Scalpel’s Edge

Healthcare is not a battle

// January 30th, 2009 // 4 Comments » // Health

This article is part of a patient education series that I previously published elsewhere. Explanation is here. If you have already read this article, please accept my apologies.

I’m sick of the fighting

Healthcare doesn’t have to be oppositional. In fact, a doctor and patient should be acting as partners to reach a common goal. Although I am sure it will be unpopular, I have to say some of this is about patients behaving like a customer.

Some doctors have issues with patients who stand up for themselves, demand to be understood, or who ask lots of questions. However, your health is more important than any consumer product you might buy. If you would jump up and down to get your entitlements when your iPod breaks, you should be doing it about your health. But a better analogy is your prized vintage car. You choose a trusted mechanic, and you make sure you understand what is going on. You take control. If you feel in control of your health, your relationship with your doctor will benefit.

It’s all about the relationship

Problems in healthcare occur when the patient or doctor (or both) don’t understand what is going on.

Being a patient is sometimes difficult, humbling and embarrassing. However, dealing with doctors can be easier, if you are a smart consumer. You can improve your healthcare, and get more out of your experience, by using smart strategies.

There is a lot of information available on the internet on “How to Be a Good Patient”. The articles seem eerily similar - health-care providers giving patient’s tips on how to behave in an appropriate manner. This advice seems, to me, more about the provider than the patient, “Behave like this and I will find you easier to deal with and therefore have more energy to sort out your problem.”

But the answer is more simple. Create a relationship with your health. Work to understand what is going on. Find a useful doctor, who you can trust. Even when you are healthy, this can help smooth out the bumps of illness. For example, if you lost a prescription, you’re working uphill to get it replaced by a doctor on holiday, but it is much easier with someone who has met you before.

What about the doctors?

In my experience, doctors sabotage healthcare relationships, too. Usually, it is not intentional, but tiredness, unrelated stress, frustrating patients and staff conflict can make us into poor communicators. A short consultation seems even shorter, and less satisfying with a grumpy doc. It’s a trite comparison, but I behave this way with my kids when I am stressed and tired, as well. I know what I should be doing and saying, but I just can’t manage it.

What’s the solution?

I am no expert on this. I don’t have great answers. But I think part of the process is recognising the difference between the doctors/patients we should and want to be, and the way we actually are. Once we find real relationships in healthcare, then it becomes easier to cut through the daily static. Once we make connections, we can approach success.

Why is a good primary care doctor important?

// January 16th, 2009 // 1 Comment » // Health

This article is part of a patient education series that I previously published elsewhere. Explanation is here. If you have already read this article, please accept my apologies.

Everyone needs a general practitioner or primary care physician, and most have trouble finding the one that is right for them. Many patients I speak to “make do” with their primary care doctor, and that is a huge mistake.

Why is the “right” general practitioner important

Your body will travel through life with you and you will be together right at the end.

It will break down and you will get ill multiple times. How well you keep it maintained is vital. If you have a poorly maintained body, you will either have a shorter life, or a more uncomfortable one. Maintenance is all about having a good relationship with a primary care doctor. It won’t make you never get sick, but you will be more likely to recover faster, be more productive and be more able to enjoy your life.

It sounds a bit washy, so here is a real life example.

A friend of mine, who we will call Sarah, got ill with pneumonia. She had a great general practitioner who she saw promptly. Sarah was treated well and continued to get better. She trusted her doctor, and didn’t want to let him down, so she went for her follow-up appointment, even though she was feeling much better. The general practitioner used that appointment to review the illness and figured out that the type of pneumonia was a bit odd for someone of Sarah’s age and general health. So he did some more tests, which showed up a very early uncommon blood cancer. That was able to be treated before causing any other symptoms (except this unusual infection). So Sarah is not cured, but is still happy and functions well, many years longer than she was expected to.

Having the right doctor means:

• You will be more likely to go to the doctor when you are feeling a bit under the weather.
• Your doctor will be able to pick up on earlier symptoms, and diagnose things faster.
• Faster diagnosis means faster recovery. Faster return to work. All those good things.
• You will be more likely to attend for results and follow-up, which is important to look after your long term health.
  
