Introduction

Reviews

Taking Control of Your Medical Care

Timothy B. McCall, M.D.

Physicians vary so greatly—in their competence, philosophies of practice and agendas—that to simply accept a doctor’s recommendations on faith is a risky proposition. It’s your body after all and you’re the one who’ll have to live with the results.

Active involvement in your medical care is a radical concept. Historically, patients have been the passive recipients of medical care, asking few questions and making few attempts to influence their physicians’ behavior. Physicians, in turn, have acted as benevolent—and sometimes not so benevolent—dictators. In fact, until recently, even the phrase “patient involvement” usually meant either the presence of a non-medical person on the board of trustees of a hospital or instructions from the doctor about what you could do about your medical problems once you got home.

The days of the passive “You’re the Doctor” mentality are over or at least they ought to be. Earlier this century when doctors had little to offer patients, it may not have been as risky to follow a physician’s dictates blindly. With advances in our understanding of various diseases and with increasingly effective—and increasingly dangerous—interventions to diagnose and treat disease, you need to get actively involved.

Consider this study by researchers from the New England Medical Center in Boston. They trained a group of patients to ask questions, express their feeling and to assert control of the doctor-patient interaction. The researchers discovered that the assertive patients stayed healthier than similar patients who weren’t taught to be assertive. Assertive patients with hypertension had lower blood pressure readings; assertive diabetics had lower blood sugars. The patients taught to be assertive reported that they functioned better, had fewer health problems and lost fewer days from work.

Your Rights as a Patient

You have a right to expect your doctor to explain everything that’s done to you. If a test or a therapy is planned, its risks and benefits should be reviewed. If you’re given a drug, you should be told what it is, why you need it, have long you’ll have to take it and what it’s side effects are.

For each diagnosis made, the doctor should explain what it is, how you got it and what needs to be done. If a test or procedure is done, its results should be discussed with you. Don’t assume everything is fine, just because you haven’t heard anything from the doctor. There are tragic cases where nobody bothered to inform a patient that her Pap smear was abnormal or a biopsy showed cancer. If your doctor doesn’t volunteer the information, ask. If you don’t hear anything, call the doctors office.

The American Hospital Association publishes what they call The Patient’s Bill of Rights, a copy of which should be given to all patients on admission to the hospital and which hospitals should also post in conspicuous locations. According to the association, you have the right to:

• receive complete information about your diagnosis, treatment and prognosis in language you can understand
• be informed about the nature, risks and benefits of any proposed test or treatment and be asked for your consent to proceed
• refuse any tests or treatment
• refuse to participate in medical research
• have your privacy respected to the extent possible while getting medical care
• have your medical records remain private and confidential
• receive emergency care
• know the name of the physician in charge of your case
• know the name and function of any person providing treatment
• receive an explanation of your bill
• express complaints about your care and have those complaints investigated

Knowing your rights as a patient is the first step to making sure your rights are respected.

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