Posts Tagged Magazines

Doctors and Patients: It’s All About POV

Point of view — I was struck as I read through the various essays written by Dr. Scott Haig, and published through Time and CNN during the past several weeks, how much point-of-view changes how we look at the world. More importantly, I have a better understanding about how communications improve when we see OUR world through someone else’s point of view.

Here are the essays I’ve found so far:

When the Patient is a Celebrity

When the Patient is a Googler

My Patients are Not Customers (which I’ve blogged about previously — see this post)

I’ll state up front that I think Dr. Haig does a pretty good job at seeing the medical world from a patient’s point of view. I disagree on a few observations but on the whole, in a conversation, we would respectfully get beyond those fine points and pat each other on the back for ‘getting it.’

Here’s what I mean: Dr. Haig (like my guru Jerome Groopman, MD) uses point of view to help his patients understand what to expect from him and his treatment advice. And, even more important, he is able to elicit from his patients what they expect from him, from themselves, and from their treatment decisions. He helps them see his point of view.

I believe that doctor-patient communications, and (I’ll even go so far as to say) patient outcomes, are rooted in that premise: that it’s important for both sides to see the other’s point of view. It’s a skill — and Dr. Haig seems to have mastered it.

In the one article about the patient who googles too much (She was so mired in her own point of view, that she was having a problem working with any doctor who could help her. ) The real point to the essay is that Dr. Haig was able to analyze his patient’s point of view, realized he would not work well with her, and then decided to send her away. [[ Note: — I’m not sure it was her googling, but rather her attitude, that made him decide to send her away. I think that patients who learn about their symptoms and diagnoses are empowered to have a respectful conversation with their doctors, and that’s what I encourage. ]]

Another article talks about a football player who became Dr. Haig’s patient. They had a good relationship because Dr. Haig managed his the patient’s expectations based on what he knew about the patient — he was respectful of the man’s sports career, even though he really had no idea who the player was. And later, when the player returned for still more treatment related to his new career — pharm sales — Dr. Haig was able to take point of view into consideration to work with the patient.

Here’s the problem. There just aren’t enough doctors OR patients who work with each other in this fashion.

And I realize that it’s what I’m trying to do as I work on behalf of patients — helping them understand how the medical world has changed — giving them a sense of their practitioners and providers point of view — to help them get better care.

AND — I try to do the same in reverse. For those doctors and other providers who just don’t “get it” — it’s because they either refuse, or are incapable, of seeing their patient’s world through a patient’s point of view.

Here’s your assignment for today: Pick someone you disagree with — a politician, a co-worker, a neighbor — and see if you can figure out his/her point of view. How do they see the world differently? What is their background for seeing it that way? And how do they see what you say and do through their own point of view?

It doesn’t mean you have to like them any better. But once you can see their point of view, it will certainly help you understand why they say what they say and act like they do. And you’ll be able to communicate more effectively if you’re ever in a position to need that skill.

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Posted in: Doctor Communication, Health /Medical Consumerism, Healthcare Quality, Patient Advocacy, Patient Empowerment, Patient Tools, Self Help

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Isabel’s Misdiagnosis May Save YOUR Life

Jason Maude wants to save your life.

He lives in the UK where healthcare is a given, like a public education. If you are a citizen, you get healthcare. But remarkably, stories of misdiagnosis are identical to those in the US. It seems that regardless of whether healthcare is an entitlement or insured, misdiagnosis still happens.

In 1999, Jason’s daughter Isabel, then age 3, was misdiagnosed and nearly died. From a “normal” case of chicken pox, she developed toxic shock syndrome, then necrotizing fasciitis, a med-speak term for flesh eating bacteria. But the doctors didn’t see it. They didn’t diagnose it until it was almost too late. Instead, because Jason and his wife trusted their intuition, and relentlessly pursued the REAL answers, Isabel eventually got the diagnosis and care she needed. Today she is a healthy, happy 11-year-old because of her parents’ diligence.

Now suppose your child almost died – or DID die — from a misdiagnosis. How would you feel? What would YOU want to do?

Most of us would be beyond angry, and rightfully so. Most of us would make sure we did everything we could to punish those providers who had killed, or almost killed our children.

But not Jason and his wife. Instead, they decided to do something to make sure nobody else’s child, and his/her parents and loved ones, would ever have to live through such a horror.

How? Jason approached the doctor who had been in charge of Isabel’s care — the one who was ultimately responsible for Isabel’s corrected diagnosis — and suggested the two of them collaborate on putting together a system for doctors worldwide to use to make sure all diagnosis possibilities were being considered for any given medical problem. The doctor, Joseph Britto, MD, readily agreed.

Since then, they’ve made it happen. A huge database of every diagnosis framed by all its possible symptoms — and vice versa — is available to medical centers and doctors’ practices worldwide. It’s being used by the likes of Yale-Newhaven Children’s Hospital, the University of Virginia Health System, and other esteemed — and very wise — hospitals and doctors, both in the US and the UK.

Yesterday I had the honor of speaking with both gentlemen. I think we could have talked for hours and hours because we have so much in common and we agree on so many fronts! Jason and I have almost identical advocacy stories, of course. We agreed that turning our anger into something positive for others is incredibly cathartic.

And I learned, and confirmed so much! Such as:

  • Did you know misdiagnosis is the 4th leading cause of death in the US?
  • Did you know most doctors jump to judgement about your diagnosis and frame it so tightly in their minds that they dismiss other possibilities? (Just ask Jerome Groopman.)

So as you can imagine — I am ecstatic that this system exists now. I wonder whether it could have saved me from my misdiagnosis odyssey? One can only hope.

And I do have a few questions about its use — one that will remain unanswered for awhile, and one that was answered, like the answer to a prayer.

Question One: is there any way to overcome the objections of the the way-too-many-doctors who see the use of such a system as stepping on their toes, to transcend their egos for its use? If I try to answer this question myself, I think the solution will lie in showing them it can save them money because there will be fewer lawsuits (yes — money — the root of all healthcare in the US). Please note I haven’t mentioned that they would be interested in using it to save lives.

Question Two: is there any way patients can influence use of the Isabel system? or use it themselves?

Both gentlemen were quick to tell me about the beta-testing of a system for us patients to use — the Isabel Symptom Checker — that we can use and share with our doctors. Yes!!

Now if you read my work regularly, you know I don’t, in general, support the use of online symptom checkers. I think the ones that currently exist are more problematic than helpful. You’ll either decide what your problem isn’t important enough to bother the doctor (and it might be life threatening!) or you’ll decide you’re dying of a rare disease (when you aren’t very sick at all.)

So why would I support the use of an Isabel-related system for consumers? Because it is intended entirely to COMPLEMENT your work with your doctor — not replace the doctor’s opinion. It is intended to help you and your doctor expand lists of possibilities — differential diagnosis options — not get in the way of your work with your doctor.

Until the patient-consumer version is available? Patients who are lucky enough to live in areas where hospitals or doctors currently use the system can choose to see those doctors. Find the most current list of Isabel users here.

So once again, my belief that everything happens for a reason is confirmed. I’m so sorry Isabel and her parents suffered as they did. But I’m thrilled that Jason took his anger in the direction he did. As the Isabel Diagnosis System saves more lives, others, too, will realize what a blessing their odyssey was, too.

I’ll keep you, my loyal readers, posted on the launch of the Isabel Symptom Checker. It’s most definitely an idea that’s time has come. Patient Empowerment at its finest.

Learn more:

Link here to the Isabel Healthcare System website.

Link here to an article in Forbes Magazine.

Link here to an article in the New York Times.

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Posted in: Doctor Communication, Health /Medical Consumerism, Healthcare Quality, Hospitals, Patient Advocacy, Patient Empowerment, Patient Safety, Patient Tools, Self Help

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Doctors Write “Information Prescriptions”

This month’s AARP Magazine has a good article about finding trustworthy health and medical information online written by David Kushner. (I tried to find it on their website to provide you with a link, but it doesn’t seem to be there.)

There is some excellent advice — points I share with readers and workshop attendees on a regular basis. And there was one point in the article that was new to me! So I thought I would share it with you.

Turns out, the American College of Physicians and the National Library of Medicine have finally figured out that patients WILL look online for information, even if they prefer patients not do so. (surprise!) In their “if you can’t beat them, join them” approach, they have now developed a “process” to help physicians help their patients find trustworthy information. They call it an “Information Prescription” — and they sell doctors little prescription pads so they can write down a web address or two, plus some keywords for patients to use.

OK. I’ll buy that. Now the question is — how do you find a doctor who buys in to the approach? (I think there may be one in Texas 🙂 !) My experience is that most doctors either hate the fact that patients use the internet, or they suffer it, sometimes not so silently.

But it’s definitely a step in the right direction.

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Posted in: Doctor Communication, Health /Medical Consumerism, Healthcare Quality, Patient Advocacy, Patient Empowerment, Patient Tools

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