“I think it’s important for people to have an advocate whether in the hospital or just seeing the doctor or some other healthcare provider. Some people are really good at being their own advocate, but there are many of us that are not good at standing up for ourselves and asking the questions that we need to ask.
I try and take care of my patients as if I was taking care of my own mother. I go prepared to their doctor’s appointments with them with a list of questions that I help them generate, and if they don’t need me to go to the doctor with them, I still help them generate that list and instruct them “Take this list out of your purse or your pocket and say, ‘I have a list, doctor, of these questions,’ and don’t leave until he answers those questions,” because they deserve that. They need to have access to the information in order to make an informed decision on what’s going on with their care.
I’m a big believer in informed decision-making, but I don’t think that people have to do it my way. I just think they need to know the pros and cons of the choices that are being offered to them, and what I find in healthcare in general is that, if you go to the doctor with a particular set of symptoms, the doctor recommends you do this or that, but nobody says, “This is what happens, or what we can reasonably predict happens, if you follow this path, and this … and if you choose to do nothing, this what we can reasonably predict will happen,” and there are times that choosing to do nothing is the right choice, but I think that informed decision-making means knowing both the pros and cons, the options, all of the options, not just the one that that doctors prefers or that that healthcare provider prefers.
That’s how I took care of my mother. That’s how I take care of my patients is trying to find all of that information for them or coach them to find it themselves that, when they make a decision, they’re really making a decision based on all of the information.
They tell me statistically the average doctor’s appointment these days is eight minutes. It may really be 15 minutes, but they’re spending half of that 15 minutes doing paperwork. Almost everybody uses some kind of an electronic documentation system these days that is almost a guide of, “I’ve asked them this. I’ve asked them this. I’ve asked them this.” The whole time, the doctor’s back is to you, and I think it’s really destroyed some of that personal interaction between the patient and the doctor. It’s hard to know who you’re dealing with when you’re only talking to the back of their head while they’re typing on a laptop.
I coach my patients to go in with a list. I help them prepare that list. Sometimes, that list is, “Here’s what my blood pressure has been with … at home that the nurse has been taking.” Sometimes, it’s, “I want to know how long I’m going to have to take this particular medicine,” or, “Would therapy at home be as effective as outpatient therapy?” but whatever it is, I like people to go in with a list so that they can get the answers to the questions that they need. Plus, I think it helps expedite what’s going on at the office visit because then the doctor has a clear idea of what the concerns are.
Just yesterday, I had a doctor say to me, “I’d like to know what’s going on with my patients that’s real,” because people lie to their doctor, and I don’t think they do that intentionally, but I myself have been known to, when the doctor says, “How are you doing with your diet?” to say, “I’m really following it,” when maybe I’m really not following it, and I know I should follow it, but I, for some reason, choose not to, so I’m not sure so much that it’s lying to the doctor, but more protecting yourself because maybe you’re not doing everything the doctor told you to do and you don’t want him to be disappointed in you.
I think that’s a place where, if the patient will allow it, I a lot of times send a report to the doctor before the appointment so that he already knows how they’re doing at home and what things I think need to be addressed in addition to them taking a list.”
Anita Roberrson RN
Director of Nursing | Aging Life Care Manager