In last month’s column I discussed the beginning steps for making informed decisions about your health and how to work with your physician and other providers in order to develop an effective plan of care. This column is part two. After building productive and positive relationships with your providers, as well as gaining knowledge about your health condition or goals for good health, you want to think about making your health care safer.
Making our Health Care Safer with Better Collaboration & Communication
Collaboration and Communication
Collaboration and Communication with clinicians is critical because in our current healthcare environment we often find ourselves with multiple caregivers and numerous physician specialists caring for us. Although having specialists involved has it benefits, information can also fall between the cracks. So what can we do to help?
1. First ask the obvious: Be specific about asking what your condition or diagnosis is. Some doctors avoid the terminology. Many times my patients with “congestive heart failure” never heard the term because they never asked for the diagnosis, and the doctor may have assumed that it sounded scary. The patients were treated and advised, but they failed to learn what their diagnosis was.
2. Do not be shy and do not assume that your doctors have communicated with each other. Ask questions and ask if the other providers talked to your physician or sent reports.
3. When you choose to obtain a second or third opinion, let these providers draw their own conclusions. Therefore, repeat your story and get a fresh perspective when you go for another opinion.
4. As noted in my last column, have a one-page medical history to present at your office visit, so you have time to get to the “heart of the visit.” If there is significant family history, include it (diabetes, autoimmune diseases, etc.).
5. Include a third eye and ear on the office visit. It always helps to have someone with you to listen, advocate and think of questions for you. It is hard to pay attention in these circumstances, especially if you are anxious.
6. Do not assume “no news is good news” (AARP Bulletin, September 2016). Test results can be lost or overlooked.
Making our Health Care Safer by Addressing Misdiagnosis
Top on the list for attaining safe care is getting the right diagnosis. We might think that misdiagnosis occurs mostly with rare or atypical conditions, but this is not the case. According to the National Academy of Sciences’ 2015 report “Improving Diagnosis in Health Care,” the following has been researched:
The consequences of being misdiagnosed can be devastating (http://www.nationalacademies.org/hmd/Reports/2015/Improving-Diagnosis-in-Healthcare.aspx). It is important to intervene. In addition to communication issues as discussed above, here are some things to think about to help prevent misdiagnoses:
1. Transparency and disclosure of mistakes
2. Stereotyping, Gender Biases, and Narrow Focus on Symptoms
We are all human, including professionals; and at times we mistakenly draw conclusions that are subjective, biased, or incomplete. When it comes to diagnosing a health condition, it is essential that you sense your physician as being objective, thorough, and careful to differentiate.
I call this the “Pooh-Pooh Syndrome.” If you feel your doctor is “pooh-poohing” your symptoms or dismissing what you have to say, move on to another doctor. Physicians who fall into this trap are either stereotyping, acting in haste, or their egos are getting too big to listen and treat their patients.
Making our Health Care Safer by Maintaining Your Personal Health Record
In order to safeguard your health, I always recommend that my clients maintain their own health record. Sign medical releases to obtain your files from your caretakers and your hospital (if you were hospitalized). If you have complex health conditions or a cumbersome file, you may want to hire someone to compile your record for you and help to interpret it. In general, include the following:
Know what HIPAA means (Patient Privacy and Protection): Most of us have heard all too often the term, HIPAA, which stands for Health Insurance Portability and Accountability Act. The basics of this 1996 act provide the consumer with a national standard for handling our medical information, access to our own records, notification of privacy practices, disclosure policies about our health information, and processes for filing complaints and penalties. The HIPAA laws pertain to providers, health insurance companies and healthcare “clearing houses.” Oddly enough, some examples of organizations not covered under HIPAA (which means they DO have access to your medical information) are life insurance companies, agencies that deliver Social Security and welfare, auto insurance plans, law enforcement agencies, Workers Compensation, and more. It is important for us to understand medical release of information and HIPAA in order to better safeguard our health.
In summary, October’s column (Part 1) addressed the steps to take to become an effective consumer, who can contribute to your own healthcare. This month’s column (Part 2) addresses ways that you can become a helpful watchdog in order to make your healthcare safer. Next month (Part 3), we will look at ways to find your inner voice to speak up and prevent harmful practices. Once again, the outcome is a worthwhile investment.
Please check back often.
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