Taking myth and mystery out of medical practitioners

November 23, 1993|By Carolyn Susman | Carolyn Susman,American Health Magazine, the National Council Against Health Fraud.Cox News Service

Many people find it difficult to take charge of their own health care. It requires assertiveness, and some patients just can't question medical authority.

"I think it's important not to put health care providers on such a pedestal," says Joely Martin Root, a nutritionist in Boca Raton, Fla. "We should recognize that we are all intelligent people, and medicine is a business and we're all consumers."

And a big business it is. Health care costs in the United States were $838 billion in 1992, or more than $3,000 a person, according to an article in the July issue of the New England Journal of Medicine.

The article's authors suggest that if people took control of their health care, costs would go down.

Ms. Root recommends you determine how you feel about various medical procedures and look for doctors who are understanding of those views. When she became pregnant, she talked with her gynecologist and other medical professionals about their philosophies of childbirth.

"I feel very strongly about natural childbirth. Did I want a home birth or birthing center? I don't want epidurals and drugs. I told [her gynecologist] and he said, 'Fine, but I just don't understand why you would do this without drugs for pain.' I said I viewed it as natural process.

"He was rejected. I've decided on a midwife who works with an obstetrician."

And her gynecologist? "He didn't act insulted. I've been very happy with him, but I see we don't agree on how a birth can be."

Communication like this is the cornerstone to controlling your medical care.

"The patient often has to initiate that," says Dr. William Jarvis, a professor in the School of Public Health at Loma Linda University California.

"Ask questions until you understand the answer and don't feel you're stupid if you don't understand right away. It's the same thing if you're getting your automatic transmission fixed," says Dr. Jarvis, who is also director of the National Council Against Health Fraud, a nonprofit organization geared toward stamping out quackery in the medical field.

"There has to be that sort of assertiveness. If you have a practitioner that gets impatient, that would be my cue to change practitioners."

Once you get a diagnosis, ask the doctor for literature on your disease or illness. Contact support groups or organizations that specialize in the illness and, most importantly, get a second opinion before agreeing to any procedure. Many insurance companies require the second opinion, anyway.

One way to make sure you ask the right questions and remember the answers is to take someone with you to sit in during the meeting with the doctor.

"This is an important component, and the doctor should feel free to speak in front of him or her," says Dr. Herbert J. Freudenberger, a New York psychologist. "When you're upset, you might block out the information."

Dr. Freudenberger, who says he first coined the term "burnout" 20 years ago to describe job stress, says it's also important that you feel the doctor pays attention to you during visits.

"Or does he take my folder when I come in and is busy reading up on me?"

Dr. Freudenberger says it's not usually necessary to get the doctor with the most medical credentials.

"If at all possible, don't get the 'toppest guy,' the top of the line, the director of, chairman of. I don't need the top of the line guy if my illness isn't so critical. He or she is not necessarily the best guy. Maybe he or she is just the best politician in the hospital."

Be sure, too, to check the doctor's background and training in medical directories, if possible.

And the most basic advice?

Don't put off going to a doctor if your attempts at self-medication don't work.

"Don't dismiss symptoms," Dr. Freudenberger warns. "Denial is a major way with which people cope."

TAKING CHARGE OF YOUR HEALTH CARE

INTERVIEW doctors. It's OK to shop around.

CHECK credentials. Look in medical directories or ask your medical society for information.

COMMUNICATE. If you have questions, ask.

LISTEN. Make sure you understand what is said. If necessary, take another person with you to the appointment.

LEAVE. Don't hesitate to change doctors if you're uncomfortable with the one you have.

READ. If you are diagnosed with an illness, find out all you can about it.

GET a second opinion. Never agree to a procedure based on one opinion.

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