Becoming an Informed Patient

To a doctor, a person who sees him is a patient. Doctors almost never use the word person. Doctors and the entire healthcare system regard you as a patient. And that's important for you to understand, because patients are not necessarily the same thing as people.

For one thing, patients have something wrong with them. It does not matter if it's lung cancer or a wart on your nose, a patient is a person who happens to have a health problem for which he or she is seeking a good solution.

How come that's so difficult?

Let's be frank: there has never been a better time in history to be sick. That's because not only is medical care at least more advanced than it used to be, but you have a wealth of information literally at your fingertips. The Internet has given ordinary people, oh, I mean patients, access to almost everything that a fully stocked medical library would offer a specialist.

The trouble is, how do you sort it all out? Even if you're educated, you won't get far in a medical journal without highly specialized knowledge.

The best way to navigate this difficult terrain is to regard your doctor or doctors (they always want to introduce you to their friends) as a partner or collaborator in your search, not as the source of all information. The old idea of doctor as authority figure has pretty much gone out of the window. Medicine has changed and your attitudes about being a patient have to change, too. A good doctor is a specialist and an advisor, but he or she may not have all of the pieces to your particular health puzzle.

In medicine, you start with a diagnosis. Your diagnosis is the disease or medical condition that you have. If you just have symptoms but don't know the disease, you are in search of your diagnosis. If you do know what you've got, you are partway home.

If you are still struggling with a diagnosis or if you think you were mis-diagnosed, you need to get an accurate diagnosis. There are websites such as http://www.webmd.com that allow you to enter symptoms and see some likely causes. However, you are going to learn one of the secrets of medicine. Diagnoses are hard. The reason they're difficult is that symptoms can be vague and can differ radically from patient to patient. On top of that, there are hundreds if not thousands of things that can break down in the body.

Most doctors diagnose illnesses using a process they call differential diagnosis. What they mean is that they start ruling stuff out. Let's say you have a bad headache but you can still move your body and speak normally. That rules out a stroke. If you have a runny nose but your eyes do not itch, that suggest the problem is not allergies. Those are ways to differentially diagnose conditions.

If you suspect you have a condition, by all means, visit a doctor who specializes in that condition. A general practitioner or non-specialist may not really be able to assess your condition. How do you find a specialist? Ask your regular physician, look in the phone book, or visit websites for that specialty. Many of them offer "physician finder" services where you type in your zip code and get the name of a specialist.

Once you have a diagnosis, you need to familiarize yourself with treatment options. Do not assume that your physician is going to tell you everything about every possible treatment option and every conceivable scenario. If you have a disease, go online and search for websites about the condition. The best resources are websites by specialty societies (medical organizations that are devoted to the study of that specialty, usually non-profit organizations with excellent academic credentials).

Companies that manufacture drugs or other medical products often have websites with lots of information aimed specifically at paitents. (Remember, you're a patient now, not a person. But don't hesitate to look at the portions of the website reserved for doctors or healthcare professionals.) Some people avoid these sites, fearing that they are tainted or biased. It is true that they are highly specific and they do provide information on their products rather than generic, across-the-board information. But if you might benefit from their drug or medical therapy, by all means, check it out. Nobody knows a product better than its manufacturer.

As you troll around the Internet for medical information, keep a notepad nearby and write down questions, ideas, thoughts, or even strange words that come up.

Words can be looked up; there are lots of medical dictionaries online (just Google for medical dictionary). As questions or concerns come to mind, note them and take them to your doctor at the next visit.

As a patient, you should feel free to bring in your notepad and any questions you have. There are websites that let you print out check lists or questions that you can take to your doctor. Don't worry if your favorite sites do not have these; make your own.

Another good idea for doctor visits is to take a friend or family member who can help listen. Doctors are crunched for time and generally do not lavish individuals with as much attention as they might need to get the full story. That's why you need to take charge of the meeting and ask the questions you want answered.

If your doctor does not live up to your expectations or if you feel that his or her answers are not thorough or correct, find a new doctor.

The old idea that your doctor will "take care of you" is no longer true. However, a patient willing to do some Internet leg work, keep notes, and truly get passionate about finding out what is wrong, you can do a lot to get the quality healthcare you deserve.