As many of my readers know, I speak at meetings and conferences fairly frequently, and most often to groups of patients and caregivers. The focus of the talks I give is usually on a patient empowerment topic – ranging from how to communicate with your doctor, to how to stay safe in the hospital, to a dozen other topics….
Every time I speak to groups of patients, I ask the question, “Have any of you ever felt rushed during a doctor appointment?”
The overwhelming majority raise their hands, and nod, and often turn to the person sitting next to them, poised to share their latest horror story about being rushed, which is often the case after they’ve waited in the waiting room for way too long. A double whammy.
Frustrating. Maddening. Unfair. And now, statistically accurate, including its negative effect on both our health and our wallets.
Newsweek Magazine published an article this week called The Doctor Will See You – If You’re Quick. Written by Shannon Brownlee (author of Overtreated), it quantifies the problem of, what I call, “drive by doctoring” – the concept that we barely see the doctor walk IN the exam room door, before the doctor has retreated back out that door, asking the empty hallway (because he’s no longer engaged with the patient at all), “Do you have any more questions?”
The point to the article (which is excellent – you really should take the time to read it in its entirety), is that over the past few decades, the trusting relationship that used to exist between patients and their doctors has eroded to almost non-existent, and has resulted in bigger problems for both parties. And both parties are suffering. Patients don’t like it, and their doctors don’t like it either.
Or (another one of my sayings) – American healthcare is not about health or care. It’s about sickness and money – using sickness to make money.
Here are some of the points that support that:
The ideal patient panel (number of patients) for primary care doctors should be fewer than 1,800 patients in order to provide the kind of care patients need. Today, the average number of patients per PCP is 2,300. And for “Medicaid Mills”, the panel is more like 3,000.
To speed things along, doctors interrupt their patients an average of 23 seconds into the answer to the question, “Why are you here today?”
One study showed that the average amount of time spent providing “critical information” to patients is 1.3 minutes (yes – that’s MINUTES.) Your quality or quantity of life only deserves 1.3 minutes?
To those of us who understand this madness, and attempt to be smart patients, there is nothing new here. But the information is beneficial to us for a few reasons:
First – because our world is being driven more and more by data, and not simply our observations and stories. With the quantification of these kinds of problems, the powers-that-be will have to look at solutions, because no nation can afford sicker and poorer people.
Second – because this kind of information is a good reminder to us all that it’s us SMART, EMPOWERED PATIENTS who will manage to get the best of a system that has the capability to be great, but is growing worse every day.
We can’t help those who won’t help themselves… but we can be the ones who will STOP this erosion, and help ourselves.
• Helping ourselves will mean we find the right doctors - the ones who WILL communicate with us. (A reminder that no doctor is average – they are either better than, or worse than, whatever average is. As empowered patients, we search out the “better than”.)
• Helping ourselves means we place ourselves squarely in the middle of our own medical decision-making - we don’t default to letting someone else make them for us.
• Helping ourselves means we find information to support our decisions, making sure it’s credible and reliable.
• Helping ourselves may mean that we try to manage our relationships with our doctors on our own, or it may mean we ask someone else to help us.
• Helping ourselves will mean understanding the roll the pursuit of profit takes on our health – we will understand the concept of Follow the Money and why that makes us poorer and sicker.
It took decades for the healthcare system to devolve to what it is today (just in time for us baby boomers to utilize it in huge numbers with, in too many cases, horrible outcomes.) It will take decades more to fix it.
Most of us don’t have decades to wait – and for that reason alone, we must engage in our own care. We can’t afford, for our health OR our wallets, to let drive-by-doctoring take its toll on us or our loved ones.
Want more Patient Empowerment? Find hundreds of articles at:
It’s that time of year again. The holidays, of course. But also the end of the tax year, when charities, including groups like cancer societies or hospital foundations, are pleading for donations.
Each year in December my husband and I make contributions to the charities we think are important, many of which are health-related. Last year money was tight, and we knew we would either have to cut back on how much we donated, or leave some organizations off our list.
To help us make those difficult decisions, I did some background research on each of the charities we ordinarily support. I was surprised at what I found! And learned some tips to share with you, too.
