If you have a medical problem, the doctor needs to listen to you or you might leave the doctor's office without ever having discussed the problem. A missed problem might get worse, needlessly.

Assuming the problem does at least get discussed, in order to make a diagnoses of what is wrong with you, the doctor needs to listen to find out what you are feeling, when it happens, when it started, things that have happened to you that might have caused it, personal and family situations that might be contributing to it, whether you have had similar problems before, and many other facts that only you can report.

Some doctors are much better than others at listening and drawing this information out from patients-making patients comfortable talking, picking up on subtle signals from patients, pursuing clues to what might be wrong. Other doctors might cut off patients or jump to conclusions before they have important information.

Doctors who don't get all the important information they can from patients might turn too soon to lab tests and other procedures to make a diagnosis. Such procedures often are not as good as listening to a patient for discovering what is wrong. And such procedures often expose patients to discomfort, inconvenience, and risk; sometimes give false results leading to other unnecessary procedures; and are often expensive.

Listening to you is important not only for making the right diagnosis but also for ensuring that you know what you need to do for your treatment. If the doctor has told you to take medicine or see a specialist or take some other steps to treat a problem, it is useful for the doctor to ask you to review your understanding of what you will be doing; that requires you to talk and the doctor to listen.

Even if you don't have an immediate medical complaint, listening is important for a doctor to be able to work with you on plans to help you remain healthy. If you need more exercise, for example, the doctor needs to know about obstacles that stand in the way of getting such exercise such as pain, time constraints, maybe just laziness-so that the doctor might suggest community resources, enjoyable or quick exercise options, ways to avoid exercise-caused pain, and other ways to make more exercise more likely.

In addition, having your doctor listen carefully to you is important if you want to have some control over what is done to you. Very often there are various different ways to deal with a medical problem. Some options might include surgery or other procedures. Other options might include drugs, with various choices of drugs. Others might be changes in diet or exercise. Sometimes an option is just to wait and see whether a problem you have gets better on its own. And there is always the option of simply doing nothing and living with a medical problem. All of these options might differ in likelihood of success, pain, inconvenience, speed of recovery, consistency with your religious beliefs or self-image, after-effects, cost, and many other aspects of your life. For you to make the choice that is best for you a doctor needs to explain the options to you; listen to your questions; and listen to your preferences.

It is not enough for doctors to listen. They must also explain things.

If you need to take medicine, change your diet, do certain exercises or stretches, have regular tests, have certain procedures done, see a specialist, come back for another visit, or do any of various other things to improve your health, it is essential that your doctor explain what is needed clearly enough that you know what to do, and explain why so you will be motivated to do it. Many medical problems are not properly treated because patients don't do their part. All too often this is because patients just don't take responsibility. But often it is because doctors don't explain things.

If things aren't explained well, you might not do what is needed, causing you to get sicker or take longer to get better. You might even do the wrong thing-for example, taking medications that interact dangerously.

The doctor needs to listen and observe to determine what each patient is capable of understanding. Then the doctor needs to explain things in a way that makes sense to the patient. To help with these explanations, many doctors have diagrams and models, printed materials and checklists, arrangements for nurses or others to do follow-ups, and other devices to make sure patients understand and remember.

Explaining things is important not only to help you adhere to the plan but also to enable you to be sure the plan is what you would want. All too often, doctors select procedures or other treatments for a patient without knowing whether the selection is what the patient would choose if the patient knew about other options. As noted above, good doctors listen to patients' preferences. But listening is not enough. To form a preference, a patient needs information. Doctors need to explain choices and the pros and cons of each. For some patients, the explanation can include detailed information on the scientific evidence about the effectiveness of each possible test or treatment; for others who don't want or can't understand such information, the choices need to be explained more simply. More and more in the health care field, there are booklets, videos, support groups, Internet-based decision tools, and other resources doctors can use to help explain options to patients. Doctors who use these resources should get credit for explaining things.

Other questions on the survey also relate to how much a doctor helps your health. For example, whether your doctor is familiar with your medical history is important for the accuracy of diagnoses and to avoid wasteful use of tests and treatments that have already proven to be ineffective. Similarly, being able to get an appointment when you need care right away might be important to relieving your discomfort and anxiety, and might prevent a medical problem from progressing to become much more serious. The same is true of being able to get an answer to medical questions promptly by phone.