Now up on YouTube:
You, the patient, are a vital component of medical decision making. Believe it or not, it’s worth your effort to find out about your treatment options! This informal FlipCam vignette models a physician encouraging the patient to ask: “Don’t you want to know??” Cast: Pat Mastors as the empowering physician, and e-Patient Dave pretending to be passive. :-)
At last December’s IHI Forum (Institute for Healthcare Improvement), through the generous support of the Cautious Patient Foundation, fifty patient advocates were brought together to participate in every session. Numerous SPM members were there – Regina Holliday, Trisha Torrey, and others I apologize for not remembering right now.
One was Pat Mastors, a former New England broadcast professional and creator of the Patient Pod, which she created after the incredibly difficult experience (all too common) of watching her father die from a hospital-acquired infection. (Story) Like so many advocates, Pat has responded to her tragedy by applying her professional skills to improving healthcare.
With her TV background she had an idea for a PSA (public service announcement) to encourage people to be engaged in medical decision making – to ask questions. I said “Hey, let’s pull out my FlipCam and do a draft. Maybe somebody will grab it and do a ‘real’ version.” She was hesitant, professional that she is, but I talked her into it. :–)
Immense thanks to Cautious Patient, and to IHI for having the vision to realize that patients should be – must be – engaged in conversations to improve healthcare. Not all events do this – for instance, at the upcoming Medicine 2.0 conference, there’s only a single patient speaking. Patients are the most underutilized resource in healthcare – Let Patients Help!
And, ladies and gents, that starts with you, the patient. Ask your doctor questions – including when you’re presented with just one option, with no discussion of risks and alternatives. Ask.
For more on questions, see Questions Are The Answer, a great website from AHRQ (the Agency for Healthcare Research and Quality), with vignettes like “You ask your waiter about the side dish, but you don’t ask your doctor about side effects. Questions are the answer.” See AHRQ question PSAs here.
A note about something Pat says at the beginning – “I’d like to schedule this as quickly as possible” – I’ve heard from numerous places (including doctors!) that “asap” is a red flag. “Real emergencies are rare,” said my oncologist, and explained that there are few situations where operating “next Tuesday” will make a difference compared to next month.
To be sure, there ARE emergencies – ruptured appendix, internal bleeding, and many more – but then, those don’t want to wait for “next Tuesday.”
Dave, had no idea about the fact that most surgeries can wait. I continue to learn from this community.
FYI on other patient advocate group pages here seems to be another emerging rallying cry for transparency and full disclosure: “I wanna know!”
I have heard from numerous clinicians that there are really very very few emergencies. There is always tome for a conversation. When there isn’t time for a conversation, you won’t be able to ask questions anyway.
Can we do one for moms with babies?
This is great! As for doing one for moms and babies, I love that idea, of course! Mary Ellen, we should put our heads together about it.
Amy and Mary-Ellen, that’s a fantastic idea. I could envision many versions of this, all done by different groups for different patient constituencies.
My 2 cents from the tv world: keep it under a minute, so more people will click to view. If we stick to a similar template, it could look like a unified campaign. There is success in numbers! Let me know if I can help…happy to.
Thanks for making this video. Great job acting Pat and Dave. Dave, you look and sound like a patient who is overwhelmed and whose mind is spinning.
What if there was a Patient Education service in which a specially trained R.N. slowly and empathetically introduced understandable, multimedia material to explain the patient’s condition, proposed surgery and evidence-based treatment options, a half-hour at a time, at their home or online, over the course of several days?
And, in which the patient(and family)determine the pace and depth of information from basic to comprehensive even including multimedia progams M.D.s use to confirm diagnosis and treatment plans.
Would this help the patient who says “Yes, I want to know, but I don’t know what to ask!?”
Would the very well-informed patient and family become participating members of the healthcare team?
Would it help the physician who doesn’t have the time or resources to provide two to four hours of professionally produced, health literacy adjusted, multimedia Patient Education?
This is a service under development by PULSE of Florida. Your thoughts?
Hi Doug – thoughts?? Just keep us informed!
Just passing through on a busy day, but Wow: “Don’t you want to know?” is a powerful question.
Double wow: Dave as “Passive Patient.” :)
> Dave as Passive Patient
Actually, Susannah, one of the formative moments in my patient life happened because I WAS too passive. The doctor objected, and I paid a small price and learned a life-long lesson. (You may recall this from the preface to my book.)
When I was 28 I developed a small skin cancer on the flare of my left nostril. (A basal cell carcinoma, easy to deal with.) I was referred to a plastic surgeon to have it removed.
My first red flag was that I couldn’t get past the front desk until I signed a waiver, agreeing never to sue his corporation, Charles P. Xxxxx Inc.
The second, though, was bigger: I DID ask a question – “Will this leave a scar?” Reasonable for surgery on the middle of one’s face, eh? He got all huffy and said “I *am* a plastic surgeon!” I let it roll off me, and we proceeded.
Well, he taught me a lesson all right: to remove this little spot, he took a skin flap from almost up at the bridge of my nose stretching down onto the cheek, and swung it around onto the nostril, in a curve. He apparently made no effort to smooth the edges, so today I have a distinct half-inch-wide bubble on that nostril.
He never came to see me in the hospital and didn’t discharge me – I had to discharge myself two days later.
So yeah, this is one cowpoke who will never again ignore his Spidey-sense: I always ask questions, and if any medical professional gets huffy at me, either s/he or I is outathere.
AweSOME! Dave as passive patient is the bonus comedy break.
This is totally worth sharing far + wide. So I will.
And remember this: I worked as a field producer in network news for a looooong time. If I can help, let me know ;)
Seeing a post by TEDxMaastricht rapper and up and coming “passive patient” actor ePatientDave on the topic of questions, I can’t help but note that the second most inspiring video I saw from TEDxMaastricht was by Tim Hurson, on The Shock of the Possible, in which he leads off with the following words of wisdom: