Are patients really the problem?

“Doctors are not the problem. Patients are.”

Anyone who has ever thought the above statement is true has not tapped into the vast well of knowledge and intellect found in their own patients. Training patients to be better patients brings the joy of medicine back into your practice.

All of us, at one time or another, sat in a classroom. The teacher spent the first day going over the rules of the classroom, the insights into getting an A and the consequences of an F. These rules gave structure, hope and guidance to us, matching teacher expectations proportionally with student performance. The student knew that these were the teacher’s rules and expectations and, if followed, better outcomes would occur.

Who of us has driven a car without any driver training? Jumping behind the wheel without mastering the basic rules of the road can be fatal. Maneuvering around bad drivers takes practice and skill. Are cellphones so easy to use that a customer can pick it up and immediately start using all the features offered? Not so. Even Millennials have to learn new features so they can figure out how to get that new contraption to work the way they want. Upload, download — it takes time and knowledge.

Yet, the practice of medicine has woefully ignored patient training. Medicine should use the slogan, “No patient without medical-method training.” Why do medical professionals think patients are ready to run out the door competent in their new diagnosis of hypertension, diabetes or low back pain without being taught how to understand our methods first? And though training can focus on disease education, we also need to focus on the rules of the medical “classroom.”

The medical profession has ignored its patient’s ability to learn how to master the health care system. By not demanding better preparation, better skill, knowledge and holding the participant responsible, American medicine has lagged far behind other medical systems in the world. Are patients ready to master the complex issues surrounding their health, insurance, hospital, doctor and medical prescription coverage? Of course they are — with the proper training.

As medical professionals, we were taught the format of medical charting — the SOAP note. When this is taught to patients, they become engaged. When I explain to my patients that they need to tell me their OLD CARTS, (remember this mnemonic?), patients get excited about what this means for them.

I train patients to understand the pressures, legal issues and time crunches providers are under. They appreciate the time anyone can spend with them. They ask more thoughtful questions and express less emotionally stressed thoughts. I even had a patient once tell me to “Hurry up, you only have 10 minutes with me, and you’re going to make the next patient late.” When trained, patients bring their own set of accurate medical records with them. Patients discuss their care, what’s best for them, what works for them. Family members become more engaged. Specialists know why I am sending patients to them because the patient has been trained to ask me why first. Patients have their answers ready when questions are asked. They even know which specialists they want to return to if needed.

Direct primary care and concierge medicine practices are on the rise. Why? Because these practitioners are spending more time with their patients. By getting to know the wants and needs of every patient, partnerships and friendships are made. Honest communication becomes the norm. The “rules of the practice” are explained as soon as the patient queries about these growing forms of medical practice and their patient training begins.

Patient advocates are on the rise as well. For families who cannot keep up with unresolved medical issues, patient advocates are trained in the art of medical methods and know how to slide through the medical system, finding hope, answers and peace-of-mind for their clients.

Doctor and patient, teacher and student, parent and child, employer and employee; these trainings go hand in hand. No health care system can fix itself when it doesn’t start with training. Patients deserve explanation, communication, understanding and trust. From this, comes better choices, outcomes, and ultimately, healing. Give them the hope they deserve. Let the training begin.

Suzanne Fiscella is a patient advocate and founder, Patient Best.

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