Health Care – Tips For Doctor’s And Patients In Today’s World

Well, I don’t do it often, or at least I don’t think I do, but, I hurt a patient’s feelings the other day.
Granted, it was unintentional, but, I did it and it made me think.
You see, after the initial interaction and doing an exam, I had already made the decision that the patient’s pain was, in part at least, due to an underlying autoimmune Rheumatic condition and what would help her the most might just be a medicine used for Rheumatoid Arthritis.
As I turned back to the computer, desperately trying to input the data as quickly as I could that is required of me by the insurance company in order to get paid, knowing full well that the minutes were flying by as I attempted to provide comprehensive and empathetic care yet stay relatively on time with my schedule, and the the allotted appointed times that other patient’s had, she continued her complaints, “Oh, and my left hip is always killing me, and I can’t sleep because of the pain all over my body, and my right elbow hurts also.” Having already made my assessment and plan and believing that she was suffering, I believe my words were, “You don’t need to convince me about your pain anymore.”
Needles to say, my words took her by surprise as she began to tear up, her body language clearly showing her disgust. Seeing her reaction, we talked about the conflict and, after each of us attempted to help one another understand our perspectives, I think we both learned something.

So, here are a few tips for both of us.

For Doctors & Health Care Providers:

1. Reconnect With Caring
Listen, I know that in the current state of traditional medicine, we as health care providers are pushed every year to a new limit. Regardless of how attentive we want to be to the individuals we care for, we have to deal with their insurance companies, the pharmaceutical companies, the shortage of qualified ancillary staff, the electronic records, and an ever decreasing reimbursement for our services regardless if we are good or not. But, at the end of the day, we need to remain mindful of why we do what we do, we care. So, here’s a tip, imagine the person that you are sitting with in the exam room is your mother, father, favorite sibling, or best friend.

2. Explain The Process – Patients’ Don’t Know
I wish I would have thought of this before my encounter with the patient that inspired this article and I am happy to say that I have changed my approach. Every health care provider has a different approach, we as patients ourselves know this. Well, here’s a thought, maybe we should let patients’ know how we operate. For myself, I only need a few pointed questions answered as honestly and direct as possible, an exam, and a review of the labs and x-rays. But, if I fail to convey this to m patient and I get frustrated with more, who’s really to blame?

3. Know Your Limits As A Health Care Provider
Some of us are better at listening to others’ complain, some of us aren’t. Fact is, people come to us because something isn’t right. No, we don’t have to fix everything, we only have to try our best to fix what we can for people. After many years as a physician, I’m okay with saying, “I can help you,” and, “I can’t help you.” But, if you can help, help, and if you can’t, we shouldn’t give false hope that we can. “I do not know what is causing you to feel the way you do,” is still an answer. Also, know when you are being pushed to do things outside your comfort level. Remember, most providers care and want to help. Patients are people and people are people, so, know when to say when.

For Patients’:

1. Define Pertinent Information
What is the real issue? What is going on with us now as patients that is limiting our health and contentment? Is it physical, mental, emotionally, or perhaps a bit of each? As much as we would all like to believe that the past matters, many times, it’s irrelevant. As patients, we need to be able to describe the problem that we are having now in a clear and concise manner. The past history of a car wreck, a history of a tic bite, or a positive blood test may not be relevant. Its relevance isn’t our job but that of our providers. Our job as patients’ is simply to know what we want help with, to answer the questions we are asked, and to either accept or reject the opinion provided to us.

2. Don’t Drift
As patients, it’s important for us to understand that our health care providers are trying to provide the best care they can in the short time they are given. Did you know that most insurance companies reimburse your providers for far less than what is billed? On average, insurances only pay 50 to 60 percent of what is billed? Please, don’t get me started about the whole health care insurance debacle, it’s a nightmare for patients and providers alike and the only people that are truly making a profit despite little effort are the insurance and drug companies. After all, my attorneys bill me by the minute regardless if I am in person or just chatting with them on the phone. I understand the frustrations that we as patients have, we want our health care providers to listen. I also understand the the frustrations that providers have. Well, as patients one thing that we can do to help ourselves get the best care is not drift. In other words, before you even go to your doctor, get rid of the the three page summary of your complaints. When we are asked a question by a health care provider, answer it as direct and concise as you can, simply put, “yes” or “no.” I understand that we all want to tell ‘our story’ but as patients, we have to remember that our doctor is there to help us heal physically and despite their intention to help, they have time constraints. So, if we need need healing in other parts of our lives other than the physical, perhaps we need other providers.

3. Choose A Second Opinion To Validate The First
Ok, I like Dr. Google. I like Web MD, but, fact is, they aren’t the ones that are carrying medical malpractice, nor are they going to prescribe anything that can actually help us. Oh, and perhaps the most important, they have zero clinical experience. Truth is, as a physician, there’s something to be said for some experience. But, remember, your automobile insurance wants three quotes before they agree to settle on a claim. So, rather than challenge or fight with our providers, or try to discredit their plan to help us, maybe we should just get a second opinion. I know that as a provider myself, I welcome it.

I’m truly sorry that I hurt a patient’s feelings, but, I’m thankful for the experience because I learned how I could be a better doctor. I hope that through our chat, she learned something as well.

Fact is, the interaction that we have as patients with our health care providers is a relationship. It’s not a lot different than the relationships we have with other people such as our friends, our family, our significant others, and even ourselves. In the end, it all comes down to being honest and direct with our wants and needs and then, communicating them in a clear and direct way with the person sitting across from us, be it an exam room, a living room, or a bedroom.  This simple reality of being honest and direct should hold true for both of us, the patient, and the health care provider alike. Regardless if we are the ones wanting to be great providers, or, we are the patient that is truly wanting to feel better, to become healthier.  Maybe it’s time we look at each other with a little more understanding.

After all, isn’t the goal of both individuals the same? Don’t we all want to live our value one choice at a time? Maybe, just maybe, we could do it and, in the process, help others do it as well.

This world would not be the same without you in it.
Everyday above the tile is great day.

Merry Christmas and Happy Holidays to you all.

-Dr. D

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