Monday, April 28, 2014

Patient Advocacy: Healthcare on your Side

Patient Advocacy: Healthcare on your side

   by Martine G. Brousse
Healthcare Specialist, Patient Advocate, Certified Mediator

Avoiding Medical Mistakes: 
                                       Be an Involved Patient

As reported during the recent National Patient Safety Foundation "Patient Safety Awareness Week", medical errors are costly to patients' health and wallets, and to the healthcare system as a whole. 

Due to a lack of accurate information from patients, difficult symptoms, inadequate diagnosis, improper treatment, dismissal of patients' complaints, test results inaccurately interpreted, poor or no access to other records, medical mistakes occur more often than previously thought. Read more here:

As reported by Patient Advocate Martine Ehrenclou, MA, patients' involvement is crucial to help reduce errors and minimize consequences. At every step of the way, patients must be involved and  informed by their physician, but also remain alert to and communicative of their own observations. While no process is full proof, patients' participation and understanding are essential.

Here are some recommendations to follow to bring about a more accurate diagnosis and treatment, and ensure a successful outcome. 

1. Keep your Med List current and accurate

2. Keep track of symptoms

Without a complete and accurate narrative, your doctor may not be given all the relevant information in order to make the proper diagnosis. Before your appointment, make a list of every ongoing or new symptom, detailed description and occurrence, and any trigger or means of amelioration.

Throughout treatment, be alert to worsening or acute symptoms, new side effects and improvements. Be sure to contact the office for sudden or severe reactions, or whenever you have a question. 

3. Provide records and History

As related in this blog about your preparation to an office visit, you should present your doctor with a list of allergies, important health events, previous diagnoses and treatments, and the names and contact information of any physician you have recently or are currently seeing. 
A family history of relevant or serious medical conditions is also in order, especially if genetic or affecting several members. 

4. Ask Questions

Many errors could be avoided with appropriate and timely questions to your physician. Ask if a diagnosis is the only probability, or if others are possible. Question if a treatment prescribed is the only option or if a less severe/expensive/radical one is available. 
Without questioning every step your physician undertakes, ask the general necessity of a surgical intervention or procedure, and if it can be safely postponed at this time. 
Ask about expected side effects, effectiveness and anticipated time frame for a cure.
Ask and understand your responsibilities: what to do, what to take, what to change, when to return, when to call, what constitutes an emergency. Be aware of diet restrictions, of impact on your daily and professional life, of specific requirements on your part, especially if following an oral medication regimen.

5. Communicate

Do not rely on a follow-up appointment down the line to indicate a worsening of your condition or the appearance of new problems. If the treatment is not as effective as you were led to understand, call to check on an alternative option. Do not miss a scheduled lab or imaging test. 
Repeat the doctor's instructions, or write them down so that you leave the office with full recollection and understanding of your involvement. 
Communicate any new treatment prescribed by another physician, even if seemingly unrelated. 

6. Do some research

Several federal agencies post up-to-date information on conditions, medications, nutrition and other health-related topics on their website. Consulting them to learn more about your diagnosis and most effective behavior can assist you on your journey to recovery. While your physician is always your primary source, his time to educate you may be limited. These websites might be valuable tools.
Here are two good ones: and

7. Be proactive

Set reminders for medications, appointments or to check your health status at regular intervals. Keep a chart or journal for observation of symptoms and self-administration of prescriptions. Forward any record from a new medical provider, or older ones that might be important. 
Contact the office before any planned intervention, medical or dental, as a drug you take or might be given may provoke negative side effects. 
Check about any refill several days before you run out. Authorizations may take a few days to clear, or for your pharmacy to get an unusual prescription in stock.
Call for lab or test results if the office does not contact you. No news do not necessarily mean good news. Your results may not have been sent to the physician or your report could have been misplaced. 

8. Trust your gut a point

A dozen years ago, I ended up in the ER with pains which I, with a high pain threshold, could not bear. Because of serious allergies to medications, taking care of my health with an emphasis on preventive care, was always a priority. Given a specific diagnosis by the ER DR, I kept insisting I "knew" this was not the case. My gut feeling and experience of so many years living in that body rejected that improbable diagnosis. Hearing "I am the doctor, you are not", I felt unheard and insignificant but accepted a discharge. It tuns out he was wrong, so wrong I had to have emergency surgery when it could have been avoided with a proper earlier diagnosis. 
I should have requested another physician, should have been more vocal, should have been more trusting of my intuition. 

If your physician is not listening, treats you like a body rather than a person, does not care about your questions or feelings, or expects you to follow directions without education or understanding, you may want to consider your options. Express your need (and right) to disclosure, trust and self-expression. Physicians are often so tied to a busy schedule that their communication skills take the back seat. You should be heard as your input is invaluable in helping establish a diagnosis,  and adhering to the best prescribed treatment.

In Conclusion:

All every step of the medical process, communication is essential. Nurtured by trust and mutual respect,  the relationship between patients and doctors can only be optimum if all parties are equal participants.

The NPSF offers a patient toolkit to help you become as involved and educated as you can, and should.

Any comments or questions? Contact us!
©  [2016] Advimedpro.
©  [2016] Martine G. Brousse.
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My objective is to offer you, the patient, concrete and beneficial information, useful tips, proven and efficient tools as well as trustworthy supportive advice as you deal with a system in the midst of sweeping adjustments, widespread misunderstandings and complex requirements

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