I have had the pleasure of meeting Martine Ehrenclou, author of The Take-Charge Patient. She is an incredible patient advocate, who also happens to be wickedly smart and intuitive. Martine’s efforts fall nothing short of excellent.

You will find that The Take-Charge Patient speaks to everyone. Martine has essentially created a healthcare life vest and thrown it out there to help all of us. If you are wondering why some have sweet success in the healthcare arena while others are barely staying afloat, look no further.

When reading Confident Voices: The Nurses’ Guide To Improving Communication and Creating Positive Workplaces by Beth Boynton, RN, MS, I was stunned by how the nursing workplace is fraught with verbal abuse, bullying and a lack of respect for nurses as individuals. I couldn’t help but wonder how this kind of workplace conflict from supervisors, physicians, co-workers and others, translates to the quality of care for patients.

On the bright side, and a very bright side it is, Boynton offers some excellent strategies for effective communication, respectful listening, assertiveness training, setting boundaries and a collaborative approach to problem solving. She asks for behavior change from all sides—the administrators, physicians, supervisors and the nurses themselves.

A key element in Confident Voices is empowering nurses to feel more confident because confidence is a key to creativity and good will toward the workforce as a group. She gives many examples and stories to illustrate her effective theory. A current theme in health care is to empower patients or medical staff to become more invested in either providing or receiving care to increase quality of care, patient safety, patient and medical provider satisfaction and more. Boynton also emphasizes that having a sense of power or control over one’s life is closely tied to motivation. This also stands to reason. Listen up hospital administrators!

Medication mistakes are the most common medical errors and the most easy to prevent. 1.5 million people are harmed by medication errors every year (Institute of Medicine). That has to be a conservative number as the report was published in 2006.

In my new book, The Take-Charge Patient: How You Can Get the Best Medical Care, I emphasize that you can prevent medication mistakes simply by taking charge of your medications.

Many of us are so busy that we don’t always pay attention to the name and dosage of a medication that is prescribed for us. You might think about changing that behavior because medication errors happen in all sorts of ways and happen all the time. By the time your prescription leaves your doctor’s hands, errors can happen in transcription, scanning, faxing, misinterpretation of the medication given over the phone to a busy pharmacist or misinterpreted by the pharmacy tech who fills it. A misplaced decimal point can give you much more than you bargained for.

I interviewed a pharmacist for my new book and he told me about a medication error that was a result of a simple, human mistake but could have had disastrous consequences. A patient’s husband picked up his wife’s medication from the pharmacy. The next morning the patient called the pharmacist. She was very upset.

Unless you’re a patient dealing with a medical issue that has not yet been successfully diagnosed and treated, you might not be easily convinced of the advantages of taking charge of yourself as a patient. Gathering copies of your pertinent medical records, writing up a health summary, creating a chronology of events which includes a list of physicians seen and the interventions each has tried, can seem like an unnecessary task–until a medical condition or disease hits.

I talked to a good friend a couple of days ago who had been treated by a new gynecologist for a suspected bladder infection. Two antibiotics later, (one prescribed by a doctor on call for the new doctor who was away) she was still in pain and the cluster of symptoms had not abated. When we spoke, she said she was going to see the new gynecologist again and possibly her internist as well. She seemed a bit overwhelmed and possibly frightened about the ongoing symptoms and the absence of an accurate diagnosis.

I told her that first, before seeing either doctor, she had to put together a health summary, something I describe in my new book, The Take-Charge Patient. I explained that her health summary had to identify her symptoms and where they were located in her body, their frequency and duration.

Next, I told her to list the name and dosage of the first antibiotic she’d been prescribed and which physician had prescribed it for her. Then, list when the second antibiotic had been introduced, it’s name and dosage and which physician had prescribed it for her. Unable to remember the names of the medications, she said, “I think I threw the bottles out since I’ve finished the antibiotics.” I suggested that she call her pharmacist and ask for what she needed. I also urged her to get a copy of the test results from the first physician she saw.

This packet of information would be presented to each doctor. I explained to my friend that taking charge of her medical information in this way would not only support her doctors’ efforts but it would help her feel more empowered as a patient and reduce any helplessness she felt.

Not that any of us needs another reason to avoid going to the hospital, but a new study done by Robert S. Wilson, PhD at Rush University in Chicago, published in the journal, Neurology, reports some particularly troubling results. Read more

1870 adults over the age of 65 were followed over a period of 9 years and were tested on their memory and cognitive skills before they had a hospital stay and then several times after. What the researchers found was that the participants’ memory and thinking skills were twice as likely to decline after a hospital stay. In other words their cognitive decline sped up. In addition, people’s long term memory suffered the most—it declined three times the normal rate after the first hospitalization.

What’s interesting about this study is that researchers found that the patients’ cognitive decline had little to do with the illness that put them in the hospital in the first place.

After discussing this last Tuesday during my weekly radio segment on Health, Wealth and Happiness, the findings of this study have stayed with me ever since. We’re all aware of the deadly medical errors that occur in hospitals every year. But this new study suggests that something happens to the older patient’s brain as a direct result of being in the hospital. I’ve been mulling over why memory and thinking skills would progressively decline across the board no matter the length of the hospital stay.

Here’s what we do know:

Relationships with physicians are a breed all their own. They are unlike any other relationship we have, unless of course you are married to one.

Most of the time, our relationships with our physicians are one-sided, and peppered with on-the-run diagnoses and treatment plans. Enhancing the relationship with your doctor, expanding it just a bit beyond the clinical interaction, can maximize your medical care in ways you might not expect. As I said in my last blog, doctors are human beings. They are pressed for time, dealing with patient overload, phone calls from you, from pharmacies and other physicians, visits to patients in the hospital, filling out insurance forms for you and other patients, and filing appeals to insurance companies so you get the medical treatment they feel is right for you. The list goes on.

With the seven to fifteen minutes you have with your doctor, create some familiarity with her. You want her to remember you beyond a set of symptoms. I can tell you from all the interviews I’ve done for The Take-Charge Patient and my last book, Critical Conditions, that physicians, nurses and other medical professionals remember the patients they really like and the ones they really don’t. It’s human nature to want to do more for someone you care for and like as a person. And you want your doctor to go the extra mile for you. It also helps if you show you are invested in your health and medical care. This increases your doctor’s investment in you as her patient.

After reading The New York Times article, Doctors Have Feelings, Too,  I began to wonder why so many doctors out of 2000 surveyed withheld information from their patients. The writer of the op-ed piece admitted to withholding the severity of a patient’s prognosis. When the patient asked if the medication prescribed would make her heart better, this doctor did not reveal that not only would the medication not help her heart but that she was not going to get better.

Was this a fatal flaw in this physician’s professionalism or simply an error because the doctor is human?

In my new book, The Take-Charge Patient, I emphasize that physicians are human beings, that just like you and me they can make errors in judgment because of who they are as people. Their personalities or personal experiences can affect how they deal with conflict or upset such as the doctor who wrote about withholding disturbing news from her patient. There’s really no justification for not revealing the truth to patients but I wonder if I were a physician, would I tell a young patient that her prognosis was completely devoid of hope?