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Every patient? Really? Are we all that dense?
on August 26, 2010
Well, yeah, I guess we are. I tried to go into this book with a critical eye, and since I consider myself a pretty health-care-savvy individual, I was ready to be insulted at being lumped in with every stupid mistake all the rubes make all the time. Well,if you're with me on that self-assured bandwagon, I think we'd better get down and take a closer look at this book.
When I consider each of Trisha Torrey's 10 mistakes honestly, I must admit that at one time or another, over the years, I've made every mistake. More important, the full title of the book (and it's long enough to make Harlan Ellison blink) tells you exactly what you're going to get from the book:
You Bet Your Life! The 10 Mistakes Every Patient Makes--How to Fix Them to Get the Health Care You Deserve.
That "How to Fix Them" is the real important part. This is a clear, easy-to-follow handbook to wending your way through the healthcare jungle. Also, the examples are awesome. Everyone should have this book.
I'm certainly not going to repeat all of Trisha's brilliant advice (she tells you how to do your own differential diagnosis--how cool is that?), but since the latter part of the title is the real meat of the book, I don't think I'm giving much away by telling you what the 10 mistakes are and why I think they really do apply to just about everyone. Now, honestly, look at these and ask yourself which ones you've NEVER made:
1) Thinking your healthcare is focused on you, the patient. Plans for your surgery were so carefully spelled out that it was easy to feel like some kind of VIP. That ends the first time a nurse comes in to check on you and doesn't have the faintest idea why you're there, or when a doctor on rounds picks up your chart and can't make out the instructions.
2) Thinking doctors put their patients' needs first. If you believe this is the case, why does the doctor always ask the same questions his nurse asked? And why won't most of them communicate with me by phone or email?
3) Not confirming your diagnosis. Have you ever accepted a diagnosis without asking for a second opinion? I have. It's easy to do when the explanation sounds rational. Remember, it sounds rational to the doctor too. She's not trying to give you a bad diagnosis.
4) Thinking you've been told about all your treatment options. I know this is true. I know that most doctors don't know ALL the options. This can be incredibly important when the doctor doing the surgery only knows one way to remove an organ, and you end up in recovery for six weeks. Later, you find out that the hospital across the road does that procedure laparoscopically, which offers a recovery time of less than two weeks.
5) Thinking you are safe in the hands of the healthcare system. If you think this, next time you're in a hospital or an in-patient rehab center, ask why some of the patients' rooms are marked "Quarantine."
6) Not understanding the reach or risk of medical records. In their brilliant 2004 exposé on medical mistakes, Internal Bleeding, Robert M. Wachter and Kaveh G. Shojania include an appendix of abbreviations that are commonly misread when written in haste. One simple example, D/C can mean "discontinue" or "discharge." Written in the wrong place, you could end up with your pharmacy refusing to fill a needed prescription because they think your doctor gave a "discontinue" order. These records are hard to get your hands on (a lot of people are fighting to change that), expensive to reproduce, and hold your life in their pages. Oh, and then there's that whole identity theft problem.
7) Spending time in the hospital when it's not absolutely necessary. We're going to keep you overnight for observation. Really? Necessary? For whom? This is the doctor's way of covering her own back acreage.
8) Using the Internet without a compass to find health information. It's easy to tell when you've done this. You can see it in the little half-smile on the doctor's face that you've found some treatment ten years out of date or that's simply from an unreliable source. I haven't done this, but my ex-wife did it--often.
9) Believing all medical researchers are searching for cures. Yeah. When I was younger, I believed in the noble scientist striving for the truth. Now, of course, I've seen the results of the Scott Reuben trials for research fraud. He signed his name to a dozen or so research papers (even added the names of colleagues who'd never heard of the research) and published the "results" in supposedly reliable, responsible, professional publications for review. Why? Well, the projects were funded by multi-billion dollar pharmacies. I wonder what his motivation might have been.
10)Letting the media determine your medical choices. The television blasts us with "Ask your doctor about..." ads. The papers tell us that this research or that offers a "miracle cure." The ads are trying to get us to help pressure the doctors for the pharmaceutical reps. The papers are trying to sell themselves with sensationalism. We all know this, but--hey--who doesn't want to believe in miracle cures?
That's the lot. I don't believe in absolutes, so I know that not EVERY patient makes ALL of these mistakes. They're all damned common, though. I forget who said it originally, I hear it all the time from patient-rights advocate Regina Holliday, but "we're all patients in the end." We all end up weak, in bed, and (if we're lucky) very old. At that point, you'll wish you had this book. Everyone needs Trisha's book. If you can't afford a copy for everyone you know, at least get one for anyone going into the hospital. You just might save a life.