Posts Tagged doctor visit

Getting Satisfaction

OK, patients are not satisfied with many provider visits.    Some people just avoid health care or just complain about it.  Consider that mummies have been found who had serious health problems during life.  Is that what we want, a postmortem in a thousand years? — “yep, he didn’t get good care”.

It is  not the patient’s job to make health care give satisfaction, but that may be what is necessary while we wait for system changes.   And yet, many patients currently walk away from a provider visit, the hospital or outpatient surgery feeling satisfied with the care and satisfied their questions were answered.  How did they do it?  What did they say?  Were they just lucky to have the “right” provider?   Getting satisfaction currently involves being proactive, doing your homework and speaking up.  Those who do are getting some degree of satisfaction.

First, understand the cycle each health care provider works in.

The “agenda” for the visit is made in step #1.   Make a list of 3 things you want to get accomplished during the visit and keep the list in hand.   Be assertive with the list right after the greeting “Just so I don’t forget I made a list of things I need today: 1)____ 2) ____ 3) ____”.  For example, this might be “review my stomach pains,  would a specialist help, get prescription refills”.  ABSOLUTELY do not wait until step #5 with these questions.  Make sure all items were answered by step #3 — if not, look at the list and repeat the items not addressed.

Make step #2 easy.  Have an up to date history in hand including past illness, past surgery, current medications and allergies.

Make step #3 understandable.  Before the visit research the symptom or known diagnosis on the Internet (like http://www.mayoclinic.com).  So when the situation is discussed you have some basis for questions, and ASK THEM.

Make step #4 interactive.  As each action is listed if you don’t know what it is (like CBC or CT scan) then  speak up “what is that and what will it tell us”.   If a procedure or surgery is suggested make sure to understand the top 2 risks and what the provider and you can do to reduce the risk.  And, what are the alternatives — understand the alternative of not doing the surgery or procedure.  Understand how you will get test results (make it clear you want the result as soon as  available whether  “normal” or not).

An informed and engaged patient will ask the above questions.  Many patients ask such questions.  Don’t be demanding, just persistent.  Give the provider a chance to do the right thing since most really want to please patients.  And, give the provider a second chance.  If there is a problem with the plan or medications discovered later, call the provider’s office for clarification.  But, repeated failure to respond to these simple questions means it is time to find another provider.

Sometimes people just can’t think clearly knowing a shot, pelvic exam, or prostate check are going to be done.  Thinking during a health care visit is essential.  So, if there are bothersome aspects to a certain visit ask to have those things done at a separate visit (yes it is more trouble for you but at least you can discuss problems intelligently).

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Inadequate Face Time – 5 minutes is not enough

Nearly 7 in 10 Americans want their doctor to spend more time with them and talk about more than just the problem at hand.  No doubt 5 minutes is not enough time for a health care visit.  Remember, just like the taxi driver, the meter is running.  Both providers and patients need to be better prepared for a visit.

  • On the provider side all data should be reviewed before the visit – not during the visit.  And, the least expensive provider should be engaged, based the nature of the visit.  Simple problems (e.g. well baby checks, blood pressure checks, and acne) should be addressed by physician assistants or nurses. Health care literacy needs to be assessed — some groups need a lot of attention by a nurse, some groups should be getting information from the Internet — giving the patient an Internet link for education saves time.  If the provider’s skill is well matched to the problem more time is available for the visit itself.  The provider should always ask “any other questions?”
  • On the patient side any patient should come to a provider visit with a written list of just 3 issues they want  to be addressed then check them off as a response is obtained.  For example:  1) my cough 2)my knee pain and 3) any less costly alternatives to my current medications.  A person should think about the issues and look in a book or on the Internet before the visit to be able to ask reasonable questions.  A visit to a surgeon is a little different.  It is always focused a single problem and the surgery to fix the problem.  The three issues usually are 1) the chance surgery will fix the problem 2) the reasonable alternatives and 3) what will the surgeon do to prevent complications (a good answer is to follow hospital protocols and use a surgical safety checklist).
  • Visits need to be on time and on task.
  • Patients are more satisfied with a provider visit if there is “discussion of broader health issues” as the poll indicates.  This finding corresponds to other work indicating America has a large problem with health literacy.  People need reliable health information and they certainly don’t get it on TV (“miracle ___ cure”, ”ask your doctor if you need ___”)

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