Empowered patient . . .

Having a background as a librarian, any doctor who doesn’t expect me to come in armed with information – highlighted with a question of what does he or she know about this new fangled treatment for my condition, is just foolish. (Occupational hazard for librarians.)

Of course, being a librarian, if I’m bringing a printout of anything but my history – for my own reference – and my list of questions, it is going to be a literature survey I found that may or may not be relevant to my particular case. I expect the physician to know whether that is relevant to me and that is why I am bringing the information to him or her. I always take the trouble of highlighting the relevant section!

Of course, there is always new information because I am not the medical expert I need the physician to clarify if it is relevant. I am the patient and want to learn as much as possible about my condition so I can manage it more effectively on a day to day basis. So, if in one of the support groups I am on online says they tried X drug or therapy, and had this benefit, I will ask if that is relevant for me if I am suffering similar treatments.

Of course, there are consults where the patient is going to have many more questions than other consults. Sometimes the first consult is an overview of a new diagnosis. Unfortunately, our system of medicine does not seem to understand that if you give a certain subclass of patients about a week to 2 weeks to digest information, a follow-up with a more focused information sharing session should probably be scheduled. This tends to be lacking in our present day system.

Also, don’t underestimate the power of the “sudden surprise” diagnosis to derail patients who are otherwise quite focused. I’ve been there, nothing like getting a new issue introduced into an already complicated medical history.

My question is, sure, the average patient isn’t going to need that kind of focus, but there is a significant population that should probably be scheduled when you have some wiggle room with your schedule – or at least offered a double-booking?

But, I admit, I seem to be in a small minority of folks who consider medical treatment yet another consumer good with much larger ramifications.

Pax,

MLO

So how about doctors letting patients know what their expectations are up front? Some look at you like you’re a dork if you don’t ask questions and talk it up; others are quick to interrupt if you say more than three one-syllable words in a row. I’m happy to be whatever kind of patient ya want…just give a clue, OK?

I have built my practice on empowered self-responsible patients because those are the kind of people that I like to deal with and dependent helpless people give me hives.

There is definetly a line. If you want to bring in lots of literature and have me talk about it, I will do that and schedule a visit to do so if I need to in order to still have time to do my assessment and treatment and respect other people’s right to be seen on time. Expect to pay for the time.

I will not spend my time explaining all the fallacious internet claims that you can possibly find. I don’t have that much time or patience and you do not have that much money. If you bring something, bring something credible.

My explainations are going to be of the sort appropriate for doctor-patient conversations. I am not goiing to take on the futile task of giving you a five minute med school course and could never teach you all that I know. I am pretty good at cutting to the gist, so that usually isn’t a problem, but some always want more.

If you fall outside the realm of what I call empowered and into what I find the pain in the ass range, I will get you to find another doctor. I have a right to pursue happiness just as much as you do. It doesn’t make you a bad person or me a bad doctor–it just makes us a poor fit for each other.

“I will get you to find another doctor. I have a right to pursue happiness just as much as you do. It doesn’t make you a bad person or me a bad doctor–it just makes us a poor fit for each other.”

If you make this decision and it affects ONLY this one doctor-patient relationship, then I’d support your approach. However, in physician groups, if one doctor terminates his/her relationship with the patient, then the patient loses access to all other doctors in that physician group. Thus, you have assumed you have the right to make the final decision about numerous other potential doctor-patient relationships that might well have worked just fine.

In every service-based occupation, we ALL have to put up with some people we just plain don’t like very much. You can be an ass, decide that you are the only one that matters, and make decisions whose permanent consequences are far worse than the temporary inconvenience that triggered them; or you can accept that your judgments in the brief time that you spend with your problem patient could easily be very incorrect, inhale deeply, grit your teeth and get the job done.

P.S

It is easy to see why freedom is so rare in human history since people are so offended by people simply autonomously minding their own business and choosing with whom they associate.

For all you “I hate the way we’re paid” physicians who also don’t like the thought of empowered patients, wait until they’re paying for it out of their pocket.

Some of you had better pray for the status quo or single payer.

Reading comments on blogs like this sometimes gives me the impression that all doctors hate all their patients. In which case, maybe some of you should find different professions.

“who asked you anyways megan”

anon 10:45 pm: are you as arrogant with your patients as you are with posters on this thread?

I can assure you that no private patients will ever be in your stable if treated with the same smart ass quips you dole out here….well, maybe if hell freezes over.

I can appreciate what the ex-librarian said.

That said, I understand quite well the difficulty of being a patient (that’d be me)in that so often, there is too little time spent in the exam room.
I think in the long run, this can and has often posed problems for both physician and patient.

One thing that comes to mind, that I think would be helpful for both, is to have a “go between.” Meaning, a qualified person (perhaps a R.N.?) who’s primary job is to answer questions.
He/she would not be there to exam or diagnose in any way, simply help the patient with their questions.
Perhaps in this, it would reduce the amount of questions (and time) in the exam room, as well as any “anxieties” that come with questions left unanswered. Just to name a few good reasons.

As a patient, this is something I would be willing to pay up front and out-of-pocket.

All one has to do is venture over to medhelp.org in the paid Q&A forums to see this.