The BETTER AGREEMENT GUIDE™
BETTER RELATIONSHIPS are in The BAG™
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PHYSICIANS, DENTISTS, AND HEALTHCARE PRACTITIONERS
I have been very fortunate. At age 55, 1 have had only a few times when I needed to take care of a major healthcare concern. In my interactions with medical professionals I am consistently amazed at the lack of care for the person behind the ailment or injury. For me, the most important information provides me with a context to frame what I will be going through; this gives me a set of expectations that allows me to anticipate what will be happening and become a partner in producing desired outcomes. I am almost always disappointed, despite my best efforts to seek out the information I need. I do understand the tremendous pressure all healthcare professionals are under within the medical insurance reimbursement system. Reimbursement rates are low, and that requires seeing many patients a day, so time is at a premium. But when I ask specific questions to take care of my expectations and anxiety about the future, healthcare professionals sometmes look at me like I'm from another planet. All I am asking is for them to help alleviate my anxiety by painting a picture of what I can expect. Please help me visualize what's coming so I can partner with you to provide a successful result! What I get instead is a look that seems to say, "Please dumb down. Why are you bothering me, can't you just trust me to do my job?" It seems as if they think I am not attached to my body; I should just make believe it's my car that I'm dropping off for an oil change. Recently I had arthroscopic kidney stone surgery. The physical result was great, but the process left a great deal of room for improvement. I can fully understand all the medical malpractice claims, given that I am a professional communicator and that I had to work hard to manage the process. On my initiative, I made a special appointment with the surgeon for the sole purpose of speaking about the process. Without me, it would not have happened, and I can't imagine that. Although it wasn't life threatening surgery, it did involve inserting a tube through my side into the kidney to provide access. I was told this would be a simple part of the process, which was understandable, given that it was being done on an outpatient basis. My assumption was that this would be no big deal. WRONG! First of all, I did not know it would be a bifurcated process until I received a call from the hospital to schedule an appointment for the outpatient procedure. I had told my surgeon I wanted the surgery done on Monday. They called to schedule the outpatient procedure for Friday and the surgery for Monday (because they don't work over the weekend). They gave no thought to me spending three days with a wire in my kidney! If the wire was nothing, I might understand that. Given what followed, it is unfathomable. I quickly tried to provide some input and take some responsibility. I tried to find out if it could all be done at the same time. No. I then insisted on doing procedure one on Monday and the surgery on Tuesday. That was a smart move, given what transpired. I had made arrangements for my sister, a nurse, to be with me for a week during the surgery. She was to arrive the day I had the "real" surgery. My niece was to pick me up after the outpatient procedure and drop me off at home so I could get some work done before being out of commission for a few days. This was my assumption based on what I had been told. Well, it was one of the worst nights of my life, and I have a very high threshold for pain. When my niece dropped me off, the pain was excruciating. She called my sister, who was five hours away, and said, "I don't know if Uncle Stewart is really in great pain or is just a difficult patient." I could not get ahead of the pain and spent eighteen miserable hours. My sister immediately got into her car and made a hurried trip. All of this could have been avoided with some routine communication that would set clear expectations and take care of the human being going through an invasive process. It is still unbelievable to me that a physician would not think of that. Last year, a friend had the same experience with a foot surgeon. This lack of communication riles me because it's so simple to correct and so obvious that it must be corrected. The simple way to fix this is to have clear agreements with your healthcare professionals about the procedures and medications they prescribe. Here's an agreement I prepared for a visionary physician in 1989. New Patient Agreement for Healthcare 1. Intent and vision: The intent of our relationship is to provide a context for addressing health and health problems, illness and disease. The vision for results created are cure, relief, awareness, greater health, greater well being, anxiety reduction, removal of limitation, life enhancement, balance, and peace. 2. Roles: You will be the patient who fully participates and is a partner in the healing process. I will be your advocate, trustee, coach/guide, nonjudgmental friend, healer, and confidant. 3. Promises: I Promise:
The relationship created will be ongoing and continue for as long as the specific intended results are produced, or until either of us wants to discontinue the relationship.
Of the physician:
8. Consequences: If we are not successful, the disease process will continue, the patient may die, and the physician will be disappointed or perhaps sued. 9. Conflict resolution: If any breakdowns occur during our relationship, we agree to continue to agree until we reach resolution. If we need a neutral third party, we will seek one to facilitate a new agreement. 10. Agreement? Yes, we have an agreement. Although long, it is truly artful. Lives are at stake, and therefore it is worth taking the time to create awareness of the true part each person plays in the process. The promises are especially important. But I think that the greatest value it can have is making patients realize they are partners and collaborators in the process of healing themselves. Summary: When hiring a physician, it is important to ask questions to take care of your expectations and anxiety about the future. You want your physician to alleviate anxiety, painting a picture of what you can expect so you can help visualize a successful result. A personal