How to Navigate the American Healthcare System: A Series

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Well… Anywhere in the US, that is.

In this first of a series of articles, I want to discuss communication. As we all know, communication is foundational to any good relationship. We also know that communication is not something we will ever perfect. We must continuously learn and evolve in how we relate to others, whether new acquaintances or old friends.

One of the reasons I write, blog, and own a podcast is to help others navigate the wilderness of the US healthcare system. I think we can all agree that the system is tremendously complex and, especially for the uninitiated, can be a frustrating maze to try to find your way.

I want first to explain why those of us in healthcare don’t empathize as much as we should with the frustrated patient — we are in the system.

For example…

Have you ever called up your IT person (or maybe you are that person, God bless you) at work and gotten a bit of a rude or less than sympathetic response to your latest computing challenge? The reason is simple — they understand the ins and outs of the machine and its connections. They have the knowledge that you seek and do not know why everyone else does not already understand what they do.

The same is true of medical professionals. We are, despite rumors to the contrary, human.

It is perfectly understandable to us that you need to remain fasting before that colonoscopy.

It is blatantly obvious to us that we wanted you to keep taking the medications we had you on and add one additional. We shouldn’t have had to tell you that!

We make assumptions too.

We assume you know more than you do and leave you feeling uninformed.

We assume you know less than you do and leave you feeling like we are treating you like a child.

Be a part of the conversation.

Too frequently, patients sit idly, and when asked, “Do you understand?” nod in agreement and move on. Later in the day, a call is received, asking for more information or clarification. The provider becomes frustrated because “I just told them that!” and the cycle of miscommunication and not wanting to “bother” the provider continues.

If you do not understand, tell the provider this. Ask him or her to utilize the “Teach-Back Method.” This method is a conversational or teaching style that requires the patient to understand what was said well enough to repeat it back, in their own words, to the provider. If they are not able to do so, the provider must go over the information in varying ways until there is sufficient comprehension.

Take notes.

While many offices and institutions have policies against recording visits, all should encourage you or a loved one to take notes during the visit. If you have questions prior to the visit, write them out and leave sufficient space to fill in the answer. Before the doctor leaves the room, read all your questions and answers, and make sure everyone is on the same page. This may take a few minutes extra during the visit but will be made up for in less confusion at home and fewer “call-backs” to sort it all out later.

Bad interactions happen.

We’ve all had them. Whether at the bank, the grocery store, or the library, there are times when things go wrong. Either you or the teller was in a bad mood, or some component of the interaction just caused you to blow your top — it happens.

It happens to us too.

Stay calm and politely ask the person, even if a physician, to please refrain from yelling, cursing, or whatever behavior they may be exhibiting. For most, just this kind word of redirection is enough to elicit an apology and an explanation.

If it does not, know that you have resources. Ultimately, you have the right to move on to another provider. Before you do that, reach back out via phone or e-mail and give it another try. You may be surprised that s/he is willing to apologize and explain and to work to ensure this never happens again.

If not, reach out to the office manager or the Chief Medical Officer. It is their responsibility to assist the physician with improving their interactions with patients. Just know these are issues we all want to work on in the healthcare system.

In the next installment of this series, I will review the what of communication. What do you want to ensure you, as the patient, communicates to the provider? Also, what information do you want to be sure to understand before you leave the office?

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