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Are You an Empowered Patient?

Written by Jenny Leyh—mother, freelance writer, cancer survivor, and integrative health advocate living in Haddon Heights, New Jersey

Confidence in your medical care is critical to your health. Ideally, you have a strong relationship with your doctor, one in which you feel comfortable opening up to them about your physical health as well as the emotional factors that can impact your health, such as stress. 

But have you ever felt as though your doctor wasn’t really listening to you? For example, you go to your doctor complaining of consistent migraines and, without skipping a beat, they take out the prescription pad and are, almost immediately, writing you a prescription for a pharmaceutical. You tell the doctor that you would rather avoid long-term medications, but they aren’t listening. This doctor seems less engaged and, as a result, so are you. You leave the office frustrated and confused.    

Conversely, what if the doctor looked you in the eye, asked you questions and really listened to your responses, engaging you with advice on how you can be proactive in your health and made suggestions such as keeping a food journal to track your migraines? You’d feel more comfortable and confident that your concerns and goals were really heard. And for that reason, you’re more likely to follow through with their suggestions.     

This concept—called patient-centered care—is crucial to integrative care. It’s also nothing new. It signifies the feeling that your well-being, concerns, and individual history are at the center of your provider’s focus. This instills confidence in their advice, and studies show that this type of care leads to healthier outcomes. 

In 2001, the Institute of Medicine (IOM) published a paper called Crossing the Quality Chasm, which outlined recommendations for improvements to the health care system. At the center of the recommendations was a need for patient-centered care. Six aims for improvement were outlined, envisioning a health care system that is: safe, effective, patient-centered, timely, efficient, and equitable. 

Eighteen years later, this vision for the future of health care is still a work in progress. 

In previous articles, we explored the five key aspects of finding an integrative physician—protect, promote, permit, partner, and payment. The need for an open line of communication—as well as feeling a level of comfort with your physician—was a constant factor in each of those five facets. That two-way line of communication helps you feel like your doctor has placed you at the center of their focus. Such thorough attention and the knowledge that you and your doctor are working together will improve your overall health outcomes. 

Here are a few ways to get on the same page.   

3 Ways to Engage Your Doctor

Be prepared for your appointment with your health concerns or goals in mind.  Consider these three ways to engage your provider: 

1. Consider typing (or jotting down) notes about your overall health to share with your provider.

2. Bring a notepad so that you can take notes on the meeting, as it’s sometimes difficult to recollect everything that was said.

3. Establish a follow-up plan, using either a future appointment or communication through a patient portal.

When you see your healthcare provider, engage them with your goals, concerns, and any factors that contribute to your health. Remember, you want them to have a full-picture understanding of your goals and the things that are important to your health. 

For example, if you are a vegetarian, you may want to bring that up, as your diet has an important impact on your health. Your doctor will take that information into account and may recommend that you take vitamins such as B-12 to make up for the potential absence in your bloodstream. If you are someone who is not interested in taking daily medications, that kind of information is important for your doctor to know so that they can come up with non-drug approaches to things like pain.

Questions for Understanding

It may be helpful for you as the patient to have an understanding of what a patient-centered provider looks like. In the HOPE note, Dr. Wayne Jonas outlines questions physicians use to guide their conversations with patients so that they cover factors in the categories of mind and spirit, social and emotional, behavior and lifestyle, and environment. Collectively, these factors paint a picture of your overall health. 

Questions include: “What is most important in your life?”; “Why do you want to get healthy?”; “How is your social support?”; “What do you do for stress management?”; “What is your home and work environment like?” 

This process will help the physician to better understand you, your concerns, and any factors that may contribute to your healing. From there, both you and your physician can begin to build the behavioral and social components and, ultimately, medical treatment plans around those factors.   

Once your doctor has a clear picture of who you are and can identify any health concerns through both medical blood tests and conversation, they are then able to pool their resources and get you on your pathway to health. Recommending a mix of conventional and complementary medical interventions, as well as methods of self-care—an integrative doctor is focused completely on you, taking several factors into account.    

Dr. Jonas provides the physician’s perspective and goals on patient-centered care. He recommends that providers ask what matters to the patient rather than what is the matter. In his book How Healing Works, he outlines how to start a path to healing using key information about a patient. This includes why a person wants to be healthy, their life goals, as well as the other factors that influence healing such as aspects of their mind and spirit, social and emotional connections, and behavior and lifestyle.

In order to take control of your health and partner with your physician, it is essential that both you and your physician have a good working relationship and that you feel comfortable communicating with one another. As Dr. Jonas describes, your health has many factors: environmental, interpersonal, behavior and lifestyle, emotional, and mind and spirit. It is critical that your doctor take all of these factors into account in order to place you, the patient, at the center of their care.      

Patient-centered care will improve outcomes for patients and will result in a more robust health care system. When your physician actually takes the time to engage you, they then will have a better understanding of what motivates and influences you, and what may improve your health. And through this two-way communication, both you and your physician will be working together to prevent future ailments, rather than merely focusing on treating symptoms as they arise.

Click here for the full Patients First Series.

Meet Jenny Leyh

Jenny Leyh is a mother, freelance writer, cancer survivor and integrative health advocate living in Haddon Heights, New Jersey.

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