Tuesday, August 23, 2011

How can we get patients to take a more active role in their medical care ?

It's extremely easy to criticize doctors for the sad state of health care today. Most patients are very articulate about the fact that their doctor spends very little time with them ; that he makes them wait unnecessarily for long hours ; and that he provides them with precious little information about their illness. This causes a lot of heartburn and frustration ; and many people believe that doctors are now behaving more like businessman rather than professionals.

While there may be some truth in this criticism , it is also equally true that doctors are soft and easy targets. In fact , the press has played a major role in bashing doctors , and while it's true that stories about unethical doctors who indulge in corrupt acts help them to sell more newspapers , sadly all these stories also end up hurting the doctor patient relationship. Patients no longer respect doctors or look upto them . And in response to this , doctors feel frustrated and unappreciated and start practicing defensive medicine. Often , the relationship has become adversarial , so that it sometimes seems to be doctor versus patient !

There's very little to be gained by blaming anyone because this does not really help to solve the problem. This just sets up a negative vicious cycle which seems to take matters from bad to worse . Rather than blame doctors and bemoan the declining standard of medical ethics and the passage of the revered family doctor of the past, we need to understand that patients are as much to blame for this present sad state of affairs !

Most patients are quite happy to be passive and do whatever the doctor tells them . Unfortunately , this does not help them to get good medical care. It’s been proven that well informed assertive patients get better care from their doctors . The question we need to be asking ourselves is - how can we mobilize patients to start becoming more actively involved in their health care ! Just like war is too important to leave up to the generals, health care is too important to leave up to the doctors !

It often breaks my heart when I see patients who have done an IVF cycle elsewhere, and don’t have a clue as to how many eggs were retrieved; or how many cells their embryos were. While this means that their doctor was not transparent , it also reflects poorly on the patient that she was poorly informed and did not do her homework properly. While it’s true that patients cannot change their doctor’s behavior , they can definitely improve their own!

Patients cannot afford to be passive and docile. If they take an active role in their health care , they will find that the same doctor is much better positioned to be able to help them get better sooner !
Patients make lots of excuses for not being actively engaged . These include:
• I'm not the expert - the doctor is ! I do not understand biology or any of these medical terms !
• If I ask too many questions , my doctor gets upset - and in any case , he's not willing to listen to
me , so why should I bother ?
• Isn't a little knowledge dangerous ? Is it a good idea to become a “half-baked doctor” ? After all, the doctor has spent 10 years learning medicine, which makes him the expert. Isn't it better to just allow him to make all the decisions ?

While it is true doctors are medical experts , we also need to remember that doctors are experts on diseases , while patients are experts on their own bodies . These two types of expertise are complementary ! We need an active mix of both medical expertise and the patient's expertise to make sure that each patient gets the care which is best for them !

If you are a patient, please get off your butt and start making sure you are well informed. You need Information Therapy , because this is powerful medicine – and you can ask your doctor t prescribe this for you – and you can find it yourself. A good starting point is the free Healthwise Knowledgebase !

Patients can help their doctor – and themselves – if they start demanding Information therapy !

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1 comment:

  1. Anonymous2:56 PM

    Dear Dr Malpani,

    Thanks a lot for this wonderful write-up. Doctors might have medical knowledge but for sure I have more knowledge about my own body. As a very intelligent patient (I think so!!!) I ask them several questions (not to annoy them) inorder to make them bit friendly because I expect that if you talk a subject which is interesting for the opposite person you create a friendly atmosphere BUT it failed everytime. The first meeting they definitely comment 'Oh you know lot of things!!!!' but then in the subsequent meetings they do not want me to ask anything 'UNNECESSARY'. Most of the time this attitude broke my self-confidence especially when I am going through the most hardest journey-IVF. Once I responded very poorly to stimulation (they had me on a low dose ofcourse) and I clearly understood from the signs my body gave (feeling warm, no cervical mucus etc) that the dosage is not enough and my estrogen is not rising in a nice way. I wanted to tell him that and he responded that he must first look at the ultra sound. He scanned my ovaries and I could clearly see very few follicles are there. I asked him what might be the reason and he responded angrily 'how will I know???' which left me dumb.

    I understand that doctors are humans and I can't blame them all the time. But I can't also tolerate docs who treat their patients in a mechanical way. I wish they have more interest in what they are doing and try to learn from their patients (to become more better in their profession).

    Love your blog because I think you write from your heart and not from your mind.



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