Taking charge

I am often asked some version of the question, "How can I ensure that I get the best possible health care and feel empowered with doctors?" Since this is typically asked by or for women, my answers are offered in that context. However, these recommendations relate to all of us.

Recognize that medicine is considered big business today, and treat it as such. If you hire contractors to do something in your home, you are paying their bills, directing their attention to your needs, and requiring them to satisfy you to be paid. You are the boss of those contractors.

The same goes for medical providers, whether doctors, nurses, hospitals, caregivers, or care facilities. You are the boss. They work for you because you pay the bill. Therefore, they have an obligation to "satisfy" you. Unlike contractors (for example, plumbers), they cannot always guarantee the outcome. But they can and should treat you in a way that enables you to learn what they are proposing and why. You have the right to expect good treatment. Anything less dishonors you.

Do your homework, and give yourself permission not to understand everything. Anything you learn from your research gives you greater credibility. Research your disease or condition, doctors, hospital or care facility, medications, and recommended treatments and side effects.

Our powerless feelings often are directly related to how little we know. By doing your homework, you will be more comfortable asking questions and the members of the medical community will know they have an educated consumer—and treat you as one. If they do not, find another care provider.

You have a right to answers. If your plumber refused to tell you what he was going to do, why, and how much it would cost, wouldn't you look for another plumber?

Propose a partnership with your doctors and tell them what that means to you. They should be practicing "patient-centered" medicine. That means that, as patients, we must understand what is going on and participate in decision making. We can no longer afford to turn these decisions over to someone else. There are too many problems in and complications with health care.

If your doctors do not have time for questions; cannot or will not explain about your disease or condition, medications, recommended treatments, and side effects; will not discuss their experience in treating it; or will not explain why they are recommending a particular hospital or care facility, find another doctor.

Be prepared to explain all your present medical conditions and identify all your medications when you interact with health care providers. I recommend that you create and carry with you at all times a document that lists the following:

• Contact information;
  
• Emergency contacts and their information;
  
• Allergies;
  
• Current medications, doses, and frequency;
  
• Current medical conditions;
  
• Primary care physician and contact information;
  
• Preferred hospital for emergency transport;
  
• Insurance information;
  
• Existence of a durable medical power of attorney, living will, or advance directive.
  

If your purse looks like mine, you may wonder how all this will fit! You can shrink the information down to an 8-point font and fit it on a single piece of 8 1/2 x 11 paper. Place it where emergency personnel will find it easily, and keep it current! When you visit a doctor, simply remove it from your purse and hand it to the intake person. You can't believe how many "wows" I've received using this procedure. Those wows tend to open doors with doctors, because you are treating them professionally by being medically professional yourself.

Be respectful and firm. The doctors with whom you are dealing are well-educated, and it is this very education and knowledge that you seek. If you don't get an answer to your questions, or if you receive an answer you don't understand, ask the doctor to explain it again and again until you do. Many doctors are not used to this insistence, and we have to train them. If we allow doctors to avoid answering our questions, we are reinforcing bad behavior as well as our own poor self-esteem.

The Golden Rule fits both sides of the patient-doctor interaction. Everything recommended here requires that you step into your power and take action. When we take action, we feel less anxious and we begin to know that we have done everything we can on our own behalf.

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