A recent study published in the Annals of Internal Medicine concluded that a majority of patients discharged from the Emergency Room (ER) do not fully understand their diagnosis, treatment, or their discharge instructions. The study of 140 patients measured four distinct categories: diagnosis, ER treatment, instructions for at-home care, and warning signs of when to return to the hospital. More than 78 percent of the patients surveyed lacked adequate recall in at least one area and almost half lacked recall in at least two areas.
“This study demonstrates a fundamental flaw in our healthcare system: too many patients, too little time,” says Dianne Savastano, MBA, BS, Nursing, founder of Healthassist, a personal healthcare consulting practice based north of Boston. “Even when patients are able to get the care they need, they are often rushed through the process and can leave the hospital or doctor’s office before they fully understand their discharge instructions. This can cause serious complications down the road.”
Savastano understands healthcare from both the clinical and business perspectives. In her twenty-five-year career in healthcare, she has worked as a nurse providing direct patient care, as a hospital manager, as a director of managed care for an insurance company, and as a manager of workers’ compensation programs. Savastano was also the primary caregiver for her uncle when he’d been diagnosed with multiple cancers. Today, Savastano runs her own business helping individuals and families navigate the complexities of the healthcare system and teaches them how to become better advocates in the process.
“There’s no doubt the average doctor’s visit is becoming shorter and shorter,” Savastano says. Whether you are a patient or a caregiver, visiting the ER or attending a regularly scheduled appointment with your primary care physician, Savastano offers the following ten tips for making the most out of every visit:
1. Keep a file that includes a detailed history of your healthcare and the recommendations, treatments, and prescriptions you receive from all your doctors. Include a list of immunizations and when you received them. Keep a chronological list of any diagnostic tests ordered along with the results.
2. Before your appointment, review the issues you discussed at your last visit with your doctor. Did the appropriate follow-up occur?
3. Make a list of your medical conditions, noting your understanding of the treatment plan for each of them. Between visits, make a note of any physical observations or changes in your symptoms or condition. Be sure to bring your notes to the doctor’s attention during your visit.
4. Make a list of all your medications: prescriptions, over-the-counter medications, and any supplements you take regularly. Include the dosage, how often you take each medication, and who prescribed them. Make a note of any changes in your medication regimen since your last visit. Check your prescription labels. Do you have adequate refills or will you need a new prescription?
5. Review any visits you made to other doctors since your last visit with your primary care doctor and explain the outcome of those visits.
6. Make a list of any questions you have for your doctor and bring them to your appointment.
7. Have someone you trust accompany you to your appointment. They can take notes to help you remember the details of your discussion. You can also ask for a copy of the doctor’s notes.
8. Once you get to see the doctor, at the beginning of the visit describe what you want to get out of your time together. For example: “Dr. Smith, during this appointment, I want to review all of my medical conditions and the treatment plan for each of them. I would also like to go over my list of medications to be sure they are necessary, that the dosages are appropriate and to make sure that they are all compatible with each other.”
9. Ask your doctor how you can communicate with him/her between visits. Be sure to find out how the medical practice responds to telephone calls from patients.
10. At the end of your appointment, summarize the discussion you had with your doctor to ensure all your questions are answered, your prescriptions are in order, and that you know what to do to educate yourself about your health. This short summary will help you feel satisfied with the outcome of your visit with your primary care physician.