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patient rights

The Most Important Member of the Treatment Team YOU!
The Most Important Member of the Treatment Team YOU! You alone have the unique perspective of living with this body the team is treating. Your input matters, and so do you!

You, the patient, have a major role in the management of your health care. We have come to expect the doctor to be the know-all and be-all of the situation, along with nurses and others on whom your physician relies to carry out orders for tests, restrictions on diet, or mobility and so on. It’s easy to feel that all of them are in charge of you, and that you don’t really have a voice or a vote. You do have a vote, and as the consumer of services whose body is at issue, you must exercise that vote or live with the consequences.

You are the expert
You too are an expert: usually regarding your family history—who had what illnesses, how long they lived and how they died; your personal history—what illnesses, surgeries and accidents you’ve had and how each was treated, its outcome and possible ongoing aftereffects; and your current status—your presenting physical symptoms as well as any cognitive or emotional difficulties, symptom onset and duration, and what treatment including medication has helped in the past; your treatment history—which physicians have treated you for which conditions, which tests and medications were given, and how you responded. Unless you have received all treatment your entire life in one medical facility, and chances are slim to none that you have, then the current physician won’t have access to your entire medical history, and it will fall to you to present it as thoroughly as you can. You are a goldmine of medical information about yourself, and the medical team should regard you as such. But often they don’t. If a clipboard with a checklist handed out at the front desk followed by a few questions from the doctor is the extent of the inquiry, you’ll need to speak up.

Skills need to outweigh personalities

When dealing with bombastic, patronizing, abrupt, rude, or judgmental medical professionals or staff, the best advice is, don’t take it personally

When dealing with bombastic, patronizing, abrupt, rude, or judgmental medical professionals or staff, the best advice is, don’t take it personally. Oversensitivity can distort an offense. Perhaps that’s just how this individual handles patient interactions, and you won’t have much impact no matter what gyrations you go through. Accept that this is how it is and deal with it, or keep looking until you find someone with whom you feel a better rapport. Because you do not always have the luxury of time when addressing a medical situation, you may need to remind yourself that the doctor’s personality is less important than his or her medical skills. But feeling misunderstood, disrespected, or dismissed is bad for your mental health, and just “taking it” is no good either. Seek advocacy if you feel you aren’t coping by yourself, speak up if you possibly can, address the problem in psychotherapy to build people skills, and consider seeing a different professional if things don’t improve.
Include a friend or family member
As a clinical psychologist with a full-spectrum practice, I see people with many needs. Some have medical conditions that complicate their psychological issues. Frequently during psychotherapy, psychological issues must be tabled in order to address health problems. Empowering patients to advocate for themselves in their medical treatment is rewarding for me as a health care provider. I’ve seen it all–inadequately communicated instructions, bombastic proclamations brooking no alternatives, patronizing “don’t worry your head about this” dismissals, abrupt bedside manners, patients branded as “troublesome” after insisting on clarifying procedures, prognosis, or options. And I’ve also seen physicians take time to hold a hand, re-explain a procedure, answer a laundry list of scribbled questions with patience and respect, and remind a woman facing breast surgery that it is her body and ultimately her choice what is done to it.

Inadequately communicated instructions suggest the sender has failed to get across the intent of the message and if aware should confirm and restate it. If you don’t get it, ask. Unless you are in the medical field, you and the doctor speak different languages regarding medical issues. You speak of hurt and fear and what-if, and how-will-I-feel and how-will-I-look (and perhaps am-I-going-to-die?), and physicians speak of discomfort and pain and side effects and complications and statistics and aftercare and follow-up and success rate. And please-read-and-sign-this-form-that-discloses-that-your-procedure-carries-with-it-a-risk-of-death-or-serious-disability. Besides jargon, there might be additional communication problems. With English, a second language for many of us, accent or idiomatic differences may cause you to miss some of what is said during your brief minutes with the doctor. Also, a hearing or neurological impairment may interfere with getting important facts.

You could miss some things if you are anxious, too. Anxiety can interfere with normal sensory processing, causing us to be “scared stiff,” pace mindlessly, wring our hands with anxiety, or stare “like a deer in the headlights” because of a shock of some sort. If you see a surgeon because your mammogram suggests a problem, your anxiety level could be so high that hysterical deafness occurs, preventing your hearing some of the important things being said. Just hearing the word “cancer” may be enough to trigger such a response, or the sight of stirrups, sigmoidoscope, or needle, or the mention of any of these, may do the job.

If you are the most important member of the treatment team, what if you do not understand what is being told to you, and your life may depend upon it? Be prepared and if possible have an ally such as a good friend, calm family member, social worker, or support agency volunteer accompany you to your appointment. You need to listen, digest, and decide. Its okay to ask questions and you should. Your ally can, too, and comparing notes afterward can help a lot.

When members of an inpatient or clinic treatment team meet, they discuss each patient, presenting diagnosis, status, symptoms, treatment, and prognosis. Sometimes patients are included at the table. Often they are not. Regardless, you have a right to weigh in on each of these—diagnosis, status, symptoms, treatment, and prognosis—ask questions and share information with the others on the team. You alone have the unique perspective of living with this body the team is treating. Your input matters, and so do you!

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"The Most Important Member of the Treatment Team YOU!"
   authored by:
Shielagh Shusta-Hochberg is a clinical psychologist in private practice in Manhattan. Dr. Shusta-Hochberg received her doctorate from the Adelphi University Derner Institute for Advanced Psychological Studies. She treats a variety of psychological is...

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