Personal Wants: Doctors and Dialogue
A Guide to Communicating Better with Your Providers
As you’ll probably agree, you may not have enough time with your health care providers to really fill them in on all of your health care concerns and issues in one visit. Even if you have a great relationship with a doctor, you can’t guarantee that he or she will be available when you have an unexpected problem. Until your health care records can be electronically stored and transferred among your providers, it’s up to you to provide your complete health care information by creating and updating your own records on a regular basis.
Your health care records are made up of your protected health information, or PHI. Recording your PHI doesn’t mean carrying around an inefficient clipboard with every paper generated by every provider you see. Instead, it’s a road map of your protected health information that should contain answers to the questions outlined in this chapter’s headings.
Who Are Your Health Care Providers?
According to the 1999 Patient’s Bill of Rights, each patient has a right to have his or her personal physician notified upon admission to a hospital. Although patients have rights, they also have responsibilities. We like to think that our providers are miracle workers, but it’s up to us to help them perform these “miracles” by providing our vital information in the form of our personal health care systems. (See Chapter 1, “Health and Medical Wants: Your Personal Health Care System.”) Make sure your list includes what you’re seeing each doctor for, even if you don’t think a certain doctor is relevant to your current problem. Every doctor can tell you that he or she has been called to consult on a patient, only to find that the patient has already been seeing another physician for that particular problem. Talk about a waste of time, money, and opportunity!
Where Were Your Last Tests Done?
Keep a list of the tests you have had, where the tests were taken, and the results (if you know) as part of your PHI Record. Unfortunately, the tendency is to block out negative experiences, which include health care testing. MRIs, CT scans, and biopsies aren’t a lot of fun, so it’s no wonder we try to forget. But your providers need this information. Without it, your health care delivery can be impaired or time and money wasted with retesting. It’s remarkable just how much time and money is wasted because patients can’t remember what they had done and where. Be courteous to your physician and kind to yourself. Write down the test information, and bring it with you!
What Medicines Are You Taking?
Telling a physician that you’re taking “that little white pill,” “a blood pressure pill,” “a water pill,” or “a sugar pill” really isn’t helpful. Sadly, we can recite ballgame statistics and what’s on TV tonight but not what we’re putting in our bodies each day. If your doctor didn’t prescribe it, he or she may not know that you’re taking it. And even if your provider prescribed a particular drug, copies of prescriptions get lost.
Here’s a real-world example. You go to Doctor A, who puts you on three medications. Doctor B takes you off one and puts you on two more. Doctor C adds another new prescription. Which physician knows what you are taking? The answer is none. Just because you have a prescription doesn’t mean you’re actually taking the prescribed medicine! More than a few patients overdose on medications by thinking two different bottles are different drugs. Who but a health care professional would really know that Lasix is the same thing as Furosemide? Both refer to the same compound. Take too much, and you may become dehydrated, which could lead to life-threatening kidney failure. Take too little, and your doctor may over-prescribe for you the next time. If only you’d told your doctors and pharmacist everything.
Make sure you mention all natural remedies and alternative medicines you’re taking, too. We can’t emphasize enough the importance of telling your health care providers about every pill you pop. Remember that aspirin, antacid, and acetaminophen are medications, too. Most people don’t take this “full disclosure” seriously. Physicians are constantly frustrated by patients’ failures to tell them about all medications, both prescription and over-the-counter. Even the countless patients who wind up hospitalized as a result don’t get the message. Do you really have to tell your doctor everything? Only if you want the best medical care possible.
What Are You Allergic To? What Are You Intolerant Of?
Allergies and intolerances are two different things, so choose your words carefully when speaking with your health care providers. Just casually saying, “I’m allergic” to a drug or compound when you’re not could deny you important treatments. If you are, in fact, allergic to a particular substance, be sure your health care providers know and it’s recorded correctly. Review what’s in your chart regarding allergies and intolerances, and make sure the following distinctions are made:
Serious medication or substance allergy—Only those substances or drugs that make our faces, tongues, and throats swell, cause shortness of breath, or result in a severe whole-body rash should be listed under this heading. These conditions are called anaphylactic reactions and are very dangerous. A person’s blood pressure can drop, or his or her airway may become compromised to the point that brain damage or death can occur. We’ve all heard of people dying from a bee sting or a peanut allergy. It can also happen with some prescribed drugs or substances.
Mild allergic reactions—These allergies, which are characterized by mild rashes or itching, may occur with any substance or medication. These are much more common than serious allergies.
Nontolerance—Often people refer to this as an allergy, but it really isn’t. An example is stomach upset from a particular medication. You should be sure to include any intolerances as part of your PHI.
How Are You Feeling?
Fill your provider in on each ache, pain, bump, lump, and everything else that’s troubling you. Start with the reason you’re visiting and your chief complaints. Tell your doctor why you’re there—he or she won’t necessarily know unless you make the purpose of your appointment clear. Not only that, but sometimes physicians forget all the reasons they’re seeing you. A friendly reminder when you first see a doctor is never out of line: “As you may recall, doctor, when we met last we discussed A and B and were waiting for the results of tests C and D. E is what’s happening to me now. What have you found out?” Next, tell your physician every other symptom. Those details matter.
What’s Your Health History?
Your physician needs to hear it all—from your broken leg to your bout with chicken pox to your chronic cough. It’s not up to you to decide what’s important. If you’ve seen this doctor before, review your chart to make sure all of your information has been recorded correctly. Information to be included as part of your health history is listed next.