Going to the Doctor?... Better be Prepared

Written by Dr.Scott Rosenthal. Posted in Family Health.

“Hospitals haven’t given safety the attention it deserves,”
—says Peter Pronovost, M.D., senior vice president for patient safety and quality at Johns Hopkins in Baltimore.

You secure your SCUBA mask and jump through the water’s surface, leaving only a splash as you begin your 100 meter descent into the watery depths. The water is murky and filled with unforeseen horrors that can rip the life from your body in a second. Sharks. The sharp steel of shipwrecks. Gear malfunctions. Such territory requires split second decisions for survival.

You feel the chilling temperatures reach your bones, and wonder in panic, “Did I check all of my equipment? Tanks? Regulator? Where is my partner? Where are the sharks? Am I fully prepared?” Millions navigate other depths that carry as much complexity and danger. Frequently, they do so without planning. Just blind faith and a hope for the best. These waters are filled with white coats, prescriptions and procedures. Next time you dive into the waters of health care, be PREPARED!
With 90 deaths annually from SCUBA diving accidents, one must plan carefully before strapping on a set of tanks and leaping into the water. Meanwhile, projections outlined in 2010 from the Department of Health and Human Services cast out alarming numbers that would make even the bravest diver squirt ink like a squid. The report states that infections, surgical mistakes, and other medical harm contribute to the deaths of 180,000 hospital patients per year. In addition, 1.4 million patients are seriously hurt by their hospital care. And... these numbers only refer to Medicare patients.
“Hospitals haven’t given safety the attention it deserves,” says Peter Pronovost, M.D., senior vice president for patient safety and quality at Johns Hopkins in Baltimore. “Medical harm is probably one of the three leading causes of death in the U.S., but the government doesn’t adequately track it as it does deaths from automobiles, plane crashes, and cancer. It’s appalling.”1
Avoiding the hazards of health care can be as difficult as swimming upstream in spring. Even if you avoid hospitals, outpatient deaths run approximately 199,000 per year in the US.2 Trying to be clever by staying in the kiddie pool and attempting to limit medication use to over-the-counter drugs still carries a whale-sized risk. As a single example from the sea of pills, at least 16,500 people seeking relief from arthritis will die each year from taking NSAIDS (nonsteroidal anti-inflammatory drugs such as aspirin, naproxen (Aleve and Naprosyn) or ibuprofen (Advil and Motrin).3
Is it realistic to avoid all doctors, hospitals and medications at all times? It is NOT! Can you lessen your risk of death by educating yourself and making calculated choices? Most definitely. All you need to do is learn to be your own patient advocate.
Being a self advocate means you will search for the safest and most effective treatment options. Get second and third opinions. Talk to doctors in different fields. Consider natural, less invasive options that allow you to avoid the greater risks associated with medications and surgery. The type of health professional you see will determine the type of approach recommended. As Abraham Maslow said, “I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail.” An example of how your choice of doctor influences your treatment can be found in a recent study published in the medical journal Spine. Surgery rates varied when injured workers first saw a surgeon as opposed to a doctor of chiropractic. Only 1.5% of the patients first seeking chiropractic care had back surgery compared to 42.7% of those who first saw a surgeon. The authors concluded that “there was a very strong association between surgery and first provider seen for the injury, even after adjustment for other important variables.”4
Prior to visiting a doctor, you (the self advocate) will create a list of concerns to take with you. While at the visit, you repeat statements back to the doctor to assure your understanding. Bravely ask for further explanation when needed. Take notes to refer to later. If a silent thought ends with a question mark- SPEAK UP! Make statements such as “doctor, please help me understand this more.” Soften confrontation by using sentences similar to, “I am not trying to challenge your advice, I just want to be fully aware of all my options and risks and be comfortable with my decision.”

Below is a sample list of questions and concepts (in no specific order) for your health care professional. They can help you survive and make it back to the surface of the murky medical waters unscathed:

Can I change my lifestyle choices in order to feel better?
Are there any natural and/or safer alternatives?
Is there an underlying cause of my condition that should be addressed?
What are the long-term risks of masking the symptoms?
Does this drug interact with any of the other medications I am taking?
What are the long-term effects of taking this drug?
How would I know if I am becoming addicted to the medication?
What are the common and uncommon side effects?
What is the best way to reach you, if I have a question or concern?
What can I expect immediately following treatment?
What if I wait and do nothing?
Is it urgent that I treat the condition immediately or do I have time to consider my options?
Can you please tell me about your experience treating this condition?
Are you aware of other treatments that you do not offer but could help me?
Do the benefits of the new medication outweigh the safety record of the older medication?

Most doctors should be open to discussion and value your engagement in the process. A busy doctor may ask you when you can schedule time to talk further. For more information on this specific topic, read the past Living Well article When to Fire Your Doctor archived at rosenthalchiropractic.com.
An easy way to avoid being hooked by a potentially unnecessary product or procedure from someone constantly trolling for your business is to stop watching drug advertisements on television. Trash the ads from your magazines as you spout, “You will not catch me!” Tell your pill popping friend at work that you are thankful for his information, but not interested. If he keeps sounding his call, tell him to close his blow hole and surface later (but, nicely!). Learn to think for yourself. Research and find answers to every question you have. Always believe you play the most important part in your own health care - the self advocate.
The next time you need to go for a swim in the ocean of health care, you have a decision to make! Dive in blindly and hope for the best or take responsibility and plan ahead. The latter may feel like swimming against a strong current of authority or feel impolite and unappreciative, but it beats becoming chum in the waters of your future health. Become an advocate for your health like your life depends on it. After all, if you don’t, who will?

2Starfield B. Is US health really the best in the world? JAMA. 2000 Jul 26;284(4):483-5. Starfield B. Deficiencies in US medical care. JAMA. 2000 Nov 1;284(17):2184-5.
3Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. Am J Med 1998 Jul 27;105(1B):31S-38S
4Early Predictors of Lumbar Spine Surgery after Occupational Back Injury: Results from a Prospective Study of Workers in Washington State. Spine (Phila Pa 1976). 2012 Dec 12. [Epub ahead of print]

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