Transcription:
Developing a Relationship with your GI Doctor

Scott Webb: Gastrointestinal issues can be very personal and sometimes embarrassing, and developing an honest relationship with your gastroenterologist is one of the keys to overcoming these feelings. And I'm joined today by Dr. Jennifer Nayor. She's a gastroenterologist with Concord Gastroenterology Associates, and she's going to take us through the process of developing a relationship with our GI doctors.

This is the Health Works Here podcast for Emerson Hospital. I'm Scott Webb. Dr. Nayor, thanks so much for your time. Today, we're going to go through the steps in developing a relationship with a gastroenterologist, which you are. So how often do patients typically see their GI doctors each year?

Dr. Jennifer Nayor: So it's variable. So it depends on the condition that they're coming to see me for. So if I have a patient who comes to see me with an acute issue, something like diarrhea or vomiting, and we start a workup, I sometimes will see that patient back in a week or a month to follow up on their symptoms and follow up on the testing results and see if the treatments that I've recommended are helping.

There are other patients that I see for more chronic conditions, for example, inflammatory bowel disease, like Crohn's disease or ulcerative colitis, or things like acid reflux or Barrett's esophagus. Those patients I see somewhat less frequently if they are in the stage of the disease where things are well-controlled. But it's important that we keep up that relationship so that I can continue to monitor their symptoms over time.

Scott Webb: Yeah, definitely. And it sounds like it varies depending on the patient and conditions and what you're dealing with. And, doctor, I don't want to be treated as a condition or a number as nobody really would want to be treated that way. I want to be treated as a person. So how can I create a productive relationship with my gastroenterologist to achieve this?

Dr. Jennifer Nayor: I think a lot of people have that concern. Everyone wants to be treated as a person and people are individuals and they're unique. And it's important to foster that relationship with your doctor. Personally on my side, on the physician side of things, I try to learn about my patients, not just as their medical conditions, but in the social context of what's going on in their lives. So I like to ask patients about their families, about their jobs, about things that are going on outside of the clinic visit because it helps me understand their condition and how I can best treat them.

And I think that's true on the patient side as well. So I think it's nice when patients come into my office and they ask me about me. See, I'm not just a doctor. I have a family, I have interests outside of the office. So I think it's good to know who your doctor is. I have a lot of patients who will Google me before coming in, so they know what's found on the internet about me before they arrive. And I think that's a fine, that information is out there. But I think it's good to talk to your doctor on a personal level and not just a patient-doctor level. Of course, you don't want to get too intimate with your doctor, but I think it's good to have conversations and tell them what's going on in your life.

Scott Webb: Yeah, of course. We all want to be conscious of TMI, if you will, too much information, but I think we all have been there. And if I need to reach my gastroenterologist quickly, can I ask for their cell phone number or another way to get in touch with them quickly?

Dr. Jennifer Nayor: So I think communication with my patients is very important. I think cell phone numbers are not the best way to reach your doctor or reach me or a gastroenterologist. But I think there are a lot of ways that patients can quickly get in touch with their gastroenterologist. So I know, for example, my office staff is fantastic, so when a patient calls, I get a message right away. And if it's something urgent, my office staff will let me know very quickly. So just a phone call can sometimes be a great way to reach your doctor,

In other practices, a phone call is not a great way. So a lot of medical centers have set up patient portals where you can send an email or a question through a portal so that they can get that question answered. I think portal messages are also really good because sometimes when I call patients back, they might not be available right at that moment. But an email is an easier thing to check and have access to. So I think portal is a great way.

Some gastroenterologists will give their email address. But I think portals are nice because they connect to the medical record. And it's a good way to refresh your memory on patients and connected to their records in the system.

Scott Webb: GI issues can be very personal and sometimes embarrassing. So what if I'm anxious or embarrassed to discuss my symptoms in front of the gastroenterologist?

Dr. Jennifer Nayor: So this question comes up a lot in GI clinics. So GI issues are very personal and they are sometimes embarrassing. One thing is everything that you're feeling is important. So no symptom is insignificant and it's important to discuss all of the symptoms that you're having with your doctor. That's why you're going to see the doctor. And sometimes it's those little details, even if they're an embarrassing little detail, can help me figure out what's going on with my patients. So one is, don’t be embarrassed and don't hold back on symptoms because it's somewhat embarrassing to talk about.

