At the window with Dementia - Episode 23 "What to look for in a neurologist"

This episode will help you know if the neurologist is a good fit for YOU.  Not all neurologists are the same and this episode will give you some things to consider when you first meet them.

Transcript

So down here in the south, we've been having quite a summer season. It's been unseasonably wet with afternoon storms just about every day, and I was trying to wait until the weather cleared up so I could go ahead and do this podcast. But I started to think. This is reality, this is my day to day life. It doesn't always work out the way we wanted.

So I just say that as a little disclaimer, if you hear a little tap-tap in the background and perhaps the occasional rolling thunder, just what's going on here, guess maybe you could look at that as a metaphor for what might be happening in your life right now. Maybe you're struggling; maybe things aren't working out quite the way that you wanted them to, maybe life is a bit inconvenient, maybe you're facing some difficult situations, perhaps you personally or a loved one is starting to have some memory problems, and the timing isn't good, but you can't change it, and you're wondering what you should do, Where do you turn. Who do you go see to get some clarification?
 
Well, I'll tell you the first step is to start with your primary care doctor or practitioner and tell them what's going on, tell them that you're noticing some changes, a little bit of recall difficulty, having a hard time expressing your thoughts, and it's not just that normal age-related forgetfulness that we know exists, but your fear is that perhaps it might be something more. And you just need a better understanding. So I would start with your primary care doctor, and they may go ahead and refer you to a neurologist. And I think that most people have no idea what a neurologist does. So I want to focus a little bit on what you should be looking for when you go see a neurologist. Should you just accept their credentials? And whatever they say is, or are there things that you really need to evaluate?

Well, I've always been a proponent of being a consumer of every service and product that you buy that you request that you interact with, and this is really no different. Because I will say that when you go to your neurologist, to have either your memory or loved ones memory evaluated, you need to have confidence, you need to trust their judgment and have faith in what they say, and let's, let's be real here, regardless of what degree someone might have, or training they may have gone through. We're still looking at a human. And for all the benefits and all the skillset and wonderful qualities, a person may have, regardless of their credentials, they're human, and there's personality then plays in, and approach, in their style. And this all matters. And what I find is that a lot of people in my profession, in the neurology community shy away from treating people with memory impairment.
 
And I don't know, I suspect there's a lot of reasons, perhaps it's uncomfortable for them because we all entered healthcare to make a difference and to hopefully fix things and turn things around for the betterment of the individual. And some people might actually feel that when it comes to dementia, we know where this is going to end up. And that no matter how much we do. We can't change that, we can't stop it, we can't turn it around, we can't fix it.

But I happen to see it in a different way; I actually think that we can make a difference. Yes, it's true we cannot stop the progression, we can't turn it around. But we certainly can have a significant impact on what the journey looks like. And even after your traditional medications have been prescribed, and are no longer effective. We still offer a lot of benefits. We can hold your hand and take you through this journey and tell you what to anticipate next, and to know that you're not alone is powerful.

But long before you get to that stage, back in the early stages when you're first meeting the neurologist or the neurology provider. What should you look for? Because early on is when you really want to establish that relationship, so that, as things progress, perhaps you can just pick up the phone and say what's going on, and have someone on the other end. Who knows, knows your history or your loved ones' history. And there's been a report developed so that what you hear will make a difference. So again, what should you look for?

Well, the first thing that I would say is, research them. Do your own due diligence, read the reviews, although I will put this out there, most people who are apt to write a review are unhappy. It's rare that you'll find someone taking the time to post a remark about a provider, that is flattering and endorsing. Usually, people want to write things to vocalize a gripe to tell someone how angry they are about something. Sometimes it's well-founded, but honestly, sometimes they're not.

So yes, do your due diligence, and do your research, read reviews, take them with a grain of salt, don't let that alone be the determining factor. Schedule an appointment. And when you go in, and you meet them, see how you feel, see if you're comfortable. See if you feel that there is a gap, you and them, or do you feel that you are both on the same page, and there's a connection, and even though you don't know each other, you feel comfortable. You don't feel judged; you feel free to go ahead and share what you're experiencing or what your loved one is going through.

