It’s a simple question, but it has stirred some controversy. It’s the word “friendly.”
Colleague and fellow passionate advocate Bart Windrum got (as my mother would say) his blood in a bubble after reading an article about engaging a patient advocate to help you navigate your healthcare, recently published in a Tampa newspaper.
In a list of tips about how to advocate for someone else, one tip said, “In hospitals ask, in a friendly way, that every pill, every injection, ….”
Business-like may be a term lost on some who don’t operate in a business environment. So I call it commanding respect. To gain respect, which is so necessary in any medical setting, you must command it. You earn it by your actions and approach.
(Please note — that does not say “demand respect” — I believe that is impossible in any medical setting unless the other person fears you — another post for another day.)
How will you command that respect? By being diplomatic and concise. Start with polite. Let them know you have specific expectations and want accurate information. Earn / command the respect of those who can get you what you (your patient) needs. If you don’t get the information or action you need in a fair amount of time (some actions require seconds or minutes, others can wait a half hour) then become assertive. Never, ever become aggressive unless it is life and death and you are being ignored.
Here’s an example I got from Charles Inlander, a gentleman who was advocating for patients before most realized they needed it. He was in the hospital, and needed a nurse’s help in the middle of the night. He pushed the call button a number of times and got no response. (Does THAT sound familiar!) So finally he picked up the hospital phone, dialed “O” to get the operator, asked for the nurses’ station on his floor, told the person who answered what need needed, and seconds later the nurse showed up in his room. (I love these kinds of ideas!)
What’s your experience? Have you advocated for a loved one in a hospital? Did “friendly” work when you actually needed something? Or did you find yourself having to be more definite and concise?
It’s been awhile since I posted — but you’ll understand why.
My father suffered a mild heart attack a few days ago, and (thanks for asking) is doing as well as can be expected. In his 80+ years, he has never had any indication he had a problem with his heart! A variety of other health issues have arisen over time, but Dad’s heart was always thought to be as strong as could be….
In fact, despite protestations (“I don’t really think these chest pains are a big deal… let me just make an appointment to see my primary….”) emergency personnel arrived and whisked him off to Sarasota Memorial Hospital (Florida) where he spent the better part of the next three days.
Some rigorous testing, a heart catheterization and an angioplasty of a small artery later, Dad is home and getting his sea legs back.
I happened to be visiting him when it struck – amazing timing, don’t you think? I’ll be here for a few more days to make sure he’s on his feet and feeling more confident, as we review what led him to a heart attack and what adjustments he’ll need to make from here.
Of course, little did those who helped Dad know that a critique would be forthcoming once we were past the initial shock and care. I’ve been making observations throughout that might help all of us get the care we need.
I can’t say enough GOOD about Sarasota Memorial Hospital. I’ve been admitted to, and visited, many hospitals, but by far, SMH is the best I’ve experienced. Here’s why I say that:
The personnel were very helpful. No one was ever too busy to answer a question or explain what we needed to know. When we had questions about the meaning of the various numbers appearing on the monitor he was attached to, each section was patiently explained to us. When they moved Dad to a room, I was able to get easy directions to find him. When Dad was admitted, he mentioned he hadn’t eaten any breakfast or lunch, and a turkey sandwich appeared.
The hospital is immaculately clean, from the facilities to the people. A great deal of emphasis is placed on washing and sanitizing hands and surfaces. I watched the cleaning people use great care in cleaning up behind the patient in the next bed, wiping off every surface including the phone, the bed controls, the TV remote. The personnel that actually touch patients (nurses, others) were diligent about washing their hands and sanitizing. The only time either Dad or I asked them to wash their hands was in the emergency room, and then the nurse told us she had sanitized before she came in the room (although I didn’t see any dispensers outside the room.) But she was happy to comply when Dad asked. Of course, the entire point is to avoid infections.
Dad’s nurses, in particular a young man named Eyves who was available the entire day of his procedure, and the night nurse, Bren, were particularly helpful. Dad had a rough time of it — a lot of pain and nausea. Both were right there for him and did everything they could to keep him comfortable.
The check-out process was excellent. All instructions were explained to us carefully. Dad, foggy from so much painkiller, had some trouble processing instructions, but the discharge nurse was very patient, taking it very slowly so it could sink in.
Even the food in the restaurant is good! Add that to the free parking, great signage (very easy to find my way around) and the fact that we could use cell phones, had free internet access and no restricted visiting hours…
The ONLY fly in the hospital ointment was communication from the doctors — a problem that was a much larger minus than it needed to be. The problem was this: we were told that both the proceduralist who performed the heart cath/angioplasty and another doctor would visit us a few hours afterwards to explain the findings and next steps. It never happened. In fact, the proceduralist NEVER visited, and Dad’s new “assigned” cardiologist (the recommendation from his primary) didn’t visit until the next day. Both he and the primary get a few points for phoning me (it was 7:30 AM, and I hadn’t gone in to the hospital yet).
This problem was not about the actual communications; rather, it was about managing our expectations. If we had been told we wouldn’t be contacted by either doctor until the next morning, we would not have expected it, nor would I have been upset when we didn’t.
