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I have been a registered nurse, nurse practitioner and most importantly a patient advocate for over 20 years. I have worked in hospitals, homes and as a private consultant, always teaching patients how to speak up for themselves and to make well informed healthcare decisions that are right for them and help them to avoid all types of Medical Errors. The many things I have seen in healthcare led me write "What Did the Doctor Just Say." In it are all the steps every patient needs to take to remain safe in the healthcare system and avoid medical errors. My personal goal is help to save 100,000 people from the horrors of a medical error and I wrote What Did the Doctor Just Say? to help make that happen.

Saturday, January 9, 2010

My Doctor Does Not Listen to Me - What Can I do?


  As you know medical errors take over 200,000 lives per year
(536 lives per day). Medications errors alone hurt 1.5 million Americans per year. Statically each one of us has a one in four or 25% chance of falling victim to a medical error every time we enter the healthcare system.
In fact many of you or someone you know has
experienced an error that has somehow changed your life.
It is estimated that up to 80% of medical errors could be prevented by improving communication between doctors
and patients.
       But what happens if your doctor will not listen to you?
That's a question I am asked all the time. Patients tell me that their doctors are rushed, eager to write a prescription and annoyed by questions. Many patients have asked me how to overcome this barrier.
      In What Did the Doctor Just Say? I give readers 3 steps that encourage
doctors to listen and to take the time needed to answer questions in a
manner that provides you them fully informed consent before making any
healthcare decision
      Step One: DeBunk the Myth that the Doctor Is a god and You are
Lesser Than Him. You MUST Adjust Your Attitude. If you believe the
doctor is a higher being you will be meek and mild
you will submit to being dismissed because you feel you are wrong
or annoying for even asking a question about your life and your health.
      "The Dr is a god" is a very harmful myth and is responsible for a great
many medical errors. Because patients don't feel free to speak and offer
information or to get information. If that type of information were
freely exchanged it is estimated that up to 80% of medical errors
could be prevented.
     The best way to begin the conversation with a doctor is with the
knowledge that the Dr. is your employee. That's right the Dr. works for
you and is paid by your insurance dollars. Healthcare providers are
facilitators for you to get the best care possible, not gods.
     Step Two: Prepare for the Visit In WDTDJS I supply worksheets
that you can complete with the information you need to prepare for
your visit. 
      Some of the most important information you can share is
a detailed description of your complaints including; Onset, Location
Duration, Characteristics, Aggravating Factors,Reliving Factors and 
Severity.
      These are the 9 questions doctors ask (or should ask) about all
of your complaints. When did it start, where does it hurt, how long did
it last, what did it feel like, what makes it worse, what makes it
better, and how bad was it on a scale of 1-10. The following example
answers each of the above as they relate to a stomachache
      Ex: “The pain started two nights ago. I ate food that had been left on
the stove for about 36 hours and began having stomach cramps that
were pretty constant and very painful six hours later. Then, I had eight
very loose and watery stools over a 24-hour period. I did not have a
fever or vomiting. I was not able to work because of the pain in my
stomach was an 8-10 on the pain scale.”
      When you come prepared to speak in the OLDCARTS format doctors
are more likely to engage with you, to be interested in what you are
saying and they are able to get information quickly which will cut
down on their impatience and give them more time to answer your
questions all because you are now speaking their language.
       Coming prepared with your symptoms also helps the provider to
diagnosis you properly, this is very important as 40% of medical
diagnosis are wrong!!! Many of those errors occur because of poor
communication between the doctor and the patient.
      Also when patients speak in this manner it gets the doctors respect
and they know you know something and they had better pay attention
to you.
      Step Three: Again in WDTDJS I supply you with a list of questions
you will want to ask any provider you see to get fully informed consent
about tests, medications and procedures. Come prepared with your 
questions, this will help the doctor to use his or her time better and 
cut down on their impatience with questions.
     Once your questions are written down there may be a nurse,
nurse practitioner or nursing educator who would be more than
qualified to answer your questions and able to give you more
time and refer you to any resources you may need to learn more.
      Finally, let the physician know you are making their answers part of
your personal healthcare record and that you will be showing their
answers to consultants, second opinions, family members and friends.
      When the doctor knows you are recording and documenting their
responses they will be encouraged to answer your questions fully
and honestly because we all know any document can be shown to
a lawyer for later review.
     If these measures do not work and you cannot get your questions
answered you should FIRE your doctor and hire one who will
respect his boss, that's YOU the paying customer. A doctor who
doesn't listen increases your chances of being hurt by a medical
error by up to 80%. A provider like that has no place on
YOUR Healthcare Team


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