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Posted by on in Current Medical Issues

“Be the change you wish to see in the world”
– attributed to Ghandi

I subscribe to a number of news feeds related to healthcare and our medical system, and the dysfunctional way we pay for and administer medical care in the US is in the news constantly. In fact, it’s in the general news daily especially now that the presidential campaign season is in full swing. So I, like I am sure many of you, am not surprised when I read about how it has gone awry. Nonetheless, reading a personal story about the death of someone’s loved one from this dysfunction is heart wrenching every single time. 

When I saw this article “How American Health Care Killed My Father” by David Goldhill, it was so long that I anticipated skimming it. But I found it so gripping I read the entire piece in one sitting and it held my attention throughout. Not only does he describe what happened to his father, he discusses where the weaknesses in our system are, and then, in the section headed “A Way Forward” comes up with an excellent plan for changing the “medical industrial complex” to make it functional, economically sound, and to improve the quality of care.  

I hope you will take time to read the entire article, and I would love to hear what you think once you have read it.

HOW AMERICAN HEALTHCARE KILLED MY FATHER

Following in the path of change of the “healthcare” system, I spent last weekend at a conference for physicians who are looking for nonclinical careers in medicine. These  are not doctors who are just out of medical school or residency, but for the most part were people who had spent years practicing medicine. There were 4-500 doctors at this conference, and I served as a mentor—someone who is doing something different (serving as a healthcare advocate) and advising those who are interested in exploring my field. 

How is this related to the previous article about changing the health care system? I spoke to 60 doctors, and if I had had more time I could have spoken to many more. Doctors are well aware of the problems in our healthcare system, and are aching to change it. Passionately so—I saw that this past weekend. And it is the reason I became a healthcare advocate after 25 years of practice—I felt compelled to go “upstream” (not sure what that means? Stay tuned for next month’s newsletter) and do something about the delivery of healthcare.

Most people, I have found, don’t know that they can access someone to help them through the complex and convoluted medical system, and even more concerning, don’t realize how much they need someone to do just that.

I want to share with you two articles that really spoke to me about the necessity of having an advocate when going through a difficult medical problem.  This first one mentions someone who we all recognize, Tom Brokaw, and what he felt he needed when he was treated for multiple myeloma.

A CANCER PATIENT LEARNS THE BENEFIT -- AND NECESSITY -- OF HAVING A PATIENT ADVOCATE

Not only is Tom Brokaw’s daughter an emergency medicine physician, she has worked as a healthcare advocate as well. And with all that he is able to access, he still felt uncomfortable with the “lack of shared dialogue” in his treatment—what I would call lack of coordination of care or project management. This truly does give me pause. If he found this difficult, it is abundantly clear that we would certainly find it so.

The second article is about the ideal coordination of care—sort of a best-case scenario for how to navigate through a health crisis.

WHEN CONCIERGE CARE IS RESERVED FOR PETS

The journey of the author of this article and her cat, Humphrey, through the veterinary healthcare system made me envious of this marvelously integrated care. And it also provides a road map for what we could have if we had the will to make it happen.

I would love to hear back from all of you with your thoughts and questions about these articles, or topics you would like to hear about. 

 

Last month I talked about advocating for ourselves, whether or not we have a professional advocate with us. These were tactics dealing with gathering the information we care about at our medical appointments, and also giving complete and accurate information. Here are some tips to use once you have gathered the information, have been given an explanation of what is wrong, and hopefully some options for treatment. These are for the next step: getting the care for your medical problem.

1. Always ask, “What else could this be”?
Be sure your doctor has considered other options. In medicine we call this the differential diagnosis. Why have other options been ruled out? Why has this option been ruled in? Make sure you understand the thinking.

2. Never undergo a treatment unless you understand what it is, why it’s needed, and what the alternatives are. This is the corollary to number one above, but is critical if you are going to have a treatment such as surgery, or even a minor procedure. If you don’t feel convinced you need that treatment, hold off until you do or decide on a different modality.

3. When you are in the hospital, make sure everyone who enters your room washes their hands.
I mean everyone! No exceptions! It is okay to ask, and to demand this. Almost every hospital in America has a plan for 100% compliance with this. Think of yourself as just helping them achieve their goal. And improving your safety at the same time. A win-win.

4. If you are feeling uncomfortable, uncared for, not listened to, and talking about it doesn’t resolve these feelings, change doctors.
Yes, really. It is okay to change. It happens to all of us. You are far more important than the concern you might hurt your doctor’s feelings.

5. Be assertive (see 1-4 above).

6. Trust your gut.
This one comes with a caveat—sometimes your instinct is not accurate, its really fear rearing its ugly head. But if you think something is not right, trust yourself. Don’t go along with it if it doesn’t feel right (see number 5 above).
I hope these tactics help you get the most responsive and best and safest healthcare for you and your family members. Let me know if you have questions or comments.