Administration and Leadership, Columns

Empower Your Patients to Take Charge of Their Health

Issue 5 and Volume 39.

“Ignorance is bliss until one confronts it.” — C.B. Smith

Raise your hand if you’re a prehospital healthcare provider who’s ever had grave reservations about a particular physician, nurse or hospital network that was about to treat a patient of yours while you were in the process of transferring them from your cot to the ER bed.

If you didn’t raise your hand, you either:

A. Haven’t been in EMS long enough to be “in the know”;
B. Don’t care as long as the patient doesn’t throw up in the back of your ambulance;
C. Aren’t even reading the article as you just wanted to glance at the cartoon; or
D. Automatically realized that raising your hand while reading would simply make you look ridiculous.

What about a fellow EMSer or firefighter? Do you know of anyone you would never want your family to be treated by? (Note: If you currently see a medic sitting next to you raising his hand while staring at you, a reevaluation of your training or bedside manner may be in order.)

For the most part, EMS providers are fortunate enough to know who they can and can’t entrust their personal and family healthcare to.

Any naïve idolizations many in our society may have about medicine will more than likely become tainted by the realities of life. I’m still amazed by some of our patients who unquestionably entrust, with reckless indifference, their lives to a medical community in which over 99,000 U.S. patients die each year from medical errors in hospitals alone.

Some are so blind to their own health that they don’t even bother to take the time to inquire or educate themselves of their own homeopathic needs, much less know the medications they take.

Medic: Were you having chest pain or shortness of breath when you took your two sprays of prescription nitro?
Patient: No.
M: Why’d you take it then?
P: I felt dizzy.
M: That might explain why your wife called us after you passed out. What kind of cardiac history do you have?
P: Do I have a cardiac history?
M: Well, I assume you do based on the nitro prescription you have. Do you have a history of hypertension, angina, coronary artery disease, congestive heart failure or prior heart attack?
P: I don’t think so.
M: I noticed you’re on home oxygen. Do you have a chronic respiratory illness, also known as COPD?
P: Don’t know, but the doc said I had to have it after he put in a stunt.
M: Do you mean stent?
P: I dunno. Maybe.
M: So you do have a cardiac history.
P: If you say so.
M: My 12-lead ECG shows me you have an irregular heartbeat. Were you told you have an arrhythmia?
P: News to me. No … wait. The doc did say I have africkulationitis.
M: Atrial fibrillation?
P: I guess. I feel better now except for this damn headache. Must be from the whiskey I drank just before I took the nitro.
M: When was the last time you had a medical checkup?
P: Not sure. Probably right after the last time the ambulance drivers did VCR on me.
P: Whatever. I’m feeling dizzy again. I think I need to take that nitrusglysiren again.

Empower You Patient to Take Charge of Their Health

I can’t help but think that whoever out there believes ignorance is bliss, especially when it comes to medicine, is someday going to pass on into the next world with a really big surprised look on their face. And, if ignorance really is bliss, why then aren’t there any euphoric politicians out there?

When it comes to one’s own health, what you don’t know really can hurt you. My parents’ generation was indoctrinated to never question a physician’s diagnosis and course of treatment—to do so would be an act of betrayal, potentially jeopardizing the circle of trust between themselves and their all-knowing doctor.

I’ve also heard patients try to rationalize their unfamiliarity with their own health history from a fatalistic perspective. “It’s out of my hands anyway. Out of sight, out of mind. I just do what the doctor tells me to do.”

For others, ignorance is simply a falsely justified excuse to embrace apathy and irresponsibility.

Someone once said, “Ignorance simply states, ‘We do not know.’ Ignorance is not stupidity until someone embraces it.”

With the threat of U.S. medicine becoming overwhelmed in caring for the needs of all our citizens, I’m hoping more and more patients will begin to take on the responsibility of empowering themselves with knowledge regarding their own health care.

Many don’t understand the complexities of medicine, and when the average time a doctor spends with a patient in consult is 15 minutes, there are bound to be mistakes and misunderstandings caused by not having enough time to adequately listen to what the patient is saying or by the patient feeling too intimidated or rushed.

Patients should be encouraged by EMS providers to be their own best health care advocate when in captive transit to the hospital. Medics can help empower patients by providing a brief discussion on how to appropriately ask questions of their physicians even if that requires them to be more assertive or, dare I say, ask for a second opinion.

And if the patient asks you and your partner about your qualifications to treat him, resulting in both of you simultaneously raising your hands while pointing at each other, the patient should be made to feel empowered to call for another ambulance.

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