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Get Assertive About Your Health

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By JOE O'NEILL Tribune Correspondent

The Tampa Tribune

Published: January 21, 2009

America has long been the ultimate consumer society. From houses and autos to high fashion and designer decor to iPods, iPhones and all things computerized.

Buyers typically check prices, consult the Internet, talk to references and make a purchase. They keep receipts and collateral information and expect service after the sale.

Yet, when it comes to the ultimate consumer purchase - health care - Americans invariably are much less involved.

We grow up venerating doctors. They have a mystique, some a God complex. They have specialized expertise and medical argot; we have these flawed bodies and the passive voice. They're in charge - of us.

And while the number of patient deaths due to misdiagnosis is shockingly high (one in 12, according to a 2003 report in the Journal of the American Medical Association), we typically don't ask for second opinions. Even when it's elective surgery.

But if Jeff Knott has anything to say about it - and he does - Americans will begin to become more proactive about their healthcare and more assertive in their role as consumer-patients. The Apollo Beach resident is the author of "Navigating the Healthcare Maze," a compelling self-help book of tools and tips that aims to empower. He posits that we can all become "change agents" within the system if we do our homework, engage our "medical team" and hold people accountable. In the process, we become our own best advocates.

"Navigating the Healthcare Maze" is now in its second printing and is a staple on Amazon.com. Knott has done book signings at Barnes & Noble, as well as media rounds locally and nationally. "Navigating" has been nominated for the Books for a Better Life national award that is sponsored by the National Multiple Sclerosis Society.

Knott, a robustly outgoing, 60-something native of Eastleigh, England, has been in the U.S. since 1969. His interest in the health care "maze" was initially piqued while he was international marketing director for Johnson & Johnson. His wife's thyroid condition and subsequent entrance into the "maze," plus his own open-heart surgerymade it personal.

But he was still taken aback once he really delved into his research.

Knott was surprised, he says, by "how much patients got pushed around in the system and how dangerous that can be for the outcome. Knott, who serves on the Initiative for Global Development that seeks to affect medical, educational and agricultural change in the developing world, faults patients for their passivity. In effect, he says, they allow themselves to get "pushed around.

"That's the point," he stresses. "We get pushed around in retail stores and restaurants if we don't take action, but with health care many are intimidated and think that doctors have all the answers. White coat syndrome has to be eliminated!"

Knott is very emphatic about the importance of developing a "team" concept among patients and practitioners. Patients need to interact, ask questions and generally do everything to become more than just a name on a chart, he urges.

Knott advises patients to ramp up their communications skills when in health care contexts. And it doesn't require a Type A personality.

"We all have basic good communication, observation and listening skills, and we are lazy in using them," notes Knott. "When it comes to our most precious possession, ourselves, we don't use these skills."

Knott's book is dotted with suggestions and do's and don'ts that are gleaned from research, personal experience and common sense. A sampling:

•"Be proactive in finding a primary doctor."

•"Always shoot for an early (doctor's) appointment or even first appointment after lunch." Offices - not unlike airlines - often overbook to compensate for no-shows.

•"Look for 'one-stop shopping.' It is very important to be able to get as many tests and treatments done at a single physician's office."

•Don't be reluctant to ask for a discount. "You will be amazed how an extra 5 percent to 10 percent (off) can be achieved just by asking."

•"Specialist/surgeons are often too eager to cut. That is what they are trained to do. They shouldn't be faulted. But their approach may not always be the 'only' approach."

•"Knowledge is power. It can lower your fear level. It can give you the boost needed to ask questions or explain your symptoms in an understandable way. ... It is of vital importance in today's world to be able to access the Internet. ... Doctors are more responsive to patients in the know. Likewise, so are staff members."

•Have a living will.

•Keep your own medical history file. Give "serious consideration to maintaining a set of records for yourself and family members."

•Before surgery: "Make sure you take a list of all the medications you are taking - dosage, frequency as well as OTC (over-the-counter) medications. Also compile a list of all herbal medicines. Some might increase the risk of problems during surgery (such as bleeding)."

•In the hospital: "Never accept medication from someone you haven't worked with previously, recognize or seems confused. ... You need to be vigilant, and don't accept anything you don't recognize."

•"There are numerous ways patients can help reduce the risk that they fall victim to errors and incidents that could lead to errors, injury and even death. The best way to begin is to always ask questions. Don't be intimidated by your surroundings or the people working on and with you."

•Expectations aren't always managed: "No one had explained or even mentioned to me about the effects the anesthesia or surgery or my stay could have in the area of memory loss or noticeable mood swings or eating habits. ... Research and experience suggest that surgery under general anesthesia may impact cognitive functions."

•Discharge: Studies have shown that the transfer of patient care from the hospital team to a primary care and other providers outside the hospital can be a "high-risk process. Be proactive and involved when it comes to your care after leaving the hospital. ... Don't leave without receiving printed guidelines on caring for yourself or your family member."

•Annual physicals: "Routine checkups, in my case, probably saved my life."

•"There are no stupid questions. Ask away."

Joe O'Neill is a South Tampa writer who can be contacted at moesez@aol.com or www .opinionstogoonline.com.

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