Gupta: Communication as vital as vitals

When you get sick you go to the doctor, she prescribes you some medicine and you go on your… When you get sick you go to the doctor, she prescribes you some medicine and you go on your merry way. But I have all too often not gone on my merry way. Why? I’m not getting my questions answered.

Let me give you a sampling of what is an unfortunately long list of my grievances. My dad went to see a doctor only to find the doctor was already writing the prescription before my dad had finished explaining his symptoms. A friend of mine was put on steroids and not tapered off them, leading to a horrible allergic reaction. Steroids are a common enough prescription that every doctor should know patients should be tapered off them. I have gone to get blood work done only to find that not all the tests were written on the order sheet and not enough blood was drawn. And because Murphy’s law reigns, the most important test was the one left out.

But you can be satisfied and you can be healthier. As with other resources and opportunities, you will get out what you put in. Stop being a passive patient and take responsibility for your health.

So why are we passive patients instead of smart patients? Many are intimidated by their doctor or believe their doctor knows everything. Doctors do know a lot, but the body of scientific and medical knowledge is constantly growing and changing. According to a report by the Institute of Medicine, up to 98,000 people die due to medical mistakes annually. This could be in part because of human error or negligence. All the same — you still need to be your own safety net. If everyone watched over her doctor’s shoulders, that 98,000-person statistic would surely decrease. Also, doctors have many patients, but you have only one doctor and only one you. If you are not an advocate for yourself, who will be?

A key dilemma is the falsely defined roles that a patient and doctor assume in the examination room. Dr. Paul Haidet, staff physician at the Michael E. DeBakey VA Medical Center in Houston, says the doctor-patient relationship should be the meeting of two “experts.” Your doctor has medical expertise, and you are an expert on yourself. You have a lot of valuable information and your doctor needs that information if she is going to treat you effectively.

My cousin had abnormal hormonal levels even after trying a few treatments. My aunt thought she might have an insulin problem because of family history. The doctor said she “really didn’t think” that was the problem. Finally, six months later, my aunt insisted that my cousin get a glucose tolerance test. After the numbers came back higher than normal and she was put on the appropriate medication, her hormone levels returned to the normal range. A family history of diabetes is a strong indicator of insulin problems since her type is hereditary. Since her doctor forgot, it was good that my aunt did not. Make it your business to know as much as you can.

According to Dr. Mehmet Oz, a regular on the Oprah Winfrey Show, doctors are forever learning and gaining experience through their patients. If a doctor learns about new treatments, indicators or side effects from one patient, she is able to carry on that new information to all her patients. Hence, if a doctor is not being questioned by her patients, she stagnates and the quality of areas of care never improves.

Being a “smart patient” is difficult because it requires us to modify the highly authoritative role doctors traditionally have in our society. Picking up some useful habits will result in the desired effect.

Always ask questions. If you don’t understand terminology or are unfamiliar with a diagnosis, ask for an explanation. You should know what is going on inside of your body. Second, be prepared. In the rush at the doctor’s office you are likely to forget some things you wanted to talk to your doctor about. You can solve this problem by making a list of important health issues beforehand. Also, do research before and after your visits. Try and get some background knowledge before you go in and then read about the specific things your doctor mentioned.

Finally, after you understand the mechanics and weigh the choices, make sure you communicate with your doctor. If you have concerns, voice them. Be confident and remember it is your right and responsibility to ask questions and be listened to. If you’re told, “No, that is not possible” or the like, make sure your doctor tells you why. Insist on honest, focused and thorough answers.

If I ever become concerned with my health care and my role in it, I remind myself that my doctor is like my consultant and we work together. The main goal of any doctor is to help her patients become healthier. It is important to realize that doctors need our help to accomplish this goal. Really, both patient and doctor have the same goal and are on the same side.

E-mail Ragini at rgg6@pitt.edu