help you:

Know what's most important to tell your doctor and what questions to ask
Speak up for yourself and your experience of pain — for example, if your doctor talks about pain in a way that suggests it is all in your head. It's true that chronic pain involves the brain and nervous system and is impacted by things like stress. But that does not make it less real and some doctors may not know how to explain this to patients well. Understanding it for yourself can help you feel empowered when talking with a doctor.

Understanding your treatment options can help you:

Have better conversations with your doctor about your choices — like when and how to reduce opioids and start other treatments.

Finding Your Path has lots of information about chronic pain (Module 2) and treatment options (Module 5.)

Reflect

This exercise will ask you to think about conversations you’ve had with your doctor and whether you might want to do anything differently at your next doctor visit.

Click here to download the exercise worksheet

After you complete the exercise, think about ways you might want to prepare for your next visit. For example, you might want to use some of the strategies in this module, like speaking up (advocating) for yourself, preparing for appointments, or educating yourself.