31
Aug

Want better treatment? Be a good patient!

Last week I learned from my cardiologist that there are two ways elevated cholesterol levels can kill me. The first is by increasing the likelihood of a heart attack. The second is at the hands of my doctor, should I continue to refuse to follow his advice. In his two-year battle to put me on a statin drug, the heart attack argument never worked, but his demonstrated aggravation in our Wednesday morning appointment went the distance toward securing his victory. As I walked to the pharmacy to drop off my prescription, I asked myself why this doctor is so doggedly committed to ensuring my good health—especially given my resistance to following his advice—and pondered over whether we as patients can actually affect the quality of care we receive. After cogitating on this over the weekend, I came to a conclusion—an emphatic yes—and identified things we can do to ensure first-class treatment.

All doctors are committed to their patients’ health and well-being, and they wouldn’t be in the business otherwise. But from my own considerable experience as a patient and conversations with hundreds of others, I’m convinced that their level of commitment can differ from one patient to the next—this independent of the patient’s state of health. While doctors will swear on the Bible that all their patients receive the same—albeit high—level of care, I’ll use the same book to affirm that in reality, while they maintain a base level of care for all, they do go the extra mile for some of their patients. And it’s often what these patients do that invites that devotion.

So what is it that we as patients can actually do? Here are five tips.

1. Find a good primary care doctor—and stay with her. A 2009 study of more than 150,000 patients published in the Annals of Internal Medicine found that patients who have developed a strong link with a specific doctor are more likely to receive high-quality care than patients who see different doctors—even when they’re treated at the same facility. The doctor-patient relationship is central to medicine, and the fragmented nature of health care today can prevent those relationships from being realized. You can buck that trend by finding a primary care physician you trust and sticking with that doctor.

2. Be an active patient. Patients who are well-informed, ask questions, and play a role in setting goals for their personal health—active patients—have better treatment results. A 2004 Swedish study of 77 patients receiving physical therapy compared patients receiving traditional physical therapy to ones who discussed specific goals with their physical therapists before beginning treatment. The treatment results for the latter group were significantly better than the control group’s. Active patients are also more likely to comply with their doctor’s recommendations and treatment protocols.

3. Respect your doctor’s time. Doctors are under pressure to see large numbers of patients each day, and while we often blame them for not spending enough time with us, it often has to do with targets that the institution they work for establishes. If you’re asked whether you have numbness in your fingers or toes, don’t tell them about some article you read in Reader’s Digest three years ago. Listen to your doctor and help them get the information they need from you.

4. Trust your doctor. I’m not suggesting you do this on day one, but developing trust is key to the quality of care you receive. If you’re with a doctor you feel you can’t trust, it’s time to find a new one, but if you’re switching from doctor to doctor and feel that all of them are cold and incompetent, the issue is more likely to be with you. Trusting a doctor can be hard, especially when you’ve received a serious diagnosis—like cancer. Do your homework. Find a physician with an excellent reputation, and assess that doctor after your first visit against standards you establish beforehand—how well they listened to you, how patient they were, whether they answered your questions, etc. If you’ve found someone who strikes you as competent and committed, allow yourself to develop that trust. You won’t always agree with their recommendations, but don’t assume that because they say something you don’t want to hear, they’re wrong.

5. Follow their recommendations. Compliance is key to your health, and it also affects the doctor-patient relationship. If you consistently ignore your doctor’s advice, they’re going to conclude that you’re not committed to your own health, that you don’t trust them, or some combination of the two. If you don’t agree with the prescribed course of treatment, see if you can reach agreement with your doctor over an alternative—and set a timeframe for it. When my cardiologist told me he thought I should go on a statin, I asked him if I could first try a new fitness and diet regime for a period of time to see if my levels would improve. He agreed, grudgingly, and when they didn’t, I gave in.

So yes, my cardiologist won. But I’m pretty convinced that his victory is based in part on my being a good patient. And assuming he knows what he’s talking about (and I’m certain that he does), when he wins, I win. Victory is mine! Or in this case, ours.

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2
  1. September 3rd, 2010 | kriste says:

    i really like your list, and am glad that you wrote this post. i’m going to add one more from my experience… gratitude. i think that being truly appreciative and letting my docflock know how much i appreciate them has made a huge difference in my recovery. they don’t hear that kind of thing nearly enough, it seems. they have gotten on “team kriste” because of it, and it helps me keep things in perspective as i instinctively grimace about needles and bloodwork. that blood is being drawn so that my neurologist can start taking me off my seizure med – that’s something to be celebrated. so sincere thanks all around, and i walk out of the lab with a sincere smile on my face. and some mental thanks to the folks who have helped me be able to walk out of a lab.

  2. September 3rd, 2010 | Duper says:

    That’s such a great point, Kriste. Gratitude is fundamental. I’ve thought a lot about that over the years. There’s the element of expressing gratitude, making someone feel good as a result, and, as a consequence of that, receiving better care. But there’s also something powerful within you when you choose to share your gratitude — an internal healing process.

    I’m happy to hear your neurologist is going to explore taking you off your seizure medication. That’s really fantastic, and suggests that you’re making some great progress. But we already knew that, didn’t we!

    Thanks for reading Ciao, Cancer!, and have a great weekend!

    –Duper

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