By Dr. Trisha Pasricha
Special to The Washington Post

Q: I feel so rushed during my doctor’s appointments. There’s hardly any time for my doctor to get to know me or to address what concerns me the most. What can I do with these hurried 15-minute visits?

A: Many patients lament how hurried their doctors’ appointments feel. Believe me, I get it. Because as a doctor, I hate it, too.

In many cases, 15 minutes isn’t enough time for physicians to get all the information they need. Many doctors end up running abysmally late trying to ensure the 20 or so patients squished into their daily schedules feel heard and get the time they deserve.

Patients are suffering and frustrated with these crammed appointments, which also are a major driver of physician burnout.

So as a patient, what can you do? If you’ve only got 15 minutes with your doctor, here are a few tips to help you get the most out of the brief visit.

Weave in a quick fun fact about yourself

I know this may sound odd when we’re talking about a lack of time. Consider the psychology of the physician here for a moment: Imagine you’re seeing your 11th patient of the day. It’s flu season, and everyone’s masked and hard to recognize. Tales of diabetes and high blood pressure are starting to blur together. You haven’t eaten anything since that stale granola bar during your morning commute.

And then … a revelation: A patient tells you out of the blue that they used to fly airplanes for the army. Or that their teenage granddaughter is teaching them how to ski for the first time. Or that they took up yarn-crafting during the pandemic and just finished a magnificent, crocheted penguin.

We’re all human. Sometimes, your physician is transformed against their will into a robot. Years ago, we all went into medicine because we wanted to make our patients’ lives better TOP-L-HealthBeat-Hack0126 not fill out paperwork for insurance companies and write lengthy notes that meet billing requirements. These glimpses of the wonderful, unique person you are will remind your doctor that they are treating a person, and not a disease.

Decades of research in the biopsychosocial model of medicine have taught us that patient and physician outcomes are better when we integrate the patient’s story into our care. It takes an extra 15-30 seconds, but I go out of my way to ask new patients to tell me a fun fact about themselves that I make note of with their permission. In doing so, not only do I remember their medical histories better, but we both find it almost invariably brings a tiny, coveted spark of joy.

Lead with your most pressing concern

I like to open my visits by asking patients to tell me one thing they absolutely want to make sure is addressed today. Then I dive into other items on our agenda, such as following up on prescriptions or health screening tests.

It’s a classic scenario, and one I’ve experienced time and time again: me reaching for the doorknob at the end of the allotted visit, only to hear that you were saving your most concerning question for last.

Never save the most important thing for last — even if it’s embarrassing or it scares you. By raising your most pressing question first, your doctor will focus more time on what is truly worrying you.

Bring written notes to common questions

For new symptoms, your physician will probably ask a set of predictable questions:

• When did the issue start? It’s fine to just have a ballpark — but there’s big difference between a few weeks and a few years ago.

• What interventions or medications have you already tried? Know the medication names and doses — bring in your bag of pill bottles if it’ll help.

• Has anyone in the family experienced something like this? Call your family members ahead of time and ask about their medical history — it can dramatically change what a doctor decides to do next.

Rehearsing your “story” and gathering these details can help ensure our limited time is spent on diving into specifics, a physical exam and counseling — rather than searching for medication names on your smartphone.

Give A.I. a chance

When was the last time you met a doctor who spent the entire visit looking at you? How many seconds passed before they broke eye contact and began typing frenetically on their computers?

A.I. is starting to be used in many clinics to listen in on the conversation between patient and physician, and automatically create a note in your chart so that your doctor focuses directly on you, rather than the computer screen. You may not have much control over whether your doctor’s clinic offers it (within the next year or two, you can bet it’ll become more and more mainstream), but if it’s on the table, don’t be scared or ask to opt out.

Paradoxically, I think this kind of A.I. may be a step in the right direction to restore some humanity back to the doctor-patient relationship. Remember: A.I. in health care is heavily regulated. These technologies are HIPAA-compliant and are transcribing — not recording — the conversation.

