Robrt L. Pela

Health care begins at home

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Carole Leighton was afraid to appear foolish, so she didn’t ask her doctor to explain what he meant when he told her she had an esophageal malignancy.

“I figured if I had cancer, he would have said that word,” she recalls three years later. “I went home and looked up esophageal malignancy on the Internet and nearly fainted. And then, I didn’t know who I was more angry with – my doctor, for not speaking plainly, or myself, for not demanding a definition, for not being my own health care advocate.”

Leighton, who is cancer free these days, finds herself saying the words, “health care advocate,” a lot lately. “I tell everyone I know, ‘Look out for yourself, don’t do what I did. Ask questions of your doctor; make demands; just plain communicate!’”

Becoming one’s own health care advocate is the key to good health, according to Lesley Cohen, a Seattle-based writer and author of the forthcoming e-book, Calling Dr. Google: How to Get the Most Out of a Visit to Your Physician. If you are not aggressive in getting answers to your health care questions, Cohen insists, you are less likely to receive adequate attention, and more likely to remain ill.

“It’s all about fostering a great doctor-patient relationship,” she says. “The best doctor-patient relationship is one that’s a true partnership. The doctor’s job is to bring his medical expertise, and the patient must bring a very refined story about what his symptoms are, and how he’s experiencing them in his day-to-day life.” This partnership, Cohen says, will help the physician, not only to diagnose an existing malady, but will allow him to decide what treatments and therapies will work best for the patient.

“I was a better patient after I learned to tell my doctor about all the details that I thought didn’t matter,” Cohen admits about her own recent bout with breast cancer. 

“When I was told that I needed chemotherapy, I didn’t mention that I picked up my children from school every day, because I didn’t think that it was relevant. So, I requested morning sessions for chemo, because I figured I’d go after I dropped the kids off from school. The oncologist ended up scheduling me for afternoon therapy, because he knew I’d be worn out afterward and not be able to go get my kids.”

Asking questions of your physician, even during a routine checkup, is paramount. “One of my doctors spoke to me as if I were a pre-med student,” Cohen recalls. “I was afraid of appearing dumb, so I would just let him talk and then try to write down what he said and go home and look it up on Google later.”

Later, she learned to stop doctors who spoke over her head and ask, “What does that mean?” Another key question, she says, was “What are my other options?” when told of a particular treatment. Over-scheduled physicians often try to convey a lot of complicated, sometimes frightening, information to a patient in a short amount of time. These communication lapses can mean that a patient won’t fully grasp the significance of a diagnosis, which can have dire consequences.

It doesn’t hurt to remember that your physician is working for you, toward improving your health. Don’t be afraid, Cohen says, to admit your worst fears about your symptoms and what they might mean.

“You’ll leave the doctor’s office feeling much better if your doctor has explained to you why your chest pains can’t possibly be lung cancer,” she says. “Your fear is also a symptom of what ails you, so share it with your doctor.”

Perhaps the most important step you can take is choosing a primary care physician (PCP) who isn’t intimidating. It’s great to show up prepared for your doctor visit with a list of questions and concerns, but, if you’re not willing to stand up for yourself regarding his answers to your questions, the doctor may be gone from the room before you got what you came for. Challenging basic notions of what the doctor’s and the patient’s roles are can be a high hurdle for most people, but it’s one that’s always worth the leap.

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