The Role of Patient Behavior In Better Health Care (The Trickle Up Approach)

By | June 1, 2021

After forty years of providing direct patient care, it has become abundantly clear to me that patients need to change their behavior and follow three “rules” when interacting with health care providers.

Now more than ever, patients have a critical role in their own healthcare. So it makes sense to focus on them, and improve their behavior when they interact with healthcare providers to achieve better health outcomes.This is especially true now when healthcare provider’s time is so limited, because in order to get the best care that precious time needs to be used most efficiently and effectively.
First, patients need to closely listen to, and then answer all questions posed by their healthcare providers succinctly, and to the point.The questions should be easy to understand, and patients are usually quite good at answering them, despite their concern to the contrary.Patients may be asked many questions, including if they have noticed any changes to their bodies which are either new or more noticeable. These “complaints” or “experiences” are more often sensed or felt such as new or worsening pain, or they may note changes in their bodily function, such as more difficulty breathing. Less commonly these changes may also be seen by the patient, such as a rash, or swelling of their leg.Once the question is answered, the patient should stop, resist the urge to say more, let the answer “stand on its own”, and wait for the next question. The answer means so much more to the provider than the patient realizes. The question and answer process should be directed by the healthcare provider, who knows the first best question, and the next best question based on the patient’s last answer. Allowing the process to proceed uninterrupted to its natural conclusion is the most efficient and effective way to get the deeper understanding of the patient’s “story”, which in medicine is called the “history”. The history is a time line of the patient’s complaint’s, as well as all other relevant medical information. It is an understanding of the patient’s situation, condition, and serves as the basis upon which all diagnosis and treatment is rendered. The more accurate and complete the history the better the outcome, but it often takes time to complete, especially in more complicated cases.

Patients need to accept the fact that the practice of medicine is not their area of expertise, and should not behave as it is. Just because they have their own bodies does not mean they know how it works or how to fix it. All those years of ”study” really do make a difference.It is always best for patients to leave their self-diagnosis, theories, and reasoning “at the door”, and allow medical providers to lead them through the process. The only “help” the provider needs from the patient is their direct and concise answers to the questions.

It is also important for patients to recognize that all medical practice is now “evidence based”. This means that medical studies have been done over the years to substantiate everything we know, and allows for medical “standards of care” to be practiced.Researchers, and experts in the field around the globe work tirelessly to advance medical knowledge continuously, and they deserve our gratitude. Medical providers act as the “interface” between all this accumulated medical knowledge and patient care, forming a trusted “partnership” solely for the patient’s benefit.Currently we are at a time in history when we know what we know, and what we don’t. Our medical knowledge has “exploded” over the past twenty five or so years, and when added to our prior knowledge base is impressive, and should be reassuring to everyone.

Secondly, it is always best to prepare for any interview with health care providers. This includes preparing a complete list of any and all “medications” taken. This includes every prescription and over the counter pill, liquid, oral and nasal inhalers, and skin care products ever used. Additionally, patients should prepare a list of any concerns, questions, and needs they may have. This is not frowned upon. By doing so there is no need for patients to worry that they may forget these other issues while their history is being taken. These can be addressed after the history is complete, when patients get to ask their questions of the provider. It may be necessary to address some of these at a later date, but at least the health care provider will be made aware of them. Efficiency, completeness, and correctness are always the goals, which allows for a greater likelihood that this will be achieved given the time limits. “Always use the time to your best advantage”.

Third, patients need to be “keepers of their own castle”, and report any changes to their health “status quo”. Any new, or more noticeable feelings, sensations, changes to body function, or anything seen by the patient must to be reported. Do not wait to report any change that has occurred. It makes no sense worrying about what turns out to be an insignificant change, or delay reporting what might be a very significant problem when time may be critical. A phone call, or message describing the situation using the above recommendations is strongly advised.
Finally, in addition to the three “rules”, it is up to every individual to always strive to live a healthy lifestyle. “It is a battle worth fighting”.
Eating healthy, weight control, exercise, and not smoking or drinking to excess really do add healthy years to people’s lives.“Regular” visits to health care providers are valuable even when there is no change to status quo. Some significant medical illnesses are “silent”, and some require “preemptive” testing and screening. The above suggestions will not obviously totally solve our overall health care dilemma, rather they describe the patient’s responsibilities in interacting with it for their better health.

Many fixes that are needed to rehabilitate our health care system are under the control of others. However, the system will only begin to do better when each of us does our own part. 
Good health, hope you had a happy Memorial Day, and here’s to getting over Covid-19!

Peace and stay safe.

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