Falling Through the Cracks..
A few generations ago, it was commonplace that when going to your local family physician it was easy for them to be the captain of the ship. They would tell you what's going on, what you needed to do, and that would be that. We could trust that our physicians had everything in hand. Over time, healthcare has become more complicated and the relationships that we providers have with our patients have become obscured, degraded, and lost. The fact remains that in today's medical landscape, providers have become overburdened by too many patients and it has become impossible for us to keep up with each patient. Because of this, patients who are accustomed to the old ways of doing things are falling through the cracks. Lab results have gone missing, patients never hearing back from their providers, some patients forget that they were supposed to follow up, some thought that “no news was good news” and assumed everything was fine. The truth is, everything is not fine. The traditional system has too many entities, too many complex systems and too many failure points. We’ve had x-rays that were never sent to us from imaging facilities, human errors, glitches with EMR systems, patients who changed phones numbers and a multitude of other reasons that complicated our care. The healthcare system has become so convoluted that it is no longer safe for patients to assume that your healthcare provider has everything in hand. It has become increasingly important that patients play a more active role by becoming well informed, educated, and personally involved in their medical decisions. With soo many patients, and so few providers, if you want good health care the truth is, you (the patient) need to be actively involved
SHARED DECISION MAKING
The overloaded system has not gone unnoticed to medical schools these days. Every attempt is being made to improve the quality of care and one of them begins by making the patient more involved. The modern medical system has begun teaching new providers about a concept known as "Shared decision making". If you've never heard this term before, it essentially means that it is no longer the job of your provider to "tell" you what to do (though sometimes that is appropriate) but is instead usually our job to "educate" you on the options and to help you decide on what is best for you. We recognize that one size does not fit all. Your preferences, beliefs, and desires for your health are important factors that you need to bring to the table. Finding a provider who has similar beliefs to you and how you approach your health is a good first step to build rapport. Once you have a provider you can trust it becomes easier to become more involved as there is no relationship without trust. The goal is that you are actively involved in the process, aware of what is going on so you, and your provider, can come to mutual decisions together.
It is, unfortunately, all too common for patients to either A) rollover and blindly do what they're told, or B) Ignore a plan because they didn’t like it. You need to be advocating for yourself, you need to be asking questions if you do not understand what is going on. You need to give your opinions a voice so that you and your provider can come to an understanding. Your provider is not a mind reader! If you walk out of a visit with your provider without voicing your dissent to a care plan or have no intention of following through with it, then the time you and your provider spent together was, unfortunately, a waste. In the age of “cancel” culture where we will often just quit and go to a new provider, it can be more beneficial for you in the long run to voice your concerns and come to a mutual understanding rather than just quitting. Be involved, be present, and help your provider come to a “shared decision”
THE PATIENT ADVOCATE
It is your job as a patient to make sure someone knows in-depth about what is going on with you. What problems you have, what things you are at risk for, what you need to improve. They should know what medications you’re on, what dosages, when your appointments are... Everything about your health should be under control. The person who does all of this is known as a Patient Advocate. This could be a family member, a friend, a spouse, a nurse, or a variety of other people but for most patients, the best (or only) Patient Advocate you will ever get is yourself. If you are not able to advocate for yourself to manage all of your own needs, then who will advocate for you? The patients who do not have someone able to handle their needs are the ones who usually wind up with major issues down the road that could have been avoided.
QUESTIONS TO ASK YOURSELF
Take this time to think about what aspects of your care are you truly knowledgeable about and what are you not?
Am I truly able to advocate for myself?
Has my healthcare provider communicated with me everything they are doing? Is there anything I don’t understand and should be asking questions?
Do I have a list of all of the healthcare providers that I see?
Do I know all of their phone numbers and fax numbers?
Do I know their addresses?
Do I know how long their office typically books out?
Do I have follow up appointments scheduled with them?
Do I have any labs due before I see my providers?
Do I have any medications that might run out before my appointment?
Do I know what my medical history is?
Do I know my family history?
Do I have documentation of these and could readily provide them to a new Provider?
Do I have all my immunization records?
Do I know when I’m due for my screenings?
Do I know what disorders I’m at risk for (due to personal or family history)?
Am I taking steps to address my risk factors? Why not?
etc.. etc.. etc…
I know how quickly all these questions can add up and how quickly they can overwhelm. But they are important to ask and be well managed for patients long term health. When providers are seeing thousands of patients the endless array of questions become harder and harder and patients fall through the cracks more and more. I don’t want that to happen to you, and the first thing you can do is to work on changing your mindset. Treat the healthcare system like you would driving a car and practice “defensive driving”. You should assume that everyone on the road has no idea how to drive and accidents do happen. You can protect yourself by being informed, being involved and making sure you, or someone else, is always advocating for you. Find yourself a provider you can trust, voice your opinion, and be mindful of the broken system.
- Jason Rogers, PA-C
Jason Rogers is a Family Medicine provider located in Fort Collins, CO. For a monthly membership he offers unlimited visits, the ability to directly call, email or video chat as well as have relaxed unhurried appointments up to 90 minutes at a time. He can see patients anywhere in the Fort Collins area by doing house calls. By having a smaller practice size he is better able to inform and educate his patients into becoming their own patient advocates.
Starlight Health is a type of practice known as Direct Primary Care. To learn more about Direct Primary Care please go to: