What Doctors and Patients Say Doctor: Tell me about your headaches, Mrs. Jones. Patient: Well, it all started when I was 3 years old. ... Doctor: Yes, yes, that’s fine. How frequent are your headaches? Do you have an aura? Doctor: I see you brought your MRI scan. I’ll show it to you. See, this is the brain, and this is the skull. And see these little white spots? They’re high-signal intensity abnormalities on T2- weighted images that can occur with headache. Patient: Oh.

Any healthcare professional who is going to treat you for chronic headache should also be a person you feel comfortable with. The following are some characteristics that often contribute to a positive doctor-patient relationship. They are essential qualities in a comprehensive headache clinic. You have a right to expect such characteristics in the person to whom you are entrusting so much.

Accurate and open communication is the beginning of good medical care. This is especially true for headache patients, because a correct diagnosis depends almost entirely on information the patient gives the doctor. Unfortunately, both doctors and patients can fail to express their thoughts clearly and accurately. Doctors may not clearly explain their diagnosis and treatment recommendations. Patients may not clearly express their fears and concerns about their headaches. Patients may also be so anxious that they don’t hear or understand what their doctor is telling them. Doctors often complain that they simply don’t have enough time to deal with all of the questions many patients ask. Unfortunately, patients may react by thinking that their doctors are ignoring their needs and concerns. Often, what doctors say is very different from what patients hear. For example, a doctor trying to reassure a patient that her headaches aren’t caused by a serious problem might say, “You don’t have any serious medical problems.” In response, the patient might think, “Oh no! Everybody thinks I’m faking my headaches. I can’t even find a doctor who takes me seriously.” Or, if the doctor explains that migraine is a condition caused by abnormal blood vessels in the brain, the patient might think, “Oh no! My uncle died of a burst blood vessel in the brain.” There is even a difference between what patients want most from their doctors and what doctors think patients want from them. A study has shown that what patients want most from their doctors is a willingness to answer questions and a willingness to teach them about their treatment. On the other hand, doctors think that what matters most to their patients is headache expertise and understanding and compassion. Both you and your doctor need to communicate clearly to effectively treat your headaches. Here are some simple steps you can take to improve your communication skills so your concerns are expressed and your needs are met.

In this article, we interviewed Richard B. Lipton, MD, MPH, Professor and Vice Chair of Neurology at the Albert Einstein College of Medicine, Director of the Montefiore Headache Center, NY, and co-researcher of the American Migraine Communication Study (AMCS), to determine what migraine patients can do to make their visits with healthcare professionals (HCPs) as productive as possible. Q. At your headache clinic, how do you and your staff prepare for an initial visit with new migraine patients?