Featured Story
FS Dr. Greene banner

Just a generation ago, access to medical libraries was restricted to healthcare professionals. Hippocrates, an ancient Greek physician referred to as "the father of medicine," set the pattern when his famous oath asked medical doctors to swear to keep the knowledge of the medical arts a well-guarded secret. When our parents were growing up, this passive approach to our health was considered normal.

FS Dr. Greene Hippocrates

Passive participation in your health is a problem. Here’s an example of what can happen when patients are passive about their healthcare:

"Man with Ear Ache Gets Vasectomy," read the August 2003 Reuters headline. A man with an ear ache in a clinic waiting room misheard whose name was called as the next patient to be seen, and he ended up taking the place of a vasectomy patient. "But the strangest thing is that he asked no questions when the doctor started preparations in the area which had so little to do with his ear."

This is an extreme example of the old style doctor-patient relationship. The now-snipped man didn’t understand his own illness. He let others take responsibility for his health. He didn’t ask adequate questions. He didn’t choose from among the best treatment options. He didn’t enjoy productive communication with his doctor. He didn’t expect his doctor to explain how the treatment would help his problem. He was a passive patient.

Thankfully, you have better choices.

We are living in one of the most exciting times in the history of healthcare. Our understanding of health and disease is unprecedented. Technical advances continue at a staggering pace. In addition, the world’s medical knowledge is readily available in books and online.

These advances in access to healthcare resources have lead to a new kind of doctor-patient relationship: participatory medicine. The new relationship rests on the foundation of people understanding that ultimately we are each responsible for our own health. With this new dynamic, physicians and other healthcare experts are consultants to help you manage your own health.

With participatory medicine, patients are no longer passive players. We have an opportunity to share in our healthcare. Healthcare is not something done "to" us or "for" us. Health is something we promote "with" our family, our friends, our community, and with other people dedicated to fostering health. This includes doctors, yes, but could also include a wide variety of others, such as nurses, nurse practitioners, physician assistants, midwives, pharmacists, nutritionists, and therapists.

Take charge of your healthcare! The concept of evidence-based patient choice is another part of the new way of doing things. Start by taking responsibility for your own healthcare. Next, learn about your health and illness. Then ask your doctor to explain what you need to know, and ask focused questions until you understand. When you’re informed and ready, work with your doctor to choose from your treatment options. You, with the support of your doctor, choose what to do based on solid evidence of what really works. You learn to weigh the benefits of treatment against the costs. This is the opposite of the vasectomy-for-earache approach.

Before you make the appointment:

  • Hit the Internet. Visit reputable sites and learn what you can. You can start with the quick summaries found in your organization’s health & wellness portal. For example, when your 3rd-grader comes home with an itchy scalp, check out your portal to find effective treatments for the dreaded head lice. You may not even need to go to the doctor. Or you may discover that you still need to go to a doctor, but your research can help you and your doctor discuss your problem and possible solutions.
FS Dr. Greene mom

Before your office visit:

  • Use the research you’ve found to write a list of questions for your doctor. Don’t skip the "write it down" part. If you walk in with just a few ideas in your head, you may not remember to ask about all of them.
  • Make a list of all the medications you are taking, including any over-the-counter medicines, alternative treatments, and vitamins. If you can, bring the bottles with you.
  • Write a description of your health status, including anything important that has changed in your life since the last visit (at work, at home, or with your health).

During your visit:

Be honest. Participatory medicine depends on clear, honest communication. You may feel uncomfortable talking about symptoms or conditions, but it’s important to give your doctor the facts.

  • Take notes as you and your doctor discuss your health. Bring someone along if you need them to help translate or remember what was said.
  • If you don’t understand something, ask for an explanation.
  • Reach an agreement on your health plan. If you don’t agree with or don’t think you will carry out the plan, speak up. The plan must be something that will work for you.
  • Find out what to expect, in terms of how you can get better and how long it might take.
  • Determine your next step. When is the next appointment? Who will check in with whom and when?

After your visit:

  • Report back if you are thinking of stopping or changing the plan.
  • Report back if things don’t go as expected. Tell your doctor about any drug side effects or worsening of symptoms. Let your doctor know if you are not getting better when you expected to.
  • Keep doing your homework. Read new articles that may be of interest after you have left the doctor’s office.

Another quick note about your active role: Prevention is more powerful than treatment. We will spend time, attention, and money on our health, one way or another. How much better to spend it enjoying a brisk walk than sitting in a waiting room; how much better to eat a delicious, healthy meal than swallowing a handful of prescriptions!

Take care of yourself. I know -- you’ve heard this before. But it’s true: you need to eat right, move more, stop smoking, and take your vitamins. The best way to avoid having to visit your doctor for a problem is to practice preventive care for yourself and your family. And don’t forget that part of taking care of yourself is getting regular checkups.

And when you are sick, remember that you have so many resources for learning about what ails you. You may discover some gentle home treatments that are as powerful as prescription drugs, and without all of the side effects. There are even good home treatments for ear aches -- though some might surprise you!

Other home remedies are ineffective or even harmful. Learn which are which. Sometimes lifestyle choices fit hand-in-hand with prescription medicines. For example, broccoli can help prevent some cancers. And it might work alongside chemotherapy to help destroy cancer cells.

Remember -- we’re lucky that we can take advantage of the new doctor-patient relationship to improve our health and the health of those we love. Take advantage of your opportunities, and enjoy the gift of better health.

FS Author Alan Greene

Alan Greene, MD, FAAP, is a Clinical Professor at the Stanford University School of Medicine’s Department of Pediatrics, Attending Pediatrician at Lucile Packard Children’s Hospital. Reach him at featuredstories@adamcorp.com.