How is the communication? Is it as if you're on the same level, or do you feel as though you're being talked to at, or even worse, talk down to, because that's not the approach of everyone, it's certainly not my approach.

My approach. I ask a lot of questions. And for the first time that someone meets me, it may seem a bit, a bit invasive. And I do tell them that there's a reason that I asked so many questions because things are not always as they appear. And even though someone comes in and says, I'm having memory problems. That's not an automatic trigger to a diagnosis. There are so many things that can cause memory issues, as I've mentioned in previous podcasts, but again, I really believe that it is a process that you go through with your provider, and if you don't have that feeling of connection or ability to freely express, then that for me would be a red flag.

I think that you need to feel as though, even though you are not the doctor or the provider. You are a vital participant in the process of a diagnosis, and then developing a plan and executing that plan because lets be real, you're the one who is going to be dealing with the situation firsthand in the trenches, finding if the plan works, or if it doesn't.

I think you also need to find out how accessible is your provider. Is it easy to reach out and have a question and get a response? Define that the staff who answers the call is friendly and helpful or off-putting? Because even though the provider is the one you're going to see, we all know that there's a lot of interaction that happens with the office staff. What about frequency of appointments? Well, I'm the first to admit it's hard to get in to see me. And I hate that. But once you're in, is your provider able to make sure that you get appointments with the frequency that is needed. I will be honest; sometimes, patients think that they need to be seen more often than they really do. But do you feel that you're dismissed, that you're just another number just a name on a schedule because that's not acceptable.

Do you feel that your provider is able to educate you because I'm all about knowledge is power. And do you feel that your questions get answered? Do you feel hurried? Do you feel that the terms that are used are explained and is the appointment about you?

Because all of those things are important, you need to know that you have someone you can reach out to that is responsive that understands. And also that has a passion for memory issues. Some people do, and some people don't. And that's okay because they probably have a passion for something else. And that would make them good for that something else type of diagnosis, but not for dementia or cognitive impairment.

So I think you need to trust your gut. You need to know if you feel safe, and you feel welcomed, and you feel understood and be a consumer, ask questions, challenge, and you can challenge in a respectful way. And perhaps you won't see eye to eye but at the end of the discussion. Can you respect their opinion? And if you don't, they're not the right provider. There are many people out there that can help you through the journey of cognitive impairment evaluation in dementia. So be picky. This matters.

This is a very important decision that you're about to make, to enter a relationship with a provider who is going to help you. Who's going to be there for you. Who's going to be able to understand, long after the prescriptions are written. There's a lot that needs to be done, and will they be there for you for those times? That's what I would want. I'd like to believe that's the type of provider I am. I know my own shortcomings.

I think I know my own strengths, but not everyone's going to feel comfortable with me, their personalities are not going to be well suited to receive my type of personality. And that's okay. And if someone wants to go for a second opinion. I always encourage it. Sometimes they come back to me; sometimes they don't. And that's all right. They need to be where they feel that they are best fitted, best suited a good match with the provider, because, unlike many other specialties, neurology is all about questions and dialogue in time and understanding. So you're not unreasonable when you expect that.

So make sure that when you go, and you meet that neurology provider for the first time, go in with an open mind, but trust your gut makes sure that if you don't feel comfortable, perhaps you'll decide to have one more visit. But if you don't feel comfortable a second time, then I'm going to tell you it's probably not the right person for you to be going to. And go back to your primary or whoever made that referral and asked to be sent to someone else. Because again, we're all people, we all have personalities. And not all personalities are good fits for other types of personalities. And that's all right.

So when you have that first meeting, I want you to go in as a consumer as someone who is really feeling as though they are an active participant in the process because I promise you, you will have a much better experience if you can find that type of relationship than if you just went to a place, and you felt as if you were just a name on a schedule.

Anyway, I hope you find that helpful. I know I didn't go into much depth, but I think this is a really important topic, and everyone should feel empowered when they're finding a provider, please feel free to go ahead and subscribe to my podcast, I release new episodes every Tuesday. You can also follow me on my website, which is CompassionateEducation.com. We're making a lot of changes there, so be sure to check back off, and you can also find me on Instagram, my handle,@compassionate_education. 
Thanks so much.