America has long been the ultimate consumer society. From houses and autos to high fashion and designer decor to iPods, iPhones and all things computerized.
Buyers typically check prices, consult the internet, talk to references and make a purchase. They keep receipts and collateral information and expect service after the sale.
They may be meeting a real need or merely keeping up with the Joneses. Same approach applies.
And, yet, when it comes to the ultimate consumer purchase – health care – Americans invariably are much less involved. It’s not their comfort zone.
We grow up venerating doctors. They have a mystique, some a God complex. They have specialized expertise and medical argot; we have these flawed bodies and the passive voice. They’re in charge – of us.
And while the number of patient deaths due to misdiagnosis is shockingly high (one in 12, according to a 2003 report in the Journal of the American Medical Association), we typically don’t ask for second opinions. Even when it’s elective surgery.
Moreover, medicine’s all-too-traditional trappings – from the over-booked doctors’ offices with over-bearing attitudes and out-of-date magazines to the intimidating, institutional sterility that is hospital ambience – are all-too-reinforcing. Admission-to-submission is an easy morph.
But if Jeff Knott has anything to say about it – and he does – Americans will begin to become more proactive about their healthcare and more assertive in their role as consumer-patients. The Apollo Beach resident is the author of “Navigating the Healthcare Maze,” a compelling self-help book of tools and tips that aims to empower. He posits that we can all become “change agents” within the system if we do our homework, engage our “medical team” and hold people accountable. In the process, we become our own best advocates.
“Navigating the Healthcare Maze” is now in its second printing and is a staple on Amazon.com. Knott has done book signings at Barnes and Noble as well as media rounds locally and nationally. “Navigating” has been nominated for the “Books for a Better Life” national award that is sponsored by the National Multiple Sclerosis Society.
Knott, a robustly outgoing, 60-something native of Eastleigh, England, has been in the U.S. since 1969. His interest in the healthcare “maze” was initially piqued while he was international marketing director for Johnson and Johnson. His wife’s thyroid condition — and subsequent entrance into the “maze” — plus his own open-heart surgery — and all the pre-to-post op procedures and subplots that entailed — made it personal.
But he was still taken aback once he really delved into his research.
Knott was surprised, he says, by “how much patients got pushed around in the system and how dangerous that can be for the outcome…We are last out of 17 so-called developed countries in preventable deaths in hospitals.”
Knott, who currently serves on the Initiative for Global Development that seeks to affect medical, educational and agricultural change in the developing world, faults patients for their passivity. In effect, he says, they allow themselves to get “pushed around – from the primary doctor’s office through the hospital and back out with no planned, careful understandable process.
“That’s the point,” he stresses. “We get pushed around in retail stores and restaurants if we don’t take action, but with healthcare many are intimidated and think that doctors have all the answers. White coat syndrome has to be eliminated!”
Knott is very emphatic about the importance of developing a “team” concept among patients and practitioners. Patients need to interact, ask questions and generally do everything to become more than just a name on a chart, he urges. Don’t assume that your key healthcare players are going to be “empathy engines.”
“I don’t knock doctors,” explains Knott, “but if we are more knowledgeable and better prepared and have questions to ask the doctor, then the doctor can also make a more accurate diagnosis.”
Knott advises patients to ramp up their communications skills when in healthcare contexts. And it doesn’t require a Type A personality.
“We all have basic good communication, observation and listening skills, and we are lazy in using them,” notes Knott. “When it comes to our most precious possession, ourselves, we don’t use these skills.”
Knott’s book is dotted with suggestions and do’s and don’ts that are gleaned from research, personal experience and common sense. There are also supporting anecdotes, resource lists, charts and statistics that underscore the challenges — from waiting-room fluster to hospital protocol to discharge scenarios — awaiting all those who must venture into the healthcare “maze.”
A sampling:
*“Be proactive in finding a primary doctor.”
*“Always shoot for an early (doctor’s) appointment or even first appointment after lunch.” Offices – not unlike airlines – often overbook to compensate for no-shows.
*“Look for ‘one-stop shopping.’ It is very important to be able to get as many tests and treatments done at a single physician’s office.”
*Don’t be reluctant to ask for a discount. “You will be amazed how an extra 5-10% (off) can be achieved just by asking.”
*“Specialist/surgeons are often too eager to cut. That is what they are trained to do. They shouldn’t be faulted for that. But their approach may not always be the ‘only’ approach.”
*“Knowledge is power. It can lower your fear level. It can give you the boost needed to ask questions or explain your symptoms in an understandable way. …It is of vital importance in today’s world to be able to access the Internet….Doctors are more responsive to patients in the know. Likewise, so are staff members.”
*Have a living will.
*Keep your own medical history file. Give “serious consideration to maintaining a set of records for yourself and family members.”
*Before surgery: “Make sure you take a list of all the medications you are taking – dosage, frequency as well as OTC medications. Also compile a list of all herbal medicines. Some might increase the risk of problems during surgery (such as bleeding).”
*In the hospital: “Never accept medication from someone you haven’t worked with previously, recognize or seems confused. …You need to be vigilant and don’t accept anything you don’t recognize.”
*“There are numerous ways patients can help reduce the risk that they fall victim to errors and incidents that could lead to errors, injury and even death. The best way to begin is to always ask questions. Don’t be intimidated by your surroundings or the people working on and with you.”
*Expectations aren’t always managed: “No one had explained or even mentioned to me about the effects the anesthesia or surgery or my stay could have in the area of memory loss or noticeable mood swings or eating habits. …Research and experience suggest that surgery under general anesthesia may impact cognitive functions.”
*Discharge: Studies have shown that the transfer of patient care from the hospital team to a primary care and other providers outside the hospital can be a “high-risk process.” “Be proactive and involved when it comes to your care after leaving the hospital. …Don’t leave without receiving printed guidelines on caring for yourself or your family member.”
*Annual physicals: “Routine checkups, in my case, probably saved my life.”
*“There are no stupid questions. Ask away.”