To be a smart patient, you can’t be passive; you need to be a first-rate Sherlock Holmes. Like Holmes, smart patients ask intelligent questions and have the instincts (and guts) to politely challenge things they don’t understand. They don’t need to know the most esoteric medical details, but they need to put at least as much effort into finding out the basics about their health as they did in getting the driving directions to our office. Ultimately, you are the person most responsible for the success of your health. Here, what great doctors know that great patients can learn.
1. Get your stories straight. Bring your spouse or partner to your doctor’s appointment when you’re giving your health history or describing a problem; there are a lot of questions that only a partner can answer (such as how many times an hour you stop breathing while asleep). But beware the doc’s sixth sense. When you tell us that you rarely tear into the Pringles after 8 p.m. or that you’ve been taking your cholesterol-lowering drugs with the discipline of a Marine, your spouse will shoot you (or us) a look that says, “Are you kidding me?” We never miss it. And hey, sometimes your spouse wants to blow your cover. It’s called love. But if you try to snow us, we might try to trip you up. For example, we’ll ask if you’re fit enough to climb three flights of stairs. You’ll say yes, unless you’re over 85 or bedbound. Then we’ll ask, “When was the last time you climbed three flights?” You’ll say “Maybe a month… ” and your spouse will send a look that says, “You haven’t climbed three flights of stairs since we voted for Ike.”
2. Truth or consequences. We know you bend the truth a little when telling us the good and bad you do to yourself. That’s why we at least double, up or down, the most fudged claims. For example:
3. Nurses know it all. One way to find a great doctor is to grill the
head ER or ICU nurse at the largest local hospital, preferably a teaching hospital. These nurses get a battlefield view of doctors at their best and worst. If you’re visiting someone in the hospital, you may be able to swing into the unit. If all hell isn’t breaking loose and the nurses have a few relatively quiet minutes, you’ll have a chance to politely approach one and make your inquiry. A nurse may say, “Well, to be honest, Dr. Addison is a complete jerk and everybody hates him, but if you’re in serious trouble, there’s nobody better.” Endorsements like this aren’t unusual in medicine.
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4. Get friendly with your pharmacist. Your pharmacist is the least expensive and most accessible health resource you have. While it might seem easier to forge a personal relationship with one pharmacist at a small mom-and-pop pill dispensary, smart patients can and do establish great relationships with superstore pharmacists too. You can see her anytime you want, without an appointment — all consultations free. In medicine, that’s extraordinary. Your pharmacist has an amazing wealth of knowledge at her fingertips, which means at your fingertips. Many also have access to new technology that can answer questions (such as, Is it safe to take this brand-new medication with this even newer medication?) in a blink. What’s more, they get a soldier’s-eye view of patients with similar conditions using different medications every single day. They see who improves, and who complains about side effects. And they know which side effects could mean serious trouble. Why do so few people take advantage of this golden resource? It baffles us.
5. Learn the shorthand. When your doctor hands you a script (that’s doctorspeak for “prescription”), she knows you can’t understand the arcane Latin-y squiggles and abbreviations. Doctors typically write the name of the medicine first, then the form (say, capsule or tablet), dosage, amount (say, 30 tablets), directions for taking it, and finally the number of refills. Here’s the medical shorthand: