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YOU: The Smart Patient: An Insider's Handbook for Getting the Best Treatment Paperback – February 10, 2006

4.4 out of 5 stars 71 customer reviews
Book 2 of 10 in the Doctor Oz's You Book Series

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Editorial Reviews

About the Author

Michael F. Roizen, MD, is the four-time #1 New York Times bestselling author and co-founder and originator of the popular RealAge.com website. He is Chief Wellness Officer and chair of the Wellness Institute of the Cleveland Clinic and Chief Medical Consultant to The Dr. Oz Show. He currently lives in Shaker Heights, Ohio.

Mehmet C. Oz, MD, is also a New York Times #1 bestselling author and multiple Emmy Award-winning host of The Dr. Oz Show. He is professor and vice chairman of surgery at New York Presbyterian-Columbia University and the director of the Heart Institute. He currently lives in Cliffside Park, New Jersey.

Excerpt. © Reprinted by permission. All rights reserved.

Chapter One: Getting to Know You Let's Discover the Juicy Secrets About the Person Who Controls Your Health: You

Most people think they communicate with their doctors just fine. Better than fine, in fact. Fantastic. Given that most of the communication consists of nodding or a request for antibiotics, there's little to find fault with. That's the problem, of course. Most patients don't do a great job of communicating with their doctors because patients often give us too little pertinent information to go on (remember, just like the detective, we're looking for the facts). At the same time, they may also give us too many distracting or off-topic details. It reminds us a little bit of what a mechanic must think when we try to explain a noise in our car. We're not sure when it started, we're not sure what makes it worse, we think it's a whining sound but aren't sure...We bet this becomes a tedious monologue for those earnest professionals trying to help us.

An almost identical conversation goes on in doctors' offices every day. To be accurate, the parallel exchanges often concern befuddled male patients. There's a reason that women aged thirty to sixty are the prime decision makers about health care in the United States. Most of the guys they love either have no clue about their health needs or wouldn't see a doctor unless they had blood shooting out of both ears.

The goal of this chapter is to make sure you know the details and numbers in your health profile that you really need to know -- those stats and specifics that are crucial to you and your doctor. We always see health books and well-intentioned magazine articles that tell you to compile so much stuff, we get winded just reading the list. The average person would have to take a week off from work and probably hire a bounty hunter to get everything recommended. You don't need to do that, but you do need to assemble a thorough health history so that you'll have a body of evidence to use when working with your doctor. A big part of being a Smart Patient is knowing how to compare new evidence (such as new test results) against the old. Like Sherlock Holmes, even though something may seem elementary to everyone else and not worth asking about, you need to press on with your questions and your investigation.

We'll make compiling your health history simple enough to do, but we won't oversimplify the tasks so you lose accuracy. It's a small time investment that could save your life, so get started right away.

You Love Us? Ditto

The first sign of a Smart Patient is that telltale document they produce during their first visit, or even their fiftieth. It's a portent of a beautiful partnership -- that is, when it's not a form they need signed for their job, or a note asking one of our office assistants about their dinner plans. If we're lucky, it'll be their health profile. It's the sign of a patient who means business, one who will challenge us to be at our absolute best and who won't waste time and money on redundant and unnecessary efforts (which can lead to errors). To create the perfect health profile, circa early twenty-first century, flip ahead to appendix 2, Sample Forms, and find the forms labeled Your Health Journal. Make copies of them, or rip them out if that's handier. The forms are also online at www.jcrinc.com and www.realage.com.

Fill them out.

Finished? Everything? You're done. That is, if you don't have any questions, and you're sure it's all correct. Just bring those forms to your doctor along with a baggie filled with every medication, vitamin, herb, or whatever else you take regularly (in their original bottles). Store copies of the forms in a fireproof safe, and update them yearly or whenever a piece of key info changes. Everyone's happy.

What's that? It wasn't that simple? You don't know all the info by heart or have it filed neatly in your credenza? Now, that's woefully human of you. If you're like most of our patients, you've never compiled your important health info before, and you may not have the foggiest notion of where to find much of it -- or even if it exists at all. Even with using the forms as guides, your records may be so scattered that you don't know where to start.

Let's take it from the beginning.

Start in Top Form

Fill out all the easy stuff on the forms labeled Your Health Journal, such as your birth date, address, your doctor's contact info, your pharmacy, your insurance info, and everything else listed. As you may suspect, this will be your master form, the one you perhaps store on your computer, and give out whenever necessary, including when you visit a new medical professional or step foot in a hospital. (Take at least two copies, and always give one to the admitting nurse who welcomes you to your bed.)

This form won't just make your life easier, it'll prevent a severe case of hand cramps from rewriting half of this info dozens of times in the future. And bypassing twenty occasions that require you to blearily check boxes before you've had your morning coffee (and having another fallible person decipher that scrawl) is a no-brainer way of reducing errors.

Under the section entitled Your Health Now, write down every significant ailment or condition that you have right now. This would be the place to list ongoing conditions such as diabetes, hypertension, psoriasis, depression, back pain, and the like. Don't include anything you had years ago but don't have now; that goes in a different place. Be certain to include anything that you're taking medication for, even if the specific symptoms are gone; for example, if you're controlling your high blood pressure with medication, list high blood pressure. Next to each condition, list when you were diagnosed, what medication you're taking for it, if any, and any other relevant info. If you're not sure if it's relevant, jot it down. That's why your doctor's office assistant has Wite-Out.

In addition to those mentioned above, here are a few more examples of conditions that are significant:

  • Anemia
  • Heart disease
  • Heart murmur, or any other
  • heart irregularity
  • HIV
  • Herpes
  • Multiple sclerosis
  • Nerve paralysis
  • Cancer of any form
  • Diabetes
  • Gingivitis (gum or periodontal disease)
  • Hemophilia
  • Kleptomania (just making sure you're paying attention)
  • Epilepsy
  • Gulf War syndrome
  • Alcohol or other addictions
  • Vertigo
  • Sexual dysfunction
  • Paraplegia or quadriplegia
  • Sleep apnea
  • Vision or hearing loss
  • Glaucoma
  • Parkinson's disease
  • Amputation
  • Liver disease
  • Post-traumatic stress disorder
  • Dementia or frequent memory loss (for example, can't recall name of close friend or relative)
  • Multicythemia veragis (just kidding)
  • Here are some that are probably not significant:
  • Astigmatism
  • Dental cavities
  • Sore lower back after shoveling heavy snow
  • Rosacea
  • Varicose veins
  • Toenail fungus infection or athlete's foot
  • Forgetfulness (for example, can't remember where keys are, or where you were when Luke and Laura married on General Hospital)
  • Sunburn prone or can't tan
  • Insomnia before job interviews or court sentencings
  • Cat allergy
  • Hangover
  • Irritability
  • Disorganization
  • C-SPAN addiction
  • Turkey neck
  • Repeatedly date or marry losers

Now list your past significant ailments and conditions in the next section, noting when you were diagnosed and what happened. Then list all the details about the medications you're taking (all pills or tablets or anything that you regularly ingest, inject, insert, or otherwise consume regularly, whether it's prescription or over-the-counter (OTC) drugs, herbal supplements, vitamins, etc.). We'll say this again, but in addition to having this form handy when you see your doctor (in your pocket or the office file cabinet), always bring the actual bottles of all those medicinal consumables, too. It's important.

Checklist: We Ask, You Answer

For any condition or ailment you include on your list that you're still dealing with, write down and be prepared to tell the doc the following:

  • What caused this?

  • When was it diagnosed?

  • How are you treating it?

  • Has it gotten better or worse?

  • When did it first begin to noticeably improve or worsen?

  • What makes it better?

  • What makes it worse?

Don't Know Much about Genealogy

On pages 52 and 53, you'll also find the Smart Patient Family Tree. Flip to it and sharpen a pencil. This Smart Patient Family Tree is designed to bring joy (and longevity) to your life. The solid lines sprouting outward from you to your siblings, and downward to your parents, aunts and uncles, and grandparents represent blood-relative connections (not by marriage). You'll notice a dashed line going to your spouse, which represents a non-blood relationship. The reason you need to include your spouse is that he or she lives with you (at least we hope so). That means you share the same environmental exposures and, likely, similar risks. You serve as each other's personal coal-mine canary. One of you may get nauseous from the toxic waste buried under your house years before the other one. (Just kidding! You'd likely be afflicted simultaneously.) Also, even though you don't share DNA (at least not on most school nights, anyway), your spouse influences your health far more than your aunt Sadie in Perth Amboy. Auntie may have a cholesterol count that would bring a Guinness World Records rep to her door, but she isn't filling your day-to-day life with cigarette smoke, bacon, Pabst Blue Ribbon, and lost-sock argument... --This text refers to an out of print or unavailable edition of this title.


