How To Be A Good Patient

We are all patients sooner or later. What makes a patient a good patient and what makes them not so good? It helps in your care.

Everyone is a patient sooner or later. Patients are the medical version  of retail customers. As patients we shop around to find the best doctors. Then we go see them. Not all patients get the best experiences. Doctors are human. Imagine going to see your mechanic because your car was not right. You turn up late. You know nothing about the problem you have. You give misleading information. Maybe you get irritated and are rude. Then, when the bill comes and you get the car back,  you are not happy. I wonder why? Let’s translate to a few tips to make sure you get the most of medical encounters

1. Be On Time

My office runs on time. We deliberately space out appointments so that patients have enough time. We don’t make patients wait more than 10 minutes. Our waiting room is not huge and with social distancing it’s important not to fill it. Like your time, our time is valuable. I hate patients who turn up 15-30 late and don’t realise the next patient is 10 minutes away in time. I don’t want to rush the first patient. I don’t want to run late for everyone else. Be on time. Get there early.

2. Do Your Paperwork

Until Apple or Google brings us a unified digital health record there will always be paperwork. A lot of time it can be done online before hand. Sometimes it is mailed to you. If you are filling it out on site, give yourself a generous 15-30 minutes to complete it. It probably pays to make a summary of your pills, surgeries, medical conditions, allergies and other providers who care for you  on your computer and print it. We love that.

3. Bring Your Significant Other

I hate it when someone important comes with the patient to surgery and asks me why are we doing what we are doing? Seriously? We spent 45- 60 minutes, sometimes over several visits with imaging, models and diagrams and discussions going over everything. If they cared enough, why not come to the meeting to discuss surgery? Go with your significant other to the meeting with the specialist. In todays world of the pandemic I let significant others call or FaceTime in.

4. Ask Questions

No such thing as a stupid question. Ask away. I like it when I finish all I need to say then answer what’s not covered. At a minimum, here’s what you should ask.

5. Be Clear on The Answers

Your surgeon should be able to explain things in simple terms. If they don’t press them. Keep asking until you understand the answers to the questions I listed.

6. Read Everything you are Given/Do Your Homework

I typically give patients a lot of reading material on lifestyle, procedures and surgery. Read them all. Understand them. Read the postoperative recommendations. You’ll do better. It’s like prepping for a test at school. Those who prep do better.

7. Take Some Responsibility

If you are obese, smoke and have diabetes and don’t know what your HbA1c is then don’t forget the part you played in your current dilemma and outcomes with any therapies and surgeries. Smokers do worse with surgery. BMI > 40 has greater complications. HbA1c >8 has a higher complication rate. Neglecting your health for years is your problem. We will do our best.

8. There is No “Magic Pill”

Read my article on surgery for back pain. I’m a mechanic with no spare parts. We can’t fix everything. We can’t fix poor lifestyle. There is no magic pill. Managing disease states and problems is a process and much of that rests on you.

9. Be Open and Honest

I love it when patients tell me they were addicted to pain pills or were alcoholics. Or they did not do the PT I asked for or did not take the pills I wrote them for. Not because they did it, but because they were honest. We need that to make the best plan.

10. Listen

Please. Listen. I can’t tell you how many times I am asked the same questions I answered several times and wrote the answers down to. Listen.

11. Stick With The Plan

I know you think you know better, but we do this for a living. Your best chance of a good outcome is to stick to the plan.

12. Hospital Are Not Hotels

This is big. Hospitals are not where you go to rest. There is no room service. Nurses are not waitresses. You go there to get treatment and get well. Then you go home. If your doctor says go home, go home.

13. It Takes Longer  To Recover Than You Think

Whatever your surgeons says, double it. I had knee surgery. My surgeon said it takes 4 months. It took a year. The older we are the longer it takes. Be patient.

14. Most surgeons Do Not Do One Surgery Per Day

A lot of surgeons have ‘lines’. That can be 3 cases. It can be five. I often do five in a day over 14 hours. Some eye doctors can do 20. If I don’t think I am up to doing them all as well as I can, I cancel. If we did one surgery per day you would wait two years for your surgery. I try and make my last case my best case. The order is often dictated by acuity (how urgent things are), complexity (do hard ones first) and equipment availability. Going first is not always a good thing.

15. Dr. Google Doesn’t Make You an Expert

Many physicians spent up to a decade training and learning and many years refining the art. There are a lot of snake oil salesmen out there. Companies want to make profits from you (see my post on Big Pharma and Back Surgery) and as a physician it’s our sworn oath to look out for you.

Come to your doctor with the problem, not the solution.

By all means talk about what you read. Remember, you didn’t come to me because my “L4/5 disc hurts” you came because your back hurts. I will try and sort if it really is the disc (often it’s not).

You come to the surgeon with a problem. Tell them the problem. Not what surgery you want, not what the MR showed. My role is to marry your history, physical examination and investigations into a diagnosis, differential diagnosis and treatment plan. Note the progression.

16. Understand Health Care Is Changing

My dad did housecalls when I was a kid. That was another world and another time.. When I went into practice I did everything myself. I wrote in paper charts and patients had one copy of their xrays and scans that we treated like gold. It’s all changed and keeps changing. Most physicians need a village to help them. This includes schedulers, medical assistants, nurses, physician assistants and nurse practitioners. The buck stops with the doc. I do the surgery, but there is only one me. My midlevels for example can get things going. If you don’t need surgery, they are great at sorting things out. If you have no tests, ditto. The system is changing.

Don’t be the oak; be the willow.

We will all get there.

17. Doctors and Nurses Are Human Too

A simple thank you goes a long way.

If you are nice, we are nice. If you are not, we are professional. We make mistakes. We get tired. We do our best. We work hours that would make you sick. We are human. We are not servants. We are not your employees. We re trying our best to help you. Remember that next time you go to see your doctor or are in hospital. Oh, this is probably how not to be good doctor:

This is a bare bones guide and I hope it made you stop and think. Seeing a doctor is a scary time. We need to work together to give you the best outcome!

I could not finish without this video. It’s kinda related to being a patient. Well, not really. It’s just hilarioius.

Please feel free to leave questions or comments below.

 

Author:

Lali Sekhon, MD, PhD, MBA| Father | Husband | Neurosurgeon| Hockey Fan | Innovator | Inventor | Educator | ΒΓΣ | Health Care Leader | I'm a neurosurgeon (MD, PhD, MBA, FRACS, FACS) who has been a physician for over 30 years. I'm also a tech junkie and a cynical optimist. Having completed a medical degree, a PhD and an MBA, I can give you an honest opinion on anything related to medicine and health care with tips and reviews and commentaries. Some of the topics are related, others, somewhat related, but all for the layperson: honest, simple and practical. It's not brain surgery!

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