Archive for the 'Doctor Communication' Category
September 15th, 2011 by Trisha Torrey
Please note that this column appeared in the Syracuse Post Standard on September 13, 2011. It addresses the recently issued New York State Hospital Report Card. You don’t need to be a resident of Central New York, or even New York State to gain benefit from this column. Resources for you are found below.
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Dear Central New York Hospitals:
It’s report card time. That time when we patients get the opportunity to learn whether or not you’ve improved your patient care and outcomes since last year.
I was hoping to find glowing reports. After all, you know exactly what will be measured and what needs to be done to earn the highest grades. No one’s expecting miracles; just safe and timely care, a clean environment, pain management and effective communications.
But did I find stellar reports? No.
Granted, the report card says I have less of a chance of catching pneumonia at St. Joes. And, Community General, congratulations on your infection rate which is lower than the average hospital in New York State. Both St. Elizabeth’s and Faxton in Utica are doing quite well avoiding Pulmonary Embolisms and Deep Vein Thromboses.
But those are only three high grades among almost four dozen measurements. My real concerns are for those that registered lower than statewide averages – so low that some patients are dying, acquiring infections, suffering pain, and leaving your facility in worse condition than when they were admitted. Each one of you earned the lowest possible score in at least three categories.
According to news reports, one official blamed bad scores on outdated statistics. Sorry – that’s no excuse! Your patients are human beings, not statistics. Perhaps their pain, debilitation or death took place a few years ago, but many of those patients are still in pain, still debilitated and yes, still dead today.
As you know, beginning next year, Medicare will take patient satisfaction survey scores into account when it comes to determining reimbursements. We patients don’t require much to score you highly on those surveys. We expect only the basics: communicate with us respectfully, prevent infections, avoid mistakes, keep us as pain-free as possible, and send us home with instructions we understand and can carry out.
Put another way: treat us the way you would treat your own loved ones. Provide for us what you would provide for them.
Such an approach is bound to land you in the top tier on next year’s report card.
Best regards,
Trisha Torrey
Every Patient’s Advocate
PS: Patients can find New York State hospital report cards by linking to http://www.myhealthfinder.com/newyork11/. Pay particular attention to patient safety and satisfaction measures. Then use those scores to choose where you want to be hospitalized. Your life may depend on it.
……………… ADDITIONAL RESOURCES ON THIS TOPIC ………………
More Hospital Report Cards (more states)
How to Choose the Best Hospital for You
A Patient’s Guide to Hospital Infections
How to Prevent Hospital Infections
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September 1st, 2011 by Trisha Torrey
(as published in the Syracuse Post Standard August 30, 2011)
A few years ago, I changed primary care doctors.
The one I left had good credentials. Over the span of a few years and several visits, she had seemed competent and was friendly.
But on my final visit, there had been a change that caused me to leave her practice. It came in the form of a sign which hung on the walls in all of her exam rooms. It said, “Please do not phone us for your test results. We will call you if there is a problem.”
I was stunned; although I knew immediately why she imposed that policy. It costs time and money to phone all those patients, make copies and mail them. She decided the expense wasn’t worth the failsafe. As her patient, I found that to be dangerous and unacceptable.
A study published in 2008 illustrates why this is a problem. It focused on mistakes made during the ordering, administering and reporting processes of primary medical care tests. The report showed that seven percent of results that went unreported to the patient resulted in additional problems for that patient including delays in treatment, further pain and suffering, and more out-of-pocket expense.
Evidently my former primary care doctor finds it acceptable to intentionally drop the ball on care for seven percent of her patients. Those weren’t odds I was willing to accept.
Few of us visit our doctors anymore, primary care or specialists, without being tested for something. Blood work, urine tests, a CT, MRI or any other test…. No matter whether the results are perfectly normal, or identify a problem, we need to know where we stand and what to change, if necessary. Their results are always important, and we patients must always know what they are.
When you are given any sort of medical test, ask how and when the results will be reported to you. Don’t accept a “don’t call us” reply. When they phone you with results, ask for a follow-up copy by email or postal mail. If you don’t hear back when they say you will, call the office of the doctor who ordered the test and bug them until they come through.
Doctors’ practices are becoming busier than ever. It’s easy for test reporting efforts to drop through the cracks. Don’t let your test results be among them.