Embrace medical trainees in your visit

If you get your care at a major academic center, there’s a reasonable chance you’ll encounter a trainee — medical students, residents or fellows. This may mean you’ll have to repeat your story multiple times. Once each member of the team has seen you, they’ll gather with the attending physician to come up with a plan.

I realize repeating your story can feel tiresome. But consider these two things: First, studies have shown that doctors are most empathetic when they’re fresh out of medical school. So they may well be the most devoted and sensitive member of your team. Second, when a trainee is involved in your care, you as a patient can actually get a longer appointment time. This means you have a chance to discuss details and worries in a way that may otherwise have felt too rushed with just the attending physician.

You want someone to listen to your whole story. So take advantage of the fact that trainees are dedicated to hearing you and reporting back the best assessment of your case. In my experience, they often become your biggest advocate.

Alex Jensen had noticed that his 14-year-old daughter and 9-year-old son were bickering more often than usual lately. On a recent morning, while father and daughter were on an outing together, the teen turned to her dad and shared her perspective about the dynamic between her parents and brother.

“She said, ‘I’m just so annoyed that you guys always take his side,’” Jensen recalled.

It was the type of accusation that might make many parents feel a reflexive, defensive urge — to immediately say “no, we don’t,” or “that’s not true.” Instead, Jensen said: “OK — how?”

“She said, “Well, every time he’s doing something annoying, you tell me to ‘just ignore him,’ and that really drives me crazy,’” he said.

Jensen was uniquely able to understand the importance of this moment: An associate professor in the school of family life at Brigham Young University, he is the lead author of a recent study, published by the American Psychological Association, that examined parental differential treatment and which children are more likely to receive it. The study found that gender, birth order and a child’s temperament can shape whether a child is favored by their parents.

In Jensen’s family, there was a justifiable explanation for why the siblings were being treated differently — the gap in maturity between a 14-year-old and a 9-year-old, which his daughter understood as they talked about it — but the episode illustrates why a child might feel like there is a favored sibling, he said. And the implications of those feelings can be significant.

The idea of parental favoritism might seem inherently subjective (what do we mean by “favorite,” exactly?) but researchers have developed ways to identify differences in the ways parents treat their children, Jensen said.

“Very few studies are going to approach parents and say, ‘Well, who is your favorite child?’ Parents aren’t going to answer that. They’re going to say, ‘I don’t have one,’” he says. Instead, researchers asked parents for more concrete information: Does a parent experience more conflict with a particular child? With which child does a parent spend more time? Is there a child who typically receives more affection? More financial investment? More help with homework?

Similar questions are also posed to children, he said: “We’d ask the kids: ‘Compared to your sibling, who does your parent spend more time with?’”

The findings of the study indicated some clear and consistent patterns: Daughters tend to be favored by parents — according to parents themselves; children didn’t report that same pattern from their perspective, Jensen said.

“That one was surprising,” he said. “There are a couple of older studies that suggested that fathers are going to favor sons, and mothers are going to favor daughters, so that’s what we were expecting to find — but it turns out fathers favor daughters, too.”

There also were some benefits to being an older child, the study found: “Older siblings were given more freedom and more autonomy,” Jensen said. At first glance, that might seem intuitive; older children are typically more mature and responsible. “But we’re also looking to see if there’s a change between childhood, teen years, adulthood, and we found it doesn’t matter,” he said. “Even as adults, parents still give more freedom to their older kids.”

More predictably, the study also found that certain personality traits are linked to favored treatment: Children who were agreeable (“a kid who is compliant, where a parent asks them to do something and they’re more likely to do it,” Jensen said) and conscientious (“kids who are more aware and more responsible,” he said) also tend to be favored by parents.

The study, a meta-analysis of existing research, included 30 studies as well as 14 unpublished datasets about parental differential treatment, Jensen noted, representing more than 19,000 participants from across North America and Western Europe.

This information is important, Jensen noted, because “there are decades of research showing that the kids who tend to get the less-favored treatment tend to have poorer outcomes.” They are more likely to be depressed or anxious, he said, and more likely to get in trouble at school or engage in substance use as teens. “One study suggested they are less likely to go to college, and less satisfied with their life as adults,” he said. For the children who are favored, the reverse is true, he noted: Research shows that they have better mental health, less trouble at school and are more likely to go to college.