First, I learned that when children need specialized cancer treatment, they will get the same treatment whether they live in Paris, Tokyo, Sydney – or Syracuse. Pediatric oncologists worldwide share their research and successes to the benefit of children everywhere.
I had to ask myself – why would we send a contribution to a children’s hospital out of state? Since children receive the same specialized treatments, doesn’t it make more sense to donate in our own backyards? I’m sure those famous children’s hospitals provide excellent care. But if my child was sick, and I had to stay with her in a city far away, how would I get to work? Where would I stay? Bottom line – we decided to donate to our local children’s hospital, knowing local kids would get the great care they need.
Next up – family interests. Within my husband’s family or mine, we have loved ones who have dealt with Alzheimer’s, diabetes, lymphoma and breast cancer. We have always donated to those very large, national charitable foundations, thinking our money was going toward education, research, and of course, a cure.
Not so fast! It turns out that not all charitable foundations are equal – including those we’ve sent money to each year. I discovered that some charities are actually quite questionable. For example, too much of their money goes toward “undetermined” administrative costs. Or worse, only a small percentage of their budget goes toward their stated goals of education, patient support or research. One very well known charity is spending the bulk of its donations on legal fees, suing smaller charities!
Based on that information, we decided against supporting two of the organizations we’ve sent money to for years.
As a result of this process, I realized that if more of us were choosier about our donations, health-related or not, the most effective and efficient organizations would have more funds to really make progress with their missions – a benefit for everyone.
You may want to review your charity choices, too, to be sure your donations have the best chance of accomplishing the goals you think are important.
Here are some additional resources for
choosing the best charities for your donor dollars:
If you’ve watched TV, read the newspaper, or logged on to any health-related website recently, then you may already know that it’s Medicare Open Enrollment time.
Open Enrollment means you have the opportunity to make choices that affect both your access to the healthcare you need, and the cost of that care, by choosing a payer plan that fits your needs.
Too many Medicare recipients simply default to whatever plan they used the year before, perhaps because they didn’t understand how to assess which plan would work best for them.
But it doesn’t have to be so difficult. There are some excellent resources available. So why not take the time this year to figure out which plan fits you the best?
If you are a do-it-yourselfer, begin with the Medicare Find-A-Plan website. It will walk you through your options, including pricing for the drugs you take, then will reveal your options and their costs. You can compare Original Medicare against many Medicare Advantage plans. From customer service to co-pays and health ratings, you can weigh cost and coverage against quality to make your choice.
Another way to do your research is to attend plan presentation programs offered by the many insurers that offer Medicare Advantage Plans. They can be very informative, but remember that the speakers are salespeople. Their paychecks depend on enlisting new customers. Don’t be swayed by coffee, cookies and promises! Ask good questions and compare many plans before you sign a contract.
If Medicare Open Enrollment seems a bit early this year, it is. The process was started earlier so it could end earlier, too – December 7th. Ending the process early means you’ll be sure to get your Medicare ID card in time for early January appointments.
With so many ways to find help, you owe it to yourself to spend some time this Fall to review your Medicare options for 2012 and make needed adjustments. It’s “only” your health and money, after all.
When it comes to TV and video, Al Roker provides one of my favorite quotations:
“They say the camera adds 10 pounds. OK. So I figure I must be standing in front of 10 cameras.”
Oh, yes, Al. I know how you feel….
However — I’ve decided to come out of my video-avoidance closet to share the following with you all.
First — my excitement at the invitation a week ago to appear on MSNBC to speak to a problem that I actually cited a few years ago – that July is the worst month of the year to be hospitalized. Why? Watch and see!
So that’s the first one. But if I’m going to jump in to the world of video, I might as well do it with both feet. Many of you know that I am brought in to speak at various conferences and meetings across the US and Canada. I enjoy speaking! So in my attempts to do even more of it, I’m told I need to have a professional video made. So, yes, I finally bit that bullet, too, and have uploaded the online version of the opening here.
It’s not like I’ve never done TV before – I have done local TV on a number of occasions. And broadcast isn’t the problem – ferheavensake, I have hosted a radio show for 4+ years! But video, in general, has just always been a step I’ve avoided.