By Mark Harvey
Last week, while whining about the whole Medicare “observation vs. admission” debacle, I concluded the column with, “So, what’s the real answer? Right: Stay healthy, and forget the whole thing!”
Sounds easy enough, huh? Just “stay healthy” and we’ll all live happily ever after, right?
Right … if it were only that simple.
Most of us know most of the stuff that we should do in order to stay healthy, and most of us attempt to do most of them/some of them/a few of them, based on who we are and who we choose to be. Alas, most of us occasionally find ourselves in the unenviable position of having to “go to the doctor.”
There are any number of reasons why many of us might greet this task with something less than boundless enthusiasm, and most of them are pretty obvious to most of us, but allow me to pose a question: Why is it that many of us, being relatively competent, confident, experienced and reasonably articulate adults, turn into uncommunicative, insecure and overly “obedient” (at least, during the appointment) “patients” in the presence of the doc?
Because we’re intimidated? Certainly, most docs are acceptably friendly, courteous and solicitous, so why? Because we think they’re smarter than we are? Because it’s an inherently “one-down” situation, meaning, “something about me isn’t working right so I’m here because I need you to “fix’ it?” Fix “me?” Which means, I must be broken?
Because we feel guilty? It’s my fault that I’m broken (well, it often is) and I’m afraid that you’re going to bust me for it, so I’ll just keep my dirty little secrets to myself.
Because you’re going to tell me things that I don’t want to hear and tell me to do things that I don’t want to do? Probably.
Probably, all of the above plus several dozen more, but the fact is that many of us just morph into non-forthcoming adolescents, nodding and smiling our way through the ordeal, awash in stress and angst, then wonder why we only understand or remember about 25 percent of whatever it was she or he said. That’s just how it goes.
For whatever comfort it may be, that’s apparently how it goes for a whole lot of us! So many of us, in fact, that a number of high-powered organizations, including the American Board of Internal Medicine, have gotten together to help us learn how to talk to our doctors. Right: Doctors are trying to help us talk to doctors, which might tell us something about the universality of our one-down experience.
These folks have actually turned this into a campaign. (I know, that may not be our favorite word right now, but …) And since most campaigns need a name, the name of this one is, “Choosing Wisely.” I, for one, find that encouraging. And if you, for one, want to learn a lot more about it, go to https://wsma.org/choosing-wisely-clinical-toolkit#Primary and have at it.
What got my attention is the part about “5 questions to ask your doctor,” with the goal of encouraging shared decision-making (remember, these are doctors talking to us about how to talk to our doctors) about getting the right care at the right time. Here they are, verbatim:
1. Do I really need this test or procedure? Medical tests help you and your health care provider decide how to treat a problem. And medical procedures help to actually treat it.
2. What are the risks? Will there be side effects? What are the chances of getting results that aren’t accurate? Could that lead to more testing or another procedure?
3. Are there simpler, safer options? Sometimes all you need to do is make lifestyle changes, such as eating healthier foods or exercising more.
4. What happens if I don’t do anything? Ask if your condition might get worse or better if you don’t have the test or procedure right away.
5. How much does it cost? Ask if there are less-expensive tests, treatments or procedures, what your insurance may cover, and about generic drugs instead of brand-name drugs.
That’s it. Those are the “5 questions.” The web site even has a nifty little wallet card you can print out with the 5 questions on it, so when we chicken out we can shove the card at our doc and hope that she or he doesn’t turn us into toads.
Seriously, those are pretty smart questions, right?
And if we’re feeling too lousy at the time (which is often why many of us go to the doc in the first place), perhaps we could con our buddy/family member/caregiver/whomever went with us, to ask said questions on our less-than assertive behalf? Probably.
Why not? Certainly, we’re there for help, advice and expertise, but that doesn’t mean that we can’t ask questions. And most of the docs that I know personally (actually, some of my best friends are physicians) would love to have the patient be a part of the conversation. Really!
It isn’t rude and it doesn’t “question” her or his expertise. It simply says, “I have a passing interest in what happens to me, so I hope you’ll help me understand it.”
Check out the web site and give it a shot, huh? Besides, what’s the worst thing that could happen? At least toads don’t have to deal with health insurance.
Mark Harvey is the director of Information and Assistance for Olympic Area Agency on Aging. He can be reached at harvemb@dshs.wa.gov or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information &Assistance.
