Does it sometimes seem as though your doctor is repeating himself?
It may not be your imagination. It's quite common that your doctor tells you something you've heard before. It can be annoying.
When I asked a friend if he's seen his doctor lately, his reply wasn't what I expected:
"I think I'll skip the annual visit this year. My doctor always says the same thing: Eat a healthy diet, get more exercise, take my medicines. I already do two out of three - and I don't have time to exercise."
But, there may be good reasons your doctor is (or seems to be) repeating himself.
For many people — especially those who are healthy — routine visits to the doctor may not change much from year to year. You doctor will make recommendations based on your age, gender and any health concerns you or your doctor have.
And while they may get "old" to you, your doctor's suggestions will continue to focus on a healthy diet, physical activity and taking care of any ongoing health problems — as long as your health status doesn't change.
In many ways, a visit to the doctor is a learning opportunity. You will learn about the status of your health (for example, measures of blood pressure and cholesterol) and ways you can maintain or improve your health. But, as any teacher will tell you, it can be quite helpful to read or hear something more than once. And that's especially true if things aren't moving in the right direction. If you are a smoker, you can expect your doctor to talk about the importance of quitting — again and again.
Another useful teaching technique is to repeat information in a different way. For example, if you are overweight and have arthritis in your knees, your doctor may explain that obesity is a risk factor for knee arthritis and that losing weight could be helpful. But, then he or she might tell you how your knees are like your car's shock absorbers; the more people and luggage in your car, the more likely the shocks will wear out due to stress. Some of my patients "zone out" for the initial explanation but "get it" if I can explain in a way that's more relevant to them.
Studies show that people seeing their doctors retain relatively little of what the doctor says. That's one reason we often recommend bringing someone with you to the visit, taking notes or even recording the instructions. But, repeating the information – or asking you to repeat your understanding of what your doctor said – can also be effective.
Things Change Over Time
Did you ever wonder why tests are repeated at certain intervals? Doctors recommend mammograms, for example, every 1 to 2 years, even if the results are normal. To screen for colon cancer, doctors usually recommend a colonoscopy at least every 10 years. Repeating a test can detect abnormalities that have developed over time. Research studies can compare different time intervals between tests to find what's optimal. This helps avoid over testing or under testing.
The Value of Repeating a Test
A case I remember well from my training years involved an older woman with enlarged lymph nodes all over the body. She had previously had one of them removed and analyzed, but the results were inconclusive. After reviewing the prior test results, we recommended removing another lymph node. This time, it showed lymphoma, a type of cancer that commonly invades lymph nodes; in her case, it was highly treatable. The first biopsy missed it. Without retesting, her diagnosis and treatment would have been delayed.
It can be hard to understand what your doctor is saying. If that's the case, let your doctor know. And if you aren't sure why she is repeating herself, ask for an explanation. You can return the favor: repeat your questions as long as it takes to understand what your doctor is saying.
Robert H. Shmerling, M.D., is associate physician at Beth Israel Deaconess Medical Center and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years at Beth Israel Deaconess Medical Center. He is an active teacher in the Internal Medicine Residency Program, serving as the Robinson Firm Chief. He is also a teacher in the Rheumatology Fellowship Program.
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