• When you visit at other times, your doctor will be able to look at all of your health, not just the bit that hurts the most.

• Your doctor will be better at referring you to specialist care (if appropriate) as they will know you better, and be able to pick when you are particularly sick, and what specialist would best suit your personality.
• You will be more confident in the decisions they make.
• You will be more confident in asking questions, and know more abut what is going on, and therefore be more in control.
  
• You will become more involved in making your own health decisions.

• You will get better preventative care (of diabetes or hypertension, obesity or heart disease for example) because you will attend over a longer period of time.
• Attending more regularly means a better relationship - you will both get along better. More pleasant way to spend the day.

All of this things will make you a better maintained person. You and your body-mechanic need to have a close relationship, and there needs to be trust for one another. Things won’t get missed, and if you are sick, it will be a much less traumatic experience.

Take responsibility for your history, and become healthier

// December 29th, 2008 // 1 Comment » // Health

This article is part of a patient education series that I previously published elsewhere. Explanation is here. If you have already read this article, please accept my apologies.

We are having a rest here in the Southern Hemisphere. Summer holidays are an excellent time to do some health spring cleaning. I encourage you to take stock of your medical conditions, drugs and risks. This will improve you ability to have a good relationship with your doctor, and better outcomes for yourself.

How should I take stock?

This is the easiest thing in the world, but it will involve a little time. Take a paper and pencil, your favourite word-processor or one of the more technological solutions suggested below, and make three lists.

1. List all your present and past medical conditions

This includes anything you were treated for as a kid (you can leave out colds and flu’s unless they caused a hospital admission), anything you have been in hospital for, or taken long term medication for. Take a highlighter and mark those conditions that you think are still important to your health. For example, if you had a hip replacement 6 years ago, it may not cause you problems now, but you know that it might break down at some point in the future, so you still need to be aware of it.

2. List all the medications you now take

Try to work out for each medication when you are meant to take it, how many you should take and how strong the tablets/injections are. If you can, write out what the medication is for, and what other names it has. Finally, try to make a guess of how regularly you actually take the medication correctly. Remember, you are the only one that is reading this.

3. List all the doctors and health professionals who look after you

Make sure you have their contact details and write down which conditions each of them thinks they help you look after. Write down the next appointments you have with any of them. For each write down when you should make a new appointment. For example; “Make an earlier appointment with Charlie the Physio if I have worse back pain.”

Let these lists bounce around in your head for a little while to make sure they are complete and you haven’t forgotten anything. Now take a good look at your lists.

There are probably some conditions that you are not sure about, and don’t understand. Maybe there are medications you don’t know what they are for, or are forgetting to take. For those medications that you are worst at taking, make sure you know what they are meant to be treating. Check your final list to make sure all the doctors and clinics you see are listed, and you are not due for a new appointment with any of them.

What to do with your Health Audit

Once you have a good handle of all your medical problems and your list of appointment details are up to date, then find somewhere to keep that information. You might choose an old-fashioned folder in your deskdrawer, or keep the information electonrically on your computer (consider putting a password on it, in case someone steals your computer).

Another solution would be to use an online health managemnet service like Google Health, HealthVault or Revolution Health. These collate all your health information together into one archive that you can access with your web browser.

Review your information regularly

The most important next step is to make a recurring calender appointment, every month, that reminds you to update your file. This will mean you can simply grab your folder, or printout if you need to head out to a new doctor, and trust that you have everything you need.

If you have a printable or paper version, tuck it in the corner of your purse and keep it with you. This improves the care that you get - both in preventative medicine and any emergencies that occur.

I have seen this system in use and it works wonderfully. It wasn’t initiated by me, but my obstetrician when I was pregnant with my children. At the end of each office consultation, she would print out a summary of all the tests results, philosophical discussions and medications that were relevant. When I arrived for my deliveries in a state of panic and disarray, I handed the most recent print out to her, and she knew everything she needed to. It would have been the same if we ended up in a strange hospital or if her computer battery failed. It was the perfect solution to reduce my stress, and make her job easier.

Try your health audit today. Make sure there are no chinks in your knowledge and you will reap the health rewards.