Harvard Pilgrim Healthcare recently posed this question on its Facebook page:

“Keeping a good relationship with your primary care physician is key to managing your health. What do you think is the best way to keep a positive relationship with your doctor?”

 doctor shakes hands with patient

Some of the answers:

  • Come prepared to your appointments. I write down anything I need to discuss and my primary physician never leaves me until we have covered what is on my mind.
  • Be your own advocate. Be honest. Ask questions. Speak up.
  • Be an educated consumer. Mutual Respect. Be Honest. Ask questions. Refuse treatment if you have reasonable cause to do so. Have a healthy sense of humor too.
  • Try to be proactive with your health and know your own body.
  • Doctors have a thousand patients to see. Obviously, they need to make an effort to know each patient individually but we, as patients need to advocate for our health. Email would be a nice way to maintain communication!
  • I always start a note of things I want to discuss with my doctor the week before my physical exam or a follow up so I can use her time efficiently. I’ve seen my doctor for 10 years and she knows I am always prepared for my appointments. At the same time, she gives me her time and doesn’t make me feel rushed.
  • Don’t you have this backward? Shouldn’t primary care doctors be working to keep a good relationship with their patients? We are the ones who hire them.
  • Be able to, talk, email, text him or her at any time, knowing he’ll get back to you, at least after 24 hours if not sooner.

Exactly what health care journalist Nancy Finn recommends in her book “e-Patients Live Longer” and on her blog Health Care Basics. I interviewed Nancy a few weeks ago and we talked about the relationship between patients and health care providers in today’s world. “All of us, as health care consumers and individuals, have to take charge of our health,” she told me. “Doctors have to change the way they approach patients. Patients also have to become part of the health care team. They have to be involved in the decisions that are made.”

HOW TO TAKE CARE OF YOUR OWN HEALTH

In a perfect world, all of your health care providers would have electronic medical record systems and communication would be seamless. When you arrived at an appointment with any of your providers all your information would be right there. It’s not a perfect world, so here’s what Nancy suggests:

  •  Create your own personal electronic health record.
    • Include medical/family history, medications, allergies, surgeries, procedures, image scans, if possible, and lab work.

There are several online sites available that you can use to store your information, perhaps including through your insurance company. Nancy says information can also be stored on a smart card, a flash drive, or even a chip that’s embedded in your body if you’re so inclined.

The biggest concern most people have is about security. Before you sign up, do your research.

    • How is information kept private?
    • Is information added to a record from outside sources, such as insurance or doctors’ offices? How? What is added?
    • Can information be corrected or deleted?
    • Can information be shared with providers?
    • What will it cost? Are there any special fees?

Creating a personal health record is, “Something I believe patients should be doing for themselves,” says Nancy. “Even if there is an electronic health record that your PCP has —especially if you’re getting care from several providers — you absolutely should have a personal health record. That’s the only way you assure that when you need care, the information your health care provider needs is going to be there.”

  • Prepare yourself before you go to your appointment
    • Educate yourself (In her book, Nancy lists the best web sites to search for accurate information.)

“Physicians are, really, in their defense, very busy,” Nancy observes.”They are poorly compensated for the time they spend and it’s difficult for them to do everything. Again, it’s incumbent upon patients to educate themselves.”

Bring a written list of questions and don’t walk out of your appointment until they’re all answered.

“Common sense questions,” says Nancy. “Things like what is causing my symptoms? What does this mean? Why do I need the test you’re suggesting? How and when will I be able to see the results? What are the treatment options? Do you think after we get the results I’ll need to see a specialist? Why are you prescribing this particular kind of medication? What are the side effects? Are there lifestyle changes I need to make that will help my condition?”

  • People with chronic conditions need to proactively take care of themselves

Tools are available that patients can use to monitor their conditions — blood pressure, blood sugar, airflow, for instance. “Patients have to be more proactive in checking these chronic conditions,” advises Nancy, “and letting physicians know if there are changes that have to be closely watched and monitored.”

  • In the hospital? Don’t be afraid to speak up

Nancy is adamant when she says people need to be aware of the prevalence of medical errors, what they are and how to avoid some of these issues.

    • Wash your hands — use the special soaps available in the hospital.
    • Don’t be afraid to ask every single person who interacts with you to wash his/her hands. That includes your health care providers — don’t take it for granted that each one remembers to do it.
    • Make sure you have a patient advocate — a family member or close friend who is willing to:
      • Check in with the doctors and nurses
      • Make sure everything is done properly
      • Question procedures
      • Question medications that are prescribed or changed.

If you don’t have an advocate, you can request one in the hospital.”They provide social workers who do that for you,” says Nancy. “Patients should have an advocate, but it’s up to the patient to be proactive about it.”

How do you take charge of your health?

Are you already being proactive when it comes to your own health care? If you have some common sense advice, send me a message and I’ll add it to the list. Want more suggestions from Nancy? Check out her blog Health Care Basics.