By identifying the children most likely to experience these effects, Jensen’s findings might be of particular value to therapists, social workers or clinicians who support families, said Megan Gilligan, an associate professor in the department of human development and family science at the University of Missouri who has studied sibling relationships. Parental differential treatment not only shapes the bond between parent and child, she said, but between siblings, as well.

“We sometimes forget about the sibling relationship, or we make assumptions about it, but being aware of those sibling dynamics and how they play a role is important,” she said.

The sibling relationship is especially salient in adolescence, she said, and research has shown that those childhood dynamics “do set the stage for later life”: If parental differential treatment affects the sibling bond, the impact can carry through into their adult relationship.

But it’s also important to recognize that some degree of parental favoritism is far more widespread than we might want to admit, she said.

“For the families experiencing this, it feels really personal, and it feels unique to their individual family,” Gilligan said: “But it’s happening in most families. We’ve been able to document it from early childhood all the way to when folks are into their 60s, and still perceive differential treatment or favoritism from parents. It’s not just something that happens when we’re kids.” If more people understand that this phenomenon is common, she says, it might help them feel more able to acknowledge the family dynamics in their own households. “It might help them feel less defensive,” she said.

Jensen echoed that notion. “Every parent is going to treat their kids differently, so parents shouldn’t take a study like this and say: ‘Oh, shoot, I treat my kids differently, I’ve messed up.’ I don’t want parents to have that takeaway — but rather, just recognize that sometimes differences in treatment can be problematic.”

If parents take an opportunity to reflect honestly on how they interact with their children, he said, it can help make those dynamics feel more comfortable to everyone involved.

“There are some studies that suggest that two things need to happen: One, the differences in treatment need to be legitimate” — for instance, he said, a parent might need to spend more time with a sibling who requires extra academic support or has special medical needs — “and the siblings need to understand that. So even if you feel it’s legitimate, if the kids don’t understand that and don’t buy into that, it could still have these negative effects.”

But if a child does understand why a parent might need to focus more on a sibling, those negative impacts are mitigated, Jensen said. “So parents should start there: ‘Why do I treat my kids differently? Is there something legitimate about that?’”

If there’s an uptick in conflicts between siblings, or if a child says outright that they think something is unfair, “then I think as a parent, you need to be willing to listen to why they feel that way,” he says. “Not just saying, ‘hey, you’re wrong, this is OK because of X, Y and Z — but actually be open to having conversations with your kids about this.”

One thing he definitely doesn’t want, Jensen said, is for his study to add another layer of parental guilt.

“I’ve had this conversation with hundreds, maybe thousands of people, with friends and family and parents and students, and I get this sense that a lot of parents end up feeling really guilty. I don’t have a solution for that, really, but — guilt doesn’t do good things in families,” he said. “We all make mistakes as parents. So, focus on improvement, but try to leave the guilt behind.”

Mark Niquette, The Washington Post

President Donald Trump spoke Tuesday before a joint session of Congress to outline his vision for a second term that started only six weeks ago and has already resulted in an upheaval of the federal workforce, disintegration of relationships with allies and a trade war.

With his party controlling both chambers of Congress and Democrats largely on the sidelines and divided in their approach, Trump is poised to drive home his agenda of tariffs, tax breaks and spending cuts. Earlier Tuesday, his administration slapped 25% levies on goods from Mexico and Canada and layered another 10% duty on China on top of an identical hike a month before.

Here are the president’s key economic statements from the address, fact-checked and contextualized.

EGG PRICES

TRUMP: “Joe Biden especially let the price of eggs get out of control. The egg price is out of control. And we are working hard to get it back down.”

FACT CHECK: This needs context. While the cost of eggs rose under the former Democratic president and has become a symbol of high prices, interest rates and other economic woes, it’s largely due to the outbreak of avian flu.

