|Dynamic Chiropractic – June 29, 1998, Vol. 16, Issue 14|
By Deborah Pate, DC, DACBRThis is not a radiological topic, but I feel that in these times of managed care, patients need to take a more responsible role in their own health care. Passive patients may get plenty of medical advice and prescription drugs, but they don't necessarily get the best results. Unfortunately, those who don't insist on being heard may run the risk of being misdiagnosed or inadequately treated. With many people now under some form of managed care, the time they spend with a physician is often very short and many times hurried. If communication isn't quick and accurate, the patient just gets lost in the shuffle. Patients who take charge of their medical care, who communicate honestly with their clinicians, and who are decisive actually receive better care and end up healthier (Harvard Health Letter August 1996, Vol. 21, No. 10).
Sheldon Greenfield and Sherrie Kaplan, who head the Primary Care Outcomes Research Institute at New England Medical Center, are well-known for examining the relationship between patient assertiveness and health outcomes. In four separate controlled trials that they led, people with ulcer disease, hypertension, diabetes, and breast cancer were given copies of their medical records and then coached by researchers for upcoming office visits. The investigators pointed out important parts of the records and helped patients prepare questions and negotiation tactics, as well as ways to overcome embarrassment, timidity and anxiety. The office visits were recorded, and people were subsequently given physical examinations and questions about their health status. Results were compared with a control group given no special prompting.
Outcomes in all four trials indicated that coaching increased a patient's involvement in care, which in turn was associated with improved health. The patients stated they felt better and functional limitations were improved. It is indicated that the results were associated with more control by patients, more expression of emotion by both doctor and patient, and a greater exchange of questions and answers (reported by Ronny Frishman, Harvard Health Letter August 1996).
The following are a few things one can do to get more out of "the doctor's visit":
Deborah Pate, DC, DACBR
San Diego, California
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