In terms of anxiety coming in to see a gastroenterologist, I have a lot of patients that come in very anxious to talk about their symptoms. And what I remind them when they come into clinic is I see gastroenterology patients all day long. So I hear about poops and farts and burps and all of that stuff all day long. And I don't think patients should be embarrassed about it because that's my job. That's what I'm here to do, is to help with those symptoms. So I think you don't need to find exactly the right words or some patients are worried about describing their symptoms in exactly the right way. For me, what's most important is if patients tell me how they're feeling, and then I can use that and figure out what's going on.

Scott Webb: So, doctor, what are your top tips for new patients to ease the experience of going to the gastroenterologist?

Dr. Jennifer Nayor: I think it's helpful when patients think about what questions they have before they come to see me in the office. And I think that also helps with some of the anxiety. So really, I have a lot of patients who come or some patients that come and they write down what their symptoms are. They write down what their questions are. And I think that really helps them get the most out of their visit with me.

Some patients come and their primary care doctor has sent them and they don't know specifically, what they're supposed to ask. But everyone has questions and there's never a bad question. And my job as a gastroenterologist is to help answer those questions. And just thinking about it in your mind before coming into the visit, I think really helps the visit go more smoothly. And I do think it helps ease some of the anxiety of coming into the office.

Scott Webb: And doctor, I wanted to ask you about COVID-19. And during this time, have you been doing telehealth, televisits, video visits? How has that been going? How has it affected you and your practice? And how's that in terms of building that relationship between you and your patients? How's that going?

Dr. Jennifer Nayor: So I am doing both in-office visits and virtual telehealth visits. I try to do my virtual telehealth visits on the Doxy.me platform. So it's a video chat so I can see the patients. They can see me, especially for first time visits. I think it's really helpful when I can see a patient face to face. But I also will do some telephone visits here and there for patients who don't have access to a computer with video capabilities.

I think that telehealth visits are great. I think that, one, they're convenient. I think that asking a patient to take off half a day from work to come into the office for 15 to 20-minute visits, sometimes it's a lot. We're asking patients to do a lot and it leads to patients not wanting to come in to their doctor. So I've found that in terms of developing a relationship with my patients, it's actually really helpful to have the option of doing telehealth because I can see them in a more convenient way, more easily than prior to telehealth being so widely spread in the world of COVID.

The other thing about a telehealth visit is that there are some conditions that I see patients for where the physical exam doesn't always change my thought process for the patient. And there are some conditions where, you know, doing a physical exam, for example, abdominal pain, it is helpful to press on their belly and see what's going on. But for other conditions like acid reflux, there's not much that I'm seeing on a physical exam. It's really more how the patient is describing their symptoms that affects my decision-making for them.

So there are certain conditions that are better for telehealth and others that aren't. But in general, I've had a very positive experience with doing telehealth visits with my patients.

Scott Webb: Doctor, as we wrap up here, anything else you want to tell people about developing a relationship with their gastroenterologist?

Dr. Jennifer Nayor: I think you should think of your gastroenterologist similar to your primary care doctor and that it's okay to call and ask questions. Patients have a limited time in the office or on a video chat talking with their gastroenterologist and sometimes all your questions don't get answered and it's okay to call back after a visit and ask another question or if symptoms are getting worse between visits, it's okay to give your doctor a call and kind of update them on your condition.

So I think communication, it goes both ways. I want to make sure that my patients are getting all of their test results, but I also want to make sure that if patients have questions that they're being answered and that they feel heard even when we're not in a clinic visit.

Scott Webb: Yeah. And we all want that. We all want to be heard. And we love doctors like yourself who are listening, who are honest, who are open and want us to be ourselves and just tell you everything that's going on. So, doctor, thanks so much for your time today and you stay well.

Dr. Jennifer Nayor: You too. Thank you.

Scott Webb: Visit EmersonGI.org or call Concord Gastroenterology Associates at (978) 287-3835 for more information or to make an appointment. And thanks for listening to Emerson's Health Works Here podcast. I'm Scott Webb and make sure to catch the next episode by subscribing to the Health Works Here podcast on Apple podcasts, Google podcasts, Spotify, or wherever podcasts can be heard.