Experts From Chapters One and Two With A Sample Question Set
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Table of Contents
Chapter One: You Could be Injured or Killed by our Healthcare System
The facts and figures
Your insurance carrier may not cover damages
We may all have less access to healthcare?
Chapter Two: Take Charge!
Why you need to be in
Communication is key
When you don’t understand what the doctor says
Chapter Three: How to Understand What the Doctor Just Said
How your culture influences communication with your doctor
How your culture affects your overall treatment plan
How to increase your healthcare (communication skills) literacy
Help your doctor understand what you just said
Chapter Four: Choose the Right Doctor, Get Better Care
Looking for Dr. Right
Questions to ask when choosing a doctor
Questions to ask after the office visit
Chapter Five: When to Fire Your Doctor
When the doctor has to go
A story about being dehumanized by your doctor
Things to discuss with your doctor
A story about what happens when your doctor does not listen to other members of your team
Chapter Six: Choosing Personal and Professional Advocates
Why you need an advocate
Choosing a healthcare proxy
Living wills their options
Completing the paperwork
A story about what can happen when advanced care directives are not followed
Professional advocates/Case Managers
Chapter Seven: Your Personal Healthcare Record (PHR): An Important Member of YOUR Healthcare Team
Benefits of having PHR
Electronic PHRs
How to create and maintain your PHR
Provider Visit FlowSheet
Questions to ask when laboratory tests are ordered
A story about lab error
Chapter Eight: Beware of Diagnostic Error
Up to 40 percent of medical diagnoses are wrong
A story about a medication side effects and a missed diagnosis
Provider reasons for making a wrong diagnosis
Things patients do that can lead to a wrong diagnosis
A story about medication side effects and a missed diagnosis
Chapter Nine: Prepare for the Office Visit and Prevent Diagnostic Errors
You have eighteen seconds to talk
Questions to help you understand your diagnosis and treatment options
Good follow up could mean good care
It may be depression: Up to 80 percent of patients are depressed
Conditions that are worsened by depression
Depression assessment
Laboratory errors and misdiagnosis
Types of laboratory errors
Chapter Ten: You May Need a Second Opinion
Reasons to get a second opinion
Questions to help you choose the best treatment option
If you choose to do nothing
A story about getting a second opinion
Chapter Eleven: Preventing Medication Errors
Medication errors: The facts and figures
Errors at the pharmacy
A story about decimal point error
Question to help prevent medication and pharmacy errors
More medication safety tips
Hospital dangers: The facts and figures
Choose a good hospital
Questions to help you choose the best hospital for your condition
General hospital safety
Hospital acquired infections and how to prevent them
Decubitus ulcers/bedsores and how to prevent them
Chapter Thirteen: Preventing Surgical Errors
Surgical errors: The facts and figures
Questions to help you get fully informed surgical consent
Questions to help you choose the best surgeon and hospital for your surgery
How to be safer during surgery
Chapter Fourteen: You Need Good Discharge Instructions
Why discharge instructions are important
How to get really good discharge instructions
Questions to help you get really good discharge
Chapter One: You Could be Injured or Killed by our Healthcare System
“Fear is the father of courage and the mother of safety.”
Henry H. Tweedy
The Facts and Figures
If the Centers for Disease Control counted medical errors as a cause of death, they would be the fifth leading cause of death in America, taking more lives than motor vehicle accidents, breast cancer, and AIDS combined. HealthGrades, our nation’s leading reviewer of healthcare quality, found that for the years 2002-04, 1.24 million errors were made while caring for hospitalized Medicare patients in the sixteen categories of “error” they investigated. Those errors resulted in deaths of 304,702 senior citizens. Of those deaths, 250,246 (82 percent) were potentially preventable. All totaled, these errors cost patients and taxpayers $9.3 billion dollars.
Chapter Two: Take Charge
“A wise man ought to realize that his health is his most valuable possession and learn how to treat his illnesses by his own judgment.”
Hippocrates (460-377 BC)
When You Don’t Understand What the Doctor Says
Patients and their families – not healthcare professionals – are responsible for managing patients’ medical conditions outside the hospital setting. This statement may catch you a bit off guard and yet it is true. Let’s take for example the treatment of diabetes. Diet, exercise, stress reduction, and self-monitoring are the cornerstones of diabetic care. It is the diabetic who has to do the exercise, prepare his meals, monitor his blood sugars, and manage his or her stress. Without adequate knowledge of how do these things, the patient will not be able prevent the complications associated with poorly-controlled diabetes.
Patients with poorly-controlled diabetes are more likely to have nerve pain, kidney failure, amputations, blindness, and stroke. Most patients, regardless of their disease process, who do not understand how to care for themselves will have more complications and suffer worse outcomes than patients who do understand and are able to follow their treatment plans. In addition to having worse outcomes overall, patients with lower healthcare literacy are more likely to make expensive emergency room visits and to undergo unnecessary tests and procedures, all of which increase their chances of becoming a victim of a medical error and the national debt.
The Institute for Healthcare Advancement estimates healthcare costs for people with low healthcare literacy to be four times greater than for those with higher levels of literacy. When you are able to openly exchange information with your doctor and others, the quality of care you receive increases and your risk of suffering hurt and harm because of medical error decreases. That’s why you need to understand what your doctor says and to be in charge of your healthcare.
How to Use this Book
Many sections in this book include questions designed to guide you through talking with your doctor and gaining valuable information during each phase of the healthcare process. Before going to the doctor or any other healthcare provider’s office, become familiar with the questions you need for that visit and what those questions mean (by reading the book). If, for example, you need information about your diagnosis and treatment options, view the question set titled “Understanding Your Diagnosis and Treatment Options.”
Questions to Help You Understand Your Diagnosis and Treatment Options
What is my diagnosis, its medical name, and what it means in plain English?
____________________________________________________________________
Is additional testing needed before you are sure of the diagnosis or are you sure now?
____________________________________________________________________
What are my treatment options?
____________________________________________________________________
What are the benefits of each of my treatment options?
____________________________________________________________________
What are the risks associated with each of my treatment options?
____________________________________________________________________
Which option do you recommend considering my age, gender, culture, and my ability to tolerate the treatment?
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In what percentage of cases is each of my options successful?
____________________________________________________________________
What do you consider successful?
____________________________________________________________________
There are 13 question sets in What Did the Doctor Just Say? covering every aspect of health, including but not limited to; how to hire and fire a doctor, medication safety, hospital safety, and end-of-life-care decisions. The answers to these questions are of great value when going for second opinions and when you simply want to explain what the doctor said to your family members and friends. The very best thing about having answers is that they go a long way toward helping you understand what the doctor just said and helping him or her make the safest choices for you and getting the kind of care you want and deserve. Knowing the answers to the questions will help you to take control of your healthcare and your safety. And the answers can easily be made a part of your permanent healthcare record.
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