At the risk of dating myself, I recall a time when “The Three Rs” summed up American education. In case you aren’t familiar with this phrase, it stands for “Reading, ‘Riting, and ‘Rithmetic.”
I think it’s high time we develop “Three Rs” for patients. Right now, Patient World is ruled by “E” words such as “empowered” and “engaged,” with “empowered” the big one. I think “empowered” is turning into a label, and I distrust labels because they imply a certain ideological mindset. I don’t like calling myself an “empowered patient” any more than I like calling myself a “feminist,” although I have stood up for myself and others in both arenas.
So instead, I propose we adopt “Responsibility, Respect and Relationships.” As patients, we are responsible for our decisions and our actions. You may want all the details of an upcoming procedure, or you may prefer not to know too much. You are responsible for how you communicate and how much you want to learn, just as you are ultimately responsible for deciding which treatment option to follow. It’s a big responsibility and it can be a lonely one. Only you know how you’ll navigate it.
We need to respect our doctors’ knowledge. I have asked my family doctor about things I’ve looked up online or in books, but I would never presume he should do something simply because I read about it. And while no one knows our own bodies’ aches and twinges better than we do, we shouldn’t assume we know why they act that way. My prairie-stoic dad thought he was having leftover symptoms from West Nile virus when it was really a stage IV cancer. To this day, I kick myself for not insisting he see a doctor when he mentioned it, four months before he died. Self-diagnosing is hardly ever a good idea.
We need to value our relationships. I know how lucky I am to have had the same primary care doctor for more than 15 years. I’ve reached a level of trust I never thought I’d have with a doctor. My husband and I had many “one-off” visits before we found him, but he was worth the wait. I fear this type of relationship may be endangered if healthcare reform reduces access. But even if you see more healthcare professionals in shorter stretches of time, accepting responsibility and showing some respect can go a long way toward forging a trusting doctor-patient relationship in the time you have.
The best thing about the “The Three Rs” is that doctors (and nurses and PAs) can apply them too. It takes two to communicate, and we may be frightened or intimidated by the 50-cent words. So they can accept some responsibility for making sure we understand, knowing it may have to come after the initial appointment, especially for something big like cancer.
They can respect us and foster relationships built on trust by remembering they’re dealing with people, not diagnoses. I often tell people the difference between the oncology consult I fled from and the one who became my oncologist is he was mindful there’s a person attached to the breast. He told me he would support my treatment choice, even if it wasn’t what he recommended. (In case you’re curious, I did end up following his recommendation.)
Communicating can be hard work, but it’s worth it—never more so than when our health and our lives are on the line.
Jackie Fox is the author of From Zero to Mastectomy: What I Learned And You Need to Know About Stage 0 Breast Cancer, and blogs at Dispatch From Second Base.
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