……………… ADDITIONAL RESOURCES ON THIS TOPIC ………………
How to Get your Medical Test Results
How Primary Care Doctors are Dropping the Ball on Medical Tests
How to Get your Medical Records
How to Correct Your Medical Records If There Are Mistakes
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August 18th, 2011 by Trisha Torrey
(as published in the Syracuse Post Standard August 16, 2011)
Recently I was chosen to participate in a new writing project. There were some basic details and responsibilities I was expected to agree to, including a specific number of articles, average number of words, and some other typical expectations.
I was given a contract to sign. After a careful reading, there were some strange differences from others I had signed in the past. I found some hedge words in the contract which could mean I would do all the work, but they could decide not to pay me, yet still have the rights to use my work. Red flags!
I didn’t jump to conclusions. Instead I asked questions. “Will you explain what this means?” “Will you give me an example of how this might work?” Eventually we clarified the fuzzy wording, worked out the terms, and I signed the contract.
But – and this is important – I didn’t sign it without making a few alterations to the descriptions. Each party initialed those changes, then signed the contracts.
So why should you, my reader, care about my writing contract?
Because every time you need certain medical tests, any medical procedure and many treatments, you are asked to sign a contract, too. It’s called “Informed Consent.” By law, those services cannot be performed unless your signature is obtained ahead of time on an Informed Consent document. That consent provides legal protection to both you and the person who performs the service.
The real question before you sign is, have you been thoroughly informed? Do you understand the risks, benefits and alternatives to whatever service is about to be performed? Do you know exactly who will perform it? Have they managed your expectations?
Sometimes Informed Consent documents will have hedge words or statements in them, like my contract did. For example, “to be performed by Dr. Serg Ury or his representatives” may mean your surgery will be performed by someone you don’t expect. Just who are his representatives? They might be his partners, or they might be students. If it is important to you, then clarify, and change the wording if necessary.
Wise patients never sign an Informed Consent document until they are very clear on what is about to happen, who will be making it happen, and what the risks, benefits and alternatives are.
Clarity will provide confidence that you understand what is about to happen, and that you’ve made the right choices for you.
……………… ADDITIONAL RESOURCES ON THIS TOPIC ………………
Understand Informed Consent
Trauma from Violations of Informed Consent
Patients’ Rights in the United States
How to Prevent Surgery Mistakes on the Day of Surgery
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Want More Patient Empowerment?
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About.com Patient Empowerment
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Patient Empowerment Tips
August 4th, 2011 by Trisha Torrey
(as published in the Syracuse Post Standard August 2, 2011)
Recently a series of videos appeared on a doctor education website, attempting to teach doctors how to deal with difficult patients. One of the videos was entitled, “The Patient Who Knows Too Much.”
That video sparked a heated debate among empowered patients and professionals. Can patients possibly know TOO much about their medical challenges and needs?
My opinion on this controversy might surprise you.
I don’t think the real question is whether patients can know too much. In fact, I think most of our doctors prefer we understand our health challenges and the steps needed to manage or get past them.
Instead, I think the real problem is how we patients approach our doctors with what we have learned, too often putting stock in misinformation. We arrive in our doctors’ offices with a fistful of computer print outs – information we’ve gleaned from our web searches that may, or may not, be appropriate to our conditions. It’s not that we know too much. It’s that we are curious about points the doctor believes to be wrong or irrelevant.
When the doctor finds us in the exam room with that stack of printed pages, whether or not he realizes it, he may become defensive. He may even be insulted. He has spent years getting an education and amassing experience. Before him sits a patient who thinks she is knowledgeable because she spent an hour on the Internet.
Further, it’s not that he believes his patient knows too much. It’s that appointment times are short, and he knows she will have a litany of questions about her findings, many of which do not apply to her diagnosis or symptoms, and some of which are false information.
But we empowered patients do have questions! We constantly find information we want to discuss. So what should we do instead?
Begin by making sure the information you find is credible and reliable. Here are some guidelines: http://bit.ly/CredibleHealthInfo. When you find possibly useful information you would like to discuss with your doctor, prepare some notes and questions to take to your next appointment. Then leave the print-outs at home.
During your appointment, ask, “Doctor, what do you know about X?” You’ll be asking for his expertise, not putting him on the defensive.
Patients cannot possibly know too much. But they can certainly come across as if they do. Don’t let that approach come between you and your doctor.
……………… ADDITIONAL RESOURCES ON THIS TOPIC ………………
How to Verify Credible Health Information
Sharing Internet Health Information With Your Doctor
Use Blogs and Wikis to Find Health Information
Government Health Websites
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Want More Patient Empowerment?
Find Hundreds of Articles at:
Every Patient’s Advocate
About.com Patient Empowerment
…and…
sign up for 2x per month newsletters of
Patient Empowerment Tips
