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Looking for Trisha Torrey, (former) About.com Patient Empowerment Expert?

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You found me!  Here I am!

And I’m moving back in, here to my personal blog. Home. Where I started writing about Patient Empowerment in 2005.

It’s been awhile since I’ve been “home.” Look around!  You can see how dusty it is. I’ve got to wash the curtains and get them back up. Clearly the place needs to be swept and vacuumed.  Those are all tasks I’ll get squared away in the next few days. Give me a week and I may even get some new paint on the walls.

Are you wondering why I’ve moved back home? 

Simple answer – it’s because I was sent packing.

Most of my regulars know about my work at About.com Patient Empowerment.  I started writing for About.com in late 2007 and in all, I published more than 800 articles on topics from how to be an empowered patient, to how to get your medical records, to how to look up CPT codes, to how to deal with an arrogant doctors and much, much more.  In addition to those 800 articles, I wrote more than 1000 blog posts!  And I would still be writing and publishing there today… except that….

I was terminated June 30.  Gone. Kaput. Right in the middle of my contract year.  They decided they didn’t want me anymore and cut me off. Chop chop.

If you want details, here they are.  But that’s not the point of this post.

This post is to tell you that I’m going to lead by example.  That is – throughout my patient empowerment work, the advice I always give to you is to stick up for yourself and to be sure to take responsibility for the situation you’ve been dealt.  Don’t take crap from anyone.  YOU are the most important stakeholder in your own care and to get what you need, you need to take the lead.

So that’s exactly what I’m doing here.  As much as I loved my work with About.com, it’s no longer an option.  So I’m moving back home, gonna spiff up the place, and will begin publishing again right here to keep my commitment to helping you, my readers, get what you need from the healthcare system.

Here are some of my plans:

  • I’ll be writing articles just like I was writing them before – so – what topics would you like to see?
  • One of the recent changes About.com had made was to take away YOUR opportunity to comment on articles and blog posts.  By publishing here, I’ll be restoring that capability.  So please do comment!  I learn from you every time.
  • In the past two years I was sending out only 5-6 newsletters a year from this personal site, but now that there will be no more newsletters coming from me at about.com* I’ll begin sending from here.  You can help too, by letting your friends know.  Here’s the link you need to get signed up.

Together we’ll weather the healthcare system together, whether About.com wants to help in that effort or not.  I’m still Every Patient’s Advocate. They can’t take that away from me.  And I’m here for you.

Are you with me?  Great!

(Now could one of you big strong guys help me move my desk over there – under the window?  It’s a beautiful day, and I don’t want to miss the sunshine.)

I’ll be back soon with some usable healthcare information.  All suggestions welcome :-)

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*about.com will likely continue to send patient empowerment newsletters, and for the foreseeable future, they will be my articles. But there will be nothing new that hasn’t been sent out in a newsletter previously. Feel free to unsubscribe if it gets to be redundant.

More:  At About.com, Experts Are Disposable

Sometimes It’s Better to Just Say No

Story One: When I was a child (and we’re talking a lo-o-o-ng time ago – when doctors made house calls)… if I got an earache, I would suffer.  REALLY suffer. Mom would drip some warm oil into my ear, and then stuff some cotton in behind it. She’d give me an orange flavored baby aspirin or two.  And I would just lie in bed, or on the couch, miserable.  MISERABLE.  Seems like I would sleep a lot. Two days later, my earache would be gone, and because I was a kid, and resilient, I would be back on my feet.

Story Two: When I was a kid, I fell off my bike as I flew around a corner near my house.  My bike flew off in one direction and I flew in the other, and landed smack on my elbow.  OH THE PAIN!  I pulled the cinders out of my arm, and cried all the way home as I dragged my bike with me.  That evening my dad walked me across the street to see a doctor who lived in our neighborhood.  He felt along my arm, moved it around a little, declared that I had sprained it, then put my arm in a sling where I was expected to keep it for the next few weeks.

Perhaps it’s miraculous that I survived childhood!  But I don’t think so.  I think any of us over a “certain age” had very similar experiences as a child.  We all had sore throats and earaches, we all sprained and broke bones – and we didn’t have the miracles of modern medical care to help.

Fast forward to today.  Today when we go to the doctor, no matter what the complaint, we are met with a barrage of tests, procedures and treatments.  If I had a sore throat and an earache in 2012, I would likely be given a strep test (chi-ching!) and prescribed an antibiotic (chi-ching!)  If I fell off my bike in 2012, I would be given at least an X-ray (chi-ching!), but more likely a CT scan.  I’d be prescribed an antibiotic (chi-ching!) and maybe even a pain killer (chi-ching!)  I’d need follow up testing to see how well everything was healing (chi-ching!)…

Bottom line – healthcare is so much more expensive today because we do things that we don’t necessarily need to do.  We are herded into services that we don’t necessarily need.  And (shame on us) we ASK for things we don’t necessarily need and probably shouldn’t get.

Don’t need?  Shouldn’t get?

Antibiotics, the miracle drug of the 80s and 90s, were so overprescribed that today the bugs they were intended to kill have evolved into superbugs. People die from acquiring infections that didn’t become problematic until the overuse of antibiotics.  Yet – mom takes her child to the doctor with an earache and insists an antibiotic be prescribed for her child.  Two days later, the child is no longer in pain.  (But is that any improvement over the two days it took me to get past my earache 50+ years ago?)

The existence of CT scanners, MRI scanners and PET scanners, and the need to pay for them, compel doctors to order those tests, even in cases when they may not be necessary.  Of course there are times when they are very necessary – but not always, and not as often as they are used now.  When it comes to so much extra scanning, it can create big problems for our health (too much radiation exposure from x-rays or CTs) AND our wallets – imaging is expensive, even when we have insurance.

So how can we know the difference?  How can we be a bit more savvy when it comes to test and treatments, whether or not they are suggested by our doctors?

Last month, a consortium of nine different medical specialties – the very doctors who make money when we have tests and treatments – came out with their lists of tests, treatments and procedures we patients don’t need.  They listed them all on a website, called Choosing Wisely.

If these doctors don’t think we should take these tests, then why would we have them?

What we know is that this elite group has made these recommendations.  What we don’t know is that those recommendations will filter down to the doctors who order these tests, treatments and procedures – because that’s how they make their money, and (they think) that’s how they can defend against lawsuits.  (We can only imagine how unhappy that orthopedist who makes his living running CT scans is with his own peers that tell patients not to get so many CT scans.)

So, knowing that our doctors may not be aware of the lists, or may have chosen to ignore the lists, it’s up to us patients to ask questions.  “Doctor, If I take this antibiotic, how soon will I feel better?  How soon will I feel better if I don’t take it?”  — or — “Doctor, I know an X-ray is much less expensive than a CT scan.  What will a CT scan tell you that an x-ray won’t?  Can I have just the x-ray?”

So yes, fellow empowered patients, it’s time for us to begin making smarter choices, both for our wallets and for our health.  Make yourself generally aware of the new recommendations of tests, procedures and treatments you just don’t need.  Understand that leaders in healthcare who understand about reining in costs, even if they are the ones who lose income, are calling out to their peers to make changes in their recommendations….

Unfortunately, anything in medical care takes a LOT time to implement.  But this is something we patients can do – and do with no detriment to our health OR our wallets.
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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 my 2x per month newsletter
full of Patient Empowerment Tips.

Time to Put a Stop to Drive-by-Doctoring

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.

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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 my 2x per month newsletter
full of Patient Empowerment Tips.

A Tutor Who Tooted the Flute…

In a conversation with a friend the other day, I was explaining the need for patient advocates (which she got immediately) – and the “tutor tongue-twister” came to mind.  Do you know it?

A tutor who tooted the flute,

Tried to tutor two tooters to toot,

Said the two to the tutor, “It’s tougher to toot, than to tutor two tooters to toot!”

Now – you may wonder what tooting tutors have to do with patient advocacy.  And yes, I’m going to tell you….

When I explain the role and benefits of having a private patient advocate help you when you’re sick (or a loved one is sick), sometimes people don’t understand why they would want to reach into their pockets to pay for someone to help them get the healthcare they deserve.  After all – healthcare has always been free, right?  (Well – free PLUS the cost of premiums PLUS the cost of co-pays PLUS the cost of services not covered, etc….  )

So – my new metaphor is that of a tutor.  If your child is struggling to pass trigonometry, and you know his ability to go to the college he wants to go to (or you want him to go to!) is dependent on whether he will pass trig, then you have the sense that it’s not just about trig – it’s about the quality of the rest of his life.

He goes to public school, which is free, just as healthcare is free. (We pay for schools in our taxes like we, or our employers, pay for healthcare with our policies.)

He has stayed after school for extra help (still doesn’t get it), your sister-in-law the math teacher can’t seem to help him (like many hospital advocates or websites might provide some help), he won’t let you help (caregivers find it so difficult to manage their loved one’s healthcare) – but he still doesn’t understand trigonometry.

So now what?  With his future so dependent on getting past this one, very difficult hurdle…. what are you supposed to do?

You hire a private tutor.  Someone who can work one-on-one with him. Someone who knows some of the inside information needed to get him past the final exam.  Someone whose sole purpose is to make sure your son passes trig – because if his work with your son is successful, then his tutoring business will continue to grow, too…

Someone who will make sure your son has the quality future he deserves, despite the fact that the “system” (meaning, in this case, the school system) just isn’t providing the way your son needs it.  And for that, you will happily pay from your pocket – because it’s that important.

Which is exactly what a private advocate does – provides you or a loved one with the quality future you deserve, making sure you get what you need from a system that is too dysfunctional to provide it.  A private patient advocate is only interested in making sure YOUR interface with the system works well, that you get exactly what you need, whether what you need is the right diagnosis, the right tests, the right treatment – or even medical bills that are no more than they should be, or must be.

