How to Be Your Own Healthcare Advocate
Updated: Oct 18, 2020
The numbers are staggering. In the US, between 250,000-440,000 people per year die as a result of medical errors, and they are the third leading cause of death. And quite honestly, these are the numbers that were reported or counted as such (guaranteed to be exponentially higher because their is no mandatory error reporting system in hospitals or hospital systems). Between trying to stay alive and stay out of debt from the high cost of healthcare, it is time to become your own advocate. Just one extra overnight in a hospital can amount to $10,000 in charges that you may be left to pay, plus multiple extra opportunities for medical errors. And while it is far easier for me, a healthcare professional, to spot healthcare safety issues, waste, and inefficiencies a mile away, with a few guidelines, you, too, can speak up to not only save time and money, but get safer, better quality healthcare.
First, ask questions. Why do I need this test? Is it necessary, and when and how will you inform me of the results? I cannot tell you how many tests I myself have had only to find out the result through MyChart. Not the best form of communication for anyone, and definitely does not accompany a detailed explanation as to the implications of a particular test result.
Why do I need to be hospitalized? What will happen in the hospital versus what is available in the out-patient setting? If nobody knows, ask to speak directly to a hospitalist. If you have a new or unusual heart problem, ask for a cardiac consult. Make the most of your stay by speaking directly to the doctors in charge of your care on a daily basis at minimum. Believe it or not, this frequently doesn't happen. And I recall several times when I the patient had no idea why I was there, and why I was not yet discharged back home.
More questions to ask: do I need this medication? Why? Are there generic options? Is there a less expensive way to obtain the medicine, like by self-paying, through an on-line pharmacy linked to my health insurance, or through an out of the country on-line pharmacy? You would be amazed how many prescriptions are ordered that are not necessary, interact negatively with other prescriptions you are taking, or worse yet, you are allergic to what has been prescribed. Always double check, especially when being given a cupful of meds on an in-patient floor. If you have more than five medications, there is very likely to be at minimum one error in either timing, dosage, or allergy to the medicine you are being given. Speaking of allergies, just because you receive a red allergy wristband in the hospital, doesn’t mean anyone has actually bothered to check your allergy list. If you have an allergy, speak up or the staff treating you is likely to miss it. Every. Single. Time.
Make no assumptions. Just because your doctor is a 5-star rated MD doesn’t mean he or she never makes a mistake. Doctors, PAs, and nurse practitioners are human. The same goes for the healthcare systems with special designations- local stroke centers mis-diagnose strokes, Northwestern and Mayo Clinic dump patients who complain when quality is poor, Cleveland Clinic mis-manages in-patients and drops the ball on second opinions, while Froedtert leaves patients in the hospital for days waiting for tests and specialists and discharges others in dire need of urgent surgery. Bright and shiny exteriors do not make fancy healthcare systems operate any better than typical ones. It takes finding a particular provider or place of care in a health system that operates efficiently, delivers patient-centered care, and communicates to you and your care team that can effectively deliver the best care for you.
Common sense goes a long way in healthcare. No length of time in school trumps your very own perspective of what is obviously right or wrong, including a diagnosis and treatment plan that make sense based on your signs, symptoms, and imaging results. Unsure about the diagnosis or treatment? Get a second opinion. Feel you are being kept in the hospital too long? Ask why, and ask to be discharged if appropriate. Feel like your plan of care is not working? Speak up, ask for a change. Always keep in mind that no one cares about your health as much as you do. Your provider will simply go home at the end of the day and suffers no loss if the diagnosis is missed and treatment plan is completely wrong for your illness. It is up to you to make waves if necessary to get precisely the care that you need!
There are no perfect healthcare systems, hospitals, clinics, or healthcare providers. But there are some that believe in continuous improvement, and not only ask for, but act on your suggestions to improve care. Your feedback is a gift, and if your provider or system does not agree with that, it’s time to find better healthcare elsewhere!
Jill Murphy is a Doctor of Physical Therapy and founder of MotionWorks Physical Therapy and an advocate for patient-centered care. A Christian wife and mother of three, she survived a seven year journey through the broken American healthcare system in search for an answer to a heart arrhythmia that appeared during pregnancy. A stroke, open heart surgery for constrictive pericarditis, and several other surgeries later, Jill is telling her story of unfailing resilience in her upcoming book, Doctor Heal Thyself. Having grown up on a dairy farm 40 minutes from Lambeau Field, Jill is an avid Green Bay Packers and Wisconsin Badgers fan, and is up for any activity with her three children, including walking, biking, throwing the football around, hiking in scenic locales, gardening, playing piano, singing, and coaching a middle school basketball game or two.