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Level Your Health Care Playing Field

Daryl Paranada Nov 12, 2010

by David Nash, MD, MBA

Dr. David Nash is the Founding Dean and Dr. Raymond C. and Doris N. Grandon Professor of Health Policy at the Jefferson School of Population Health (JSPH) of Thomas Jefferson University.

Regardless of who we are, we are all patients at some time or other. Open and honest communication is key to a healthy relationship between patients and their doctors, so I believe there ought to be some ground rules to level the playing field.

As a physician educator and policy expert, I believe it is key to first recognize some basic “truths” about this critical relationship.

First, being a patient is scary and sometimes life altering. It may mean giving up control over one’s life and over activities we might otherwise take for granted. Being a patient may compromise our privacy or make one feel as though they are being treated as a child.

Because the stakes for patients are so high, it is important for people to keep in mind that they have a responsibility to themselves and to their loved ones to get answers to their questions about their medical care. Some people may be uncomfortable asking these questions of their doctors, so they may wish to have a family member or trusted friend accompany them to help start the conversation.

Here are some tips and questions to keep in mind to help you get the most out of your next health care visit…

  • Encourage your doctor to explain your medical condition and treatment options so that you understand it.
  • Ask questions of your health care providers (doctor, nurse, nurse practitioner, physician assistant or pharmacist) when you are given a new medication or treatment. (What is this for? What will it do? When should I take it? What are the possible side effects?)
  • Why do I need this test/procedure? How will it help you to diagnose or treat my condition?
  • Can you please share with me your personal experience and results performing this procedure? How often do you do this? Do you monitor your own outcomes? Where can I find independent information about how do your results compare with other colleagues? Should I go elsewhere to get this done?
  • Are you in a position to personally gain from some of your clinical decisions? It may be perfectly okay with me, but give me the chance to weigh the evidence myself. Do not hide any conflicts of interest from me, as I need to trust your judgment.
  • Are there any alternatives to what you are recommending? Is there another colleague we can consult whose opinion you respect? Where might we find other new information, together?
  • Will you be overseeing my care after this “episode” of illness has run its course? If not, who will take your place?

If your care involves referrals to other providers, be sure to ask your doctor to identify a primary point of contact in the practice who can help make sure your information gets to the correct persons.

You have the most to gain or lose from your health care experience. Make sure that your voice is heard

David B. Nash, MD, MBA is Dean of the Jefferson School of Population Health of Thomas Jefferson University in Philadelphia. Dr. Nash writes frequently on the topics of health policy and health care quality on his blog, “Nash on Health Policy.” He also is a regular contributor to MedPage Today’s online column, “Focus on Health Policy.”

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