Have you ever wondered how much time you spend with a doctor compared to the time you spend outside the doctor’s office tending to the pills, appointments, injections, and side effects needed to manage your health? It’s hardly a comparison.

While it’s hard to pin down a meaningful average for the time spent in a patient visit, studies indicate that doctors have spent roughly 13 to 24 minutes with patients for at least the past three decades. About 1 in 4 spend less than 12 minutes, and roughly 1 in 10 spend more than 25 minutes. All in all, it seems like doctor-patient time isn’t changing substantially.

My point is that patients with chronic illness spend the vast majority of their time outside the doctor’s office, outside of the medical chart review and outside the influence of therapists, nurses, technicians, and lab reports. Their approach to daily living has an enormous impact on their health.

But there’s a much less subtle impact — the one that comes from the stories we tell ourselves about the illnesses we face that can worsen, or improve, the condition. Even if the facts of your illness or disease aren’t in dispute, what you believe about it differs with each patient.

I shouldn’t have allowed the stress to build up? I should have gotten a flu shot? I can’t imagine walking again. This disease killed my father before he was 50, it will kill me too. I shouldn’t have to wear this contraption to get better.

It’s important to catch yourself when your internal dialogue is awfulizing the situation. Although it’s difficult to remain positive when bad news arrives, turning to a positive thought or outcome will lessen the loss.