Three Components to Getting Prime Health-care
by Dr. Marie Savard
Health Watch
October 1998

The need to take responsibility for one's own health is universal. In an era of increasingly splintered and impersonal care, with insurance companies and computers wielding an inordinate amount of power over the medical profession, no one is exempt.

A recent report on medical mistakes, noting up to 100,000 deaths yearly as a result of human error, makes taking personal charge all the more compelling. Yet, so often people take more responsibility for their pets and cars than they do for themselves, saying, "But that's what I pay my doctors to do."

I believe there are three crucial components to getting the best health-care possible in today's world of alphabet soup medicine with PCPs and HMOs: 1) trusting yourself and those close to you as the real experts; 2) compiling copies of and understanding your medical records; and 3) establishing a partnership with your doctor. A lot of patients are often cowed by doctors and afraid to have faith in their own instincts. But believe me, after years of reviewing malpractice cases, I have learned that the tendency to deify the doctor is just as dangerous as vilifying him.

I remember reviewing a malpractice case of a 45-year-old man, Jim, who was awakened early one morning with severe chest pains. His wife rushed him to the emergency room, fearing he was having a heart attack.

Two hours later, he was released with a diagnosis of indigestion. His EKG and blood tests were "apparently" normal, and the chest pain gradually subsided. The wife accepted the doctor's word that everything checked out OK and took her husband home. He died a few hours later of a heart arrhythmia. If only she had listened to her own voice and insisted that her husband be admitted to the hospital for observation and more testing, things would have been different.

Had Jim carried a copy of his prior EKG with him, the emergency room doctor would have recognized the subtle changes and considered a diagnosis of heart disease and not a benign gastrointestinal problem.

Speaking of carrying a copy of your EKG, your second job as a patient is to read and compile copies of your own medical records

Although information contained in your medical records is one of the most important things a doctor relies on to give you the best care, no one doctor has all this information together in one place.

Only you can compile all your records over a lifetime and keep them organized and available for every doctor who needs to take a look. Keeping your medical records and taking them to every doctor visit will prevent miscommunication with and between doctors, prevent medication mishaps, avoid duplication of tests and will assure that you get all the preventive tests that you need -- and on time.

Just having your medical records securely in your hands will give you tremendous power and confidence. My last but hardly least important suggestion is to learn how to partner with your doctor. This means keeping a health journal, writing out an agenda for each office visit, noting any preventive test you may need and researching your conditions.

Take someone with you to doctor visits to help you ask questions, discuss your concerns and remind you just what the doctor said. I call this person a "health buddy." If your doctor questions your new, more active involvement in your care, remind him/her of the old Chinese proverb, "Tell me and I will forget, show me and I will remember, involve me and I will understand."

In addition to having a health buddy to prepare you and go with you to doctor visits, make sure if you, a family member or friend is hospitalized, you have a team that takes turns staying with you to help out and keep you comfortable and safe.

My mother, siblings and I all took turns staying with my dad while he was recovering from heart bypass surgery. I can't tell you the difference that made for him. Nurses are overworked and can't possibly be available at every moment.

I am reminded of the philosopher Hillel: "If I am not for myself, who will be for me? If not now, when?"

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