Millions of birds have been killed just since December as the outbreak hit egg-laying farms from Iowa to California to North Carolina, prompting grocery stores to limit purchases and restaurants to add surcharges. A dozen large white eggs in the US reached a record of over $8 in February, from $2.97 a year ago, according to the benchmark indicator from price-reporting service Expana.

INFLATION

TRUMP: “We suffered the worst inflation in 48 years, but perhaps even in the history of our country – they’re not sure.”

FACT CHECK: This is false. The cumulative increase in consumer prices during Biden’s term was higher than any other president in the past 40 years, not of all time.

And Trump’s policies – including pumping in $3.5 trillion for stimulus checks and other pandemic relief – and supply chain constraints when the US roared back to life also played an important part in annual US inflation hitting a 40-year high of 9.1% in June 2022 before falling to 2.7% in November when Trump was elected. It was 3% in January.

TARIFFS

TRUMP: “We will take in trillions and trillions of dollars and create jobs like we have never seen before,” Trump said of his tariff plans.

FACT CHECK: This needs context. While tariffs do generate revenue for the US, China and other foreign nations aren’t paying them. US importers are responsible for the duties, and ultimately US businesses and consumers pay through higher costs.

One academic study in 2019 concluded that consumers and US companies paid most of the costs of Trump’s tariffs in his first administration, and that after factoring in the retaliation, the main victims of the trade wars were farmers and blue-collar workers in areas that supported Trump in 2016.

TRUMP: “Tariffs are about making America rich again and making America great again and it will happen rather quickly. There’ll be a little disturbance, but we’re OK with that. It won’t be much.”

FACT CHECK: This needs context. Trump also sees tariffs as a way to help pay for the $4.5 trillion in expiring 2017 tax cuts and even replace the $2 trillion the US government raised in individual and corporate income taxes. But since the Second World War, tariffs have never generated much more than 2% of total federal revenue, according to a Congressional Research Service report published in January. And even a US tariff rate approaching 50% would only result in $780 billion in revenue and harm economic growth, economists at the Peterson Institute for International Economics calculated last year.

Consumers and companies are worried. A Harris Poll taken for Bloomberg News found that almost 60% of US adults expect Trump’s tariffs will lead to higher prices, and that 44% believe the levies are likely to be bad for the US economy. Tariffs also have come up a record 700 times during quarterly earnings calls for S&P 500 companies, according to a Bloomberg News analysis of transcripts.

Indeed, the tariffs that Trump has already imposed on China, Canada and Mexico would cost the typical US family more than $1,200 per year, the Peterson Institute said.

AUTO INDUSTRY

TRUMP: “We’re going to have growth in the auto industry like nobody’s ever seen,” Trump said, adding that he’d spoken with excited car executives. He also claimed new plants are being built.

FACT CHECK: This needs context. The CEO of Ford Motor Co. has warned taxing imports from Canada and Mexico will “blow a hole” in the US auto industry, while Jeep maker Stellantis NV has said Trump’s levies will put the company at a disadvantage versus overseas competitors. The cost to build a crossover utility vehicle will rise by at least $4,000, while the increase would be three times that for an electric vehicle, according to a new study from Anderson Economic Group.

Japanese automaker Honda Motor Co. denied making any announcement about expanding its presence in Indiana, where Trump suggested the company was building a new factory. Honda already has been manufacturing Civics at a plant between Indianapolis and Cincinnati since 2008.

IMMIGRATION

TRUMP: “Over the past four years, 21 million people poured into the country. Many of them were murderers, human traffickers, gang members, and other criminals.”

FACT CHECK: This is false. There’s no evidence other nations were sending their prisoners and mental patients to the US to join the migrants, many fleeing violence and poverty. Trump has specifically cited 13,000 murderers allowed in the country based on US Immigration and Customs Enforcement data released during the campaign.

That included 13,099 people who were found guilty of homicide and hundreds of thousands of convicted criminals. But those numbers span decades, including during Trump’s first administration.

Trump and Republicans also accuse migrants of being responsible for crime. But study after study has shown that undocumented immigrants commit fewer crimes compared to other immigrants – and even fewer compared to US-born citizens.

Gabrielle Coppola contributed to this report.