Most people do not get the full benefit from a consultation
with a doctor. I think patients can improve this. You hear endless
stories of mishaps with the medical profession. If you listen
to bits of passing conversations on the sidewalks you will notice
that many are health system or illness related. The main topic
is horror stories of "what went wrong", malpractice, and mistreatment.
I have not seen research on the subject, but it may be that
medical mishaps, diseases and doctors have replaced the stories
of monsters and witches of fairy tales of yester-year. We never
know what really happened in these scary medical tales, but
as a doctor I know that mistakes happen; and only some of these
mistakes are the doctors. Many mistakes occur as a result of
the patients (consumers) doing or not doing something; or not
understanding how the health system works. If you can improve
your use of the system, we can cut down the chance of making
Lately patient expections (and even demands) of the health system
are very high. Patients expect to be "informed" of all stages
of the medical process - diagnosis and treatment. The medical
consumer ( you ) is expected to choose the doctor and speciality,
suggest the "workup" and discuss the differential diagnosis
( the possible diagnoses ) and then decide on the best course
The assumption that patients can fulfill this role is mistaken.
The medical literature in 2001 began discussing a Health Illiteracy
epidemicin the US. Experts estimate that up to 50% of the people
in the United States do not fully understand the patient-doctor
consultation, or do not have the capacity to understand the
written instructions about an exam or medication.
The AMA (American Medical Association) is working with the U.S.
health authorities to treat this epidemic.
In Israel we use less written instructions with patients, and
still do not implement "informed consent" fully. We have less
expectations that patients will read about their illness and
treatment options. Undoubtedly we also suffer from a similar
"health illiteracy" status. The old fashioned "paternal" medicine
in which the "fatherly" doctor makes all the decisions and the
patient just has to follow instructions has changed over one
generation to a partnership. Patients are expected to be partners
in medical decisions. If your physician doesn't want to cooperate
with you, then you should find a doctor who does. On the other
hand, if your doctor wants you to be involved in the decision
making, and you don't want to; clarify the issue!
I don't think one should learn medicine in order to cooperate
with your physician on your health issues. You can and should
learn about the health system. Learn its limitations and its
pitfalls to best navigate and improve your medical care. This
is especially important in public and Kupat Holim (HMO) medicine.
We all are irresponsible with our health. Almost all of us have
daily habits known to be unhealthy; and avoid things we know
to add to our health. In order to get the most out of modern
medicine one must take responsibility. One must think, one must
learn, you must make decisions and follow though with them.
We can assume responsibility for our health. It may be a burden
and inconvenient, but we can become active participants in the
health process. Once we decide to take responsibility and to
act upon our decisions we are on the road to maximizing our
use of doctors and modern medicine.
--TAKE RESPONSIBILITY FOR YOUR HEALTH
--AVOID HEALTH ILLITERACY
--TAKE AN ACTIVE ROLE IN YOUR HEALTH
--CLARIFY UNCLEAR ISSUES WITH YOUR DOCTOR!