Video coaches patients on talking to doctors

Better communication can improve health care, federal agency believes

By Suzanne Bohan,

02/16/2008:-  Attention, patients: Doctors want you to play a more active role when you go for an office visit.
It's all part of a massive federal effort to improve the quality of health care in the United States. More and more, the key role of patients in communicating with their doctors is coming into focus.

Last week the Agency for Healthcare Research and Quality announced the release of a five-minute online video with tips for communicating with your doctor, in the interest of reducing medical errors and improving patient outcomes.

When the Institute of Medicine in 1999 released its groundbreaking report, "To Err is Human," citing upward of

98,000 deaths per year in the United States due to preventable medical errors, "it galvanized industry and government in trying to improve the situation," said Allan Lazar, director of the office of communication for the health care research agency.

"The missing component is the patient," Lazar said experts recognized. "He or she can do a lot to improve their quality of care."

That view dovetails with what Dr. David Sobel, medical director of patient education for Kaiser Permanente Northern California, has taught for years.

"My favorite line is 'Patients are primary providers,'" Sobel said.

While neither Sobel nor the health experts featured in the new video are minimizing doctors' obvious role in ensuring quality health care, Sobel said that clinical experience shows that prepared patients can improve their physician relationships, have better outcomes and waste less time and money.

So what will make your doctor's day?

Go in with a list of concerns, and then discuss with your doctor which ones you both have the time to tackle in one visit.

"The doctor would probably pass out with joy if that happened," Sobel said. "The patient really has to understand that no doctor has time for 23 complaints."

After understanding the range of concerns, a doctor can develop a strategy for addressing them over time.

What most frustrates doctors about patients?

"The thing that drives doctors crazy is the patient who saves (sharing) a major concern until late in the visit," he said. "Doctors have a joke for that, it's called the 'hand on the door' question," referring to the fact that physicians are often turning doorknobs to leave when patients ask the most crucial question.

The Agency for Healthcare Research and Quality video features the agency's director, Dr. Carolyn Clancy, along with Lee Rucker, policy advisor for the American Association of Retired Persons, and Dr. Rick Kellerman, president of the American Academy of Family Physicians.

The three offer advice ranging from arriving with a prioritized list of questions, how to make sure patients understand everything a doctor is saying, questions patients should ask about tests, diagnoses and medicines, and how to approach asking sensitive or embarrassing questions.

"All told I thought the advice was very good and quite sound," Sobel said of the video.

Sobel agreed that patients are sometimes reluctant to share information out of embarrassment, such as concerns about sexual matters, bodily functions or mental health. But he said patients should feel assured that doctors are accustomed to discussing virtually any medical topic.

"Right now, it takes a lot to make a doctor blink," he said.

Sobel also underscored a key message in the video �?quickly getting to the point to maximize the value of the time spent together.

"The single most important thing a patient can do, in terms of improving doctor-patient communication, is to briefly summarize what they hope to accomplish with the visit, and to let the doctor know what is most distressing or bothersome to them."

This latest release from the Agency for Healthcare Research and Quality is one of numerous free videos and other materials issued by the federal agency to empower patients in the health care setting.

To get the message out, it has also launched an advertising blitz on TV and radio, in print publications and on billboards, using donated ad time and ad space. In March the agency will release a new video on disease prevention, as well as a Spanish-language patient-education video.

To view the video "Communicating With Your Doctor," visit [http://www.ahrq.gov/consumer/commdrvid.htm]. The video is also available with closed captions. For more patient education resources, visit [http://www.ahrq.gov/questionsaretheanswer].

From:   [http://www.insidebayarea.com/dailyreview/localnews/ci_8281229]