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Product Details

  • Paperback: 432 pages
  • Publisher: Scribner; 1 edition (February 10, 2006)
  • Language: English
  • ISBN-10: 0743293010
  • ISBN-13: 978-1615521531
  • Product Dimensions: 5.5 x 1 x 8.2 inches
  • Shipping Weight: 14.4 ounces (View shipping rates and policies)
  • Average Customer Review: 4.4 out of 5 stars  See all reviews (71 customer reviews)
  • Amazon Best Sellers Rank: #181,350 in Books (See Top 100 in Books)

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Customer Reviews

Top Customer Reviews

Format: Paperback
I was a hospital administrator for just under two decades so most of this information is second nature to me. I purchased this book because I liked the general style of "You: The Owner's Manual" and was curious to see how the doctors tackled this subject. I have been impressed with the way they were able to take out much of the unnecessary medical and hospital terminology and get to the point for the rest of us.

The book is subdivided as follows:

1. Getting to Know You (Information that is important to convey to your doctor)
2. Finding Doctor Right (not all doctors are created equal, 50% of all doctors finished medical school in the bottom 50% or their graduating class)
3. Let's Play Operational (what you should know if you are scheduling surgery)
4. Prescription Drugs
5. How to Case a Hospital (choosing a safe hospital)
6. Have a Happily Humdrum Hospital Stay
7. Why You Should Always Get a Second Opinion
8. Just What Gives You the Right (Patient Rights)
9. Considering the Alternatives (Alternative Medicine)
10. Take Control of Your Health Insurance
Appendix 1: Medical Jargon Explained
Appendix 2: Sample Forms (Your Health Journal, Living Will, Power of Attorney for Health Care, Do Not Resuscitate Order)
Appendix 3: Resources

If you know someone that has been diagnosed with cancer, or will be undergoing surgery this is a nice book to buy. The doctors cover a lot of important topics like: making certain a hospital has JCAHO accreditation (Joint Commission on Accreditation of Healthcare Organizations, checking the doctor's board certification, understanding HIPAA (Health Insurance Portability and Accountability Act, knowing drug interactions and getting second opinions.
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Format: Paperback
This book was an interesting read, and it certainly has some useful information in it. It's written in an irreverent style, for those who like that sort of thing. Chap. 1 does a good job of explaining how and why you should have a detailed health history on hand, as well as knowing your family history and keeping a list of your medications. Later on in the book, on p. 271, there is related advice, on getting copies of all your test results, radiology reports and specialist reports. All important to keeping your health information up-to-date.

Chap. 2 covers finding a good primary care doctor, though some of the advice is also meant for finding a specialist. Pages 91-95 are especially relevant, where it's explained that it's important for you to let a doctor ask you a lot of questions, so they can figure out what is wrong with you, and how important it is for you to answer those questions succinctly. At times, I couldn't tell if the content of this chapter was meant for finding a primary care or specialist doctor; I would have liked to have seen a chapter just on finding a specialist.

Chap. 3 is all about locating a good surgeon. It has a lot of fine points about finding the surgeon who's best for treating your condition, and has a list of important questions you should ask the surgeon before having an operation.

On p. 74, and again on p. 109, there are suggestions about finding a good doctor by asking for recommendations from nurses and anesthesiologists at nearby hospitals. I'm sure that these individuals do know who the better doctors are. However, I wonder how willing these health care providers would be to provide recommendations to patients who are complete strangers. But, it's a gambit that's worth a try.
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Format: Paperback
Medical mistakes are a disaster. And we're not just talking about sensational boo boos like amputating the wrong leg or pumping an allergic patient full of penicillin. It's all the little errors that accumulate in a person's medical life that these two popular health authors are out to correct. It's up to each individual to take charge of the quality and scope of their own health and healthcare. They need to become "The Smart Patient."

Poor communication between patient and doctor, incomplete or inaccurate health histories, small mistakes that get propagated through our health records, and incomplete understanding of the surgical or pharmaceutical options available to each of us, these are error and omissions that can, and occasionally do kill. As a fellow physician, I have seen all too often, how a misspoken or misspelled word has been allowed to misguide doctors and misdirect treatment.

In my opinion, You The Smart Patient is a terrific roadmap for the average, healthy patient wanting to scour their health record clean of misleading errors, to flesh it out with useful personal information and to prevent new inaccuracies from contaminating it in the future.

The writing style, as in all the "YOU" books, mixes health information with a lot of chatty humor and busy cartoons. making for a stimulus-rich book reading experience. For the reader who can take it in as fast as they can deliver it, this can be a bit distracting. But the information is all there. This is a comprehensive treatment of the subject, outlining what you must do to interact safely with our imperfect healthcare system.

We all know it pays to be a savvy consumer and that ignorance is costly. But nowhere is the cost of consumer ignorance higher than in medicine.
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