Scalpel’s Edge

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.

What to do when doctors go bad

// December 22nd, 2008 // 2 Comments » // Health

When I started blogging, I got excited, and made far too much of a commitment. So now I have some articles that I am proud of stuck on a blog that I no longer update, and is becoming a bit of a spam magnet. So I am taking the opportunity to edit them up an republish them here. I ask the indulgence of those who have already read this.

When doctors act inappropriately, it is alright to complain.

A friend of mine visited a doctor, when she was feeling crook with a cold and had “pinched something” in her back. She was so sick, she agreed to see a new doctor to get a quick appointement. The doctor seemed really put out about her symptoms, and suggested that she might have depression, as what she was saying made no sense to him. My friend works as a mental health professional, and she was upset by the doctors snap assessment, and appalled that mental health could be treated so flippantly. She walked out of the appointment feeling angry, dissatisfied and frustrated.

Luckily, my friend is a clever woman, and decided that the doctor was useless. However, if the situation was different, she may have been very upset, or even endangered. If she had have been depressed, she could have reacted badly to being ignored. She felt the communication problem may have been cultural. If you have a bad experience with a doctor, it often comes down to communication and culture in some way. But there are ways to make sure it doesn’t happen to someone else.

When should you consider a formal complaint?

If you simply don’t like a doctor, you have the right to visit another practitioner. Complaining is pointless. You definitely have permission to not like a doctor.

However, if you think that the doctor may have done something unprofessional or inappropriate, then you should consider complaining. It is hard to say what is appropriate, but if you are made to feel embarrassed, afraid or ashamed, then it is worth complaining. Examples would be a doctor using their position to do something unexpected, or poorly explained. These are situations where you might consider complaining.

There are lots of useful ways to make complaints about the medical system, that can help diffuse the situation quickly.

Could the doctor have done something illegal?

Occasionally doctors can act like any other unscrupulous person and rip you off, or even assault you. If you think a doctor, medical practice or hospital has broken the law, you should make a complaint to the police. Due to confidentiality concerns, most other professional bodies do not investigate fraud or assault well enough to rule out a legal problem.

Complain to the doctor’s employer

All doctors are employed by somebody, although it may be themselves. If you had bad service at a restaurant, you might complain to the restaurant owner. Likewise, if you feel someone was rude to you, for example, you could complain to the clinic manager. This method is good for dealing with minor problems, particularly where the doctor was not the only staff member involved.

If you have a complaint about something that happened in a hospital, complaining to the hospital is a good first step. Hospitals often have a patient liaison officer to deal with complaints. They will listen to what happened, investigate, and even organize mediation.

Complain to the Medical Board

Good doctors want “bad” doctors to be sorted out. Often, problems like poor communication, and cultural problems can be sorted out with education and even supervision. In most states and territories across the world, there is a public board that manages medical registration. Their role is to make sure doctors are qualified and have the necessary experience to see patients. They can also regulate what areas doctors are allowed to work in. For example, newly qualified doctors are usually supervised by more experienced doctors, and the board makes sure this happens.

The Medical Practitioners Board (named slightly differently across the world) is staffed by doctors and lawyers who understand what is reasonable in a consultation, and what is unreasonable. They will investigate any complaints and decide what consequences the doctor will experience. Sometimes they go through mediation, or further education. If the complaint is serious and the doctor has acted very poorly, then they may have their registration suspended, restricted or cancelled.

Your medical board can be found by doing an online search, or looking in the government section of your phonebook. The Medical Practitioner’s Board of Victoria covers my registration in Melbourne, Australia.

What about using lawyers to make complaints?

Television legal shows, and prominent ads for personal injury lawyers are starting to make us think of lawyers when making complaints. I think this is a weird way to go. A wronged patient may get money, but they are unlikely to understand what happened and what went wrong. Furthermore, doctors become increasingly cautious with patients who have sued before, making future health care difficult.

If you are keen on getting a lawyer to help you make a complaint, it is useful to exercise some of the other methods of complaint first. They may be quicker, and solve the problem more effectively. Furthermore, no one stands to gain financially, so you will hopefully get a bit fairer treatment. If you don’t reach a solution, then you can try legal avenues later. And if you do reach a conclusion, it is much easier to get a settlement in court if the doctor has already been judged in the wrong.