… A patient or health advocate will help you navigate the health care system to get the quality future you deserve, despite the fact that the “system” (meaning, in this care, the healthcare system) just doesn’t provide you with the real help you need.

And more…. there are dozens of ways a patient advocate can assist you.

This week is Private Professional Patient Advocate’s Week.  Whether or not you are struggling with your medical care, you will benefit from having a private health or patient advocate to lean on, and to bring you through it.

…making sure you get the quality and quantity of future you or your loved one deserves.

(Now – say that three times fast!)

…MORE…

Find a Patient Advocate to Help You

How to Interview and Choose a Patient Advocate

Why a Private Patient Advocate May Be the Answer for You

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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 my 2x per month newsletter
full of Patient Empowerment Tips.

Who’s Really a Patient? Skewed Opinions Result from Inside Information

That seems like a fairly simple question, don’t you think?  Who really is a patient? But the answer is actually more complex than you might realize.

Among the possibilities:

1.  anyone who has ever accessed medical care is a patient – which includes everyone, no matter what their relationship is to the healthcare system (so, for example, doctors would also be considered patients, as would any other provider, or even payers like insurance company employees, or pharma employees, etc.)

2.  anyone who has accessed medical care, but doesn’t have inside knowledge of the healthcare system, is a patient

By dictionary definition, the answer is #1: that anyone who ever accesses medical care is a patient.

But when it comes to defining a patient’s perspective, his or her point of view, then the answer is not so cut and dried.  In my (not so) humble opinion, a medical insider cannot possibly truly understand a non-insider patient’s point of view about their healthcare experience.

Here are some examples:

  • When a doctor, nurse or other provider finds troubling symptoms,  s/he doesn’t just make an appointment, then wait for days or weeks like the rest of us do before we see a doctor.  S/he calls a friend and gets in to see him or her right away.  So – what is that patient’s perspective?  Is the point of view going to be the same? No.
  • When an insurance company employee needs a medical test or payment for a claim, s/he knows from the inside how to get it taken care of.  Is that the same perspective as someone who struggles to get those services?  Is the point of view the same? No.
  • When an insider, who is getting paid under the table for prescribing certain medications or is rewarded by a medical device manufacturer for using that company’s devices (think artificial hips and knees, or spinal fusion material, etc), is asked about the cost of care, they can’t see it the same way as the patient who needs that new hip and doesn’t have insurance.  Do they have the same point of view about their needs?  No.
  • When a popular doctor has surgery in his own hospital, in a private room, where the nurses respond quickly to the call button (because he IS one of their favorite doctors!), and is then discharged with no infection, do you think his perspective can be nearly the same as a Medicaid patient treated in that same hospital?  Yet – they are both patients in that hospital.
  • When the director of the “National Cancer Awareness and Prevention” charitable organization, the majority of whose budget is underwritten by a handful of pharmaceutical companies, is asked to represent patients on a conference panel to discuss the development and cost of cancer drugs, how objective can her opinions be?  Does she dare step on those pharma company toes by saying what a ‘real’ patient might say?

The subject came up most recently when yet another large, influential healthcare organization decided to hold a “patient and caregiver” forum to discuss “patient-centeredness” – and yet, once again, there were no non-medical-care-industry patients included as expert speakers.  Seriously.

It also reminds me of the many times I have approached healthcare conference planners, offering my speaking abilities, representative of that important patient point of view… and they were not interested.

Their response?  “We are all patients.”  (See #1 above.)  But if what they are trying to do is help patients – well – wouldn’t it be a good idea to ask a patient who isn’t an insider to chime in? Evidently not. They only wanted speakers who were from their industries.

Put another way:  it would be like GM or Honda designing cars without ever asking the opinions of car buyers, or JCPenney only selling size 4 dresses because they never assessed gender or the sizes of their shoppers.  They would swiftly go out of business….  which, of course, doesn’t happen in healthcare because we “consumers” (I hate that word in healthcare) don’t vote with our feet.

I think we need a way to make the distinction. If we are all patients – then what can we do to distinguish between those who do, or don’t, have a “real” patient’s point of view?  Are we, as non-insiders, “pure” patients?  Or are we “unencumbered patients?”

Or, maybe we do the opposite, and use a term to describe those patients who are insiders.  Maybe we call them “industry patients” or “insider patients.”

Or – maybe I’m missing the boat entirely….

This matters. It matters because when non-industry-insider patients are expected to be the representatives of a non-medical-industry-insider’s point of view, that point of view, and the results, get skewed.

And for us patients who don’t live inside the medical industry:
Skewed = Screwed …  In more ways than we can count.

What do you think?  Do you see the distinction?  While we may all access medical care, do you agree that our points of view are different?  What do you suggest we do to help the medical care industry understand and embrace the difference?

Please provide your 2 cents below.

…MORE…

Patients – The Invisible Stakeholders

The Myth of “Doctors Are Patients, Too”

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Want More Patient Empowerment?
Find Hundreds of Articles at:

Every Patient’s Advocate

…and…
sign up for 2x per month newsletters of
Patient Empowerment Tips