And this is where Dad’s nurse, Eyves, gets more brownie points. When I made it clear how peeved I was many hours after we expected the proceduralist to arrive, he tracked down another doctor in that same practice who then called me and explained in a very detailed manner exactly what the findings were during Dad’s procedure.
This won’t be our last experience with Sarasota Memorial Hospital. My parents are both older and both have health issues. I expect I’ll get to know much more about this facility. I’m very thankful to know there is so much emphasis on the important aspects of care.
One more point to make: as mentioned, Dad was “assigned” his new cardiologist. I helped him understand that he is under no obligation to accept that assignment.
The same is always true for you. Referrals can work out well, or they may not. Just because you are referred to a specific doctor does not mean you are obligated to stay with that doctor. You may always choose your own doctor, as may Dad.
No one ever wants to be hospitalized, but if you’re in Sarasota and you need hospital care, give Sarasota Memorial Hospital a try.
I exchange thoughts with healthcare IT people on a daily basis over at Twitter. So many of them seem perplexed at why we patients look at putting our medical records on the internet with trepidation.
Then along comes this video from Elizabeth Cohen at CNN. In a matter of minutes, she was able to pull up one of her CNN colleague’s medical records, his kids’ records… She could see which doctors they’ve visited, what took place during those meetings…
HIPAA is supposed to protect us from others getting our medical records right?
We don’t want potential employers finding out we have to take meds to control blood pressure or cholesterol every day — it’s not their business!
And consider this scenario: you have no health insurance, or maybe you’ve just been laid off and you’ve lost your insurance. Now you need new insurance. Well guess what? Insurers are looking behind the scenes to find reasons to turn you down. Regardless of how easy it is for others to get your medical records, the Medical Information Bureau makes it easy for insurers anyway.
Here’s my opinion on this issue: I absolutely believe our health records need to be online, both to improve our health and to save money. Both are reason enough to do make medical records accessible digitally.
I do NOT believe patients should be putting their own health information online through Google or Microsoft Health Vault or any of the free applications out there, and I very much object to those large organizations (like the Mayo Clinic) which are getting in bed with these two privacy-sucking behemoths. Those “free” applications are not free. I’ve written about that extensively in the past.
Now the government is looking at ways to move all our records online, and they are ready to throw $20 billion into the project. I support that — with this caveat: part of that money must make sure that our records can’t get into the wrong hands — including Elizabeth Cohen’s (Elizabeth, you know I love ya!) — because while Elizabeth is only showing us the potentials, not everyone has our best interests or good motives for doing so.
By the way, Elizabeth takes time in the video to tell us how to protect our records. Take a look. It will serve you well.
(The following is reprinted with permission from John James, PhD, a patient safety advocate who came to his work after the loss of his son, Alex, to medical errors. Dr. James publishes a monthly patient safety newsletter, and has written a book focused on what he learned about the dysfunction of America’s for-profit healthcare system. His book is called A Sea of Broken Hearts. Dr. James has also been one of my guest bloggers.
I share it with you today, because it provides two lessons for us. First, that whenever we access medical information, we must be sure we are assessing it objectively, and getting objective information from it. And second, because it reminds us that medicine is so very personal, that almost no medical information can be completely objective. Even those strictly scientific medical research results we find?… they were biased to some extent when they were designed.
Among those of us who bring you patient empowerment and patient safety information, we do try to be as objective as we can. But…… well….. read what Dr. James has to say…. )
Healthcare Journalism and Truth
A perspective article in the New England Journal of Medicine gave me a dose of my own medicine to ponder. Susan Dentzer, a medical journalist, poses important questions about the role journalists should assume in communicating information to the public.6 To what extent should the big picture be conveyed? How far can one go in sensationalizing a reported medical discovery? Is the story I am writing something my readers might use to determine their own care, and if so do I have a responsibility to be more careful? How far should I go in mentioning caveats to the reported results? Have I over simplified the results to keep my story short?
I have chosen to become a medical journalist in a most unconventional way. I am neither a journalist in the usual sense, nor am I a medical caregiver. I am only a medical scientist trying to communicate to my readers the important patient safety findings that appear in selected medical journals. I am not making a living as a medical journalist. I do this because my heart has been broken by uninformed and unethical medical care, and I do not want this to happen to others.
My stories are intended to be useful to readers in their own medical care and to be useful in informing ordinary folks of risks associated with healthcare. I must ask myself, am I writing in a balanced, objective and clear way? I honestly struggle with these issues at times. Medicine is incredibly complex and placing new information in perspective is not easy. If I seem at times to give medical advice, this is not my intention. I seek to convey scientific facts to you that will help you ask the right questions of your doctor. I’m not a physician, and I don’t pretend to be one.
Am I biased in my reporting to you? As much as I want to be objective, those of you who have read my book know that I think we have an unethical, dangerous and profit-driven healthcare industry. I will do all I can to expose examples of these problems and show how we might one day have an ethical, cost-effective, inclusive, and trustworthy healthcare system. I am biased that way.
As careful as I try to be, I will make errors of perspective and balance in my stories. For all the criticism I level at the American healthcare industry, I too shall err.