Because I'm the Mom

How mothering pervades all relationships in life.

Surviving in 'Sick Land'

Doctor: Every patient is 'an immigrant' in the doctor's office

"One out of every three people admitted suffers a medication mix-up, a fall, a bed sore, or another problem related to the way care is delivered, according to research published in April in the health policy journal Health Affairs."
 -Los Angeles Times

A recent study revealed scary-high numbers of common medical mistakes and even deadly medical errors. Seniors are particularly at risk. What's the doctor's responsibility in all of this? As patients and loved ones of patients, we must be advocates who educate ourselves and coordinate our own care. What's the doc's part in all of this?

Is a doctor obligated to listen, to explain and to also be a decent human being?

What is their role and responsibility in the face of so many medical errors, miscommunications and stresses related to health care?  

Since so many of us are either dealing with medical issues ourselves or are managing the care of our parents, siblings or children, I wanted to share a model of how some medical professionals are thinking. I admire those looking for ways to treat the whole person, rather than the disease or symptom. 

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I keep finding ideas I like on the blog KevinMD.com, who is billed as "Social Media's Leading Physician Voice."

One recent post, written by guest blogger, Kathy Kastner, Founder and President of Ability for Life (a website with resources for those caring for aging parents), introduced a book, and a way of thinking, that give me hope. Kastner recommends we all read:  "Patients and Doctors: Life-changing stories from Primary Care," by primary care physician Jeffrey Borkan, who writes:

"Every encounter between doctor and patient is a cross-cultural event."

I love this idea because it is so true. We go in there, into the Doctor's Domain, and everything about it is foreign – the pace, the language, the horrifying paper-napkins that bare all. We are literally, metaphorically and psychologically stripped of our humanity, our story as an individual person. We all know how it feels to be treated like that by doctors. It's this terrifying, mysterious land where we feel—and are—the most scared, vulnerable and powerless. How wonderful to have a doctor who actually gets that, and who feels it's part of his or her mission to translate this world to us, who feels it is part of his or her responsibility to help us be strong advocates for ourselves and helping us educate ourselves. So often it seems the doctor's impulse is to silence the patient's anxiety, questions and participation outside answering their specific questions.

'Being thrust into sick-land'

Kastner reponds to this idea of patients as immigrants by writing this:

"Doesn't that put we patients into perspective: whether in the doctor's office, clinic, lab, hospital, long term care or hospice, we patients are the immigrants. We have to learn their language, protocols, processes and expectations. Then, we each have to figure out our role and how we're going to negotiate the terrain. Even patients who are activated, engaged, empowered and Type A plus can be taken down by illness like Superman with Kryptonite. The Institute of Medicine (IOM) reports that even we who are educated and skilled find it daunting to wrap our heads around complex health information when made vulnerable by poor health.

"Being thrust into sick-land is indeed like being dropped into a foreign culture, with dozens of languages and dialects. Each condition and each disease has its own nuances, acronyms, jargon and short-hand and we have to quickly get up to speed after finding ourselves on these foreign shores. Unlike the health-care professional "natives," who've had years of acculturation and training, we're expected not only to understand – if not speak – the language, but also to be able to assess, evaluate, analyze and come to an educated conclusion about our care."

This is the same idea I stress to my students: Be an active participant in your own education. Don't simply sit back and be served. Hopefully, the more active and educated we are about our own medical health and that of our loved ones, the better care we all will get.  

Pamela Cytrynbaum teaches at Northwestern University's Medill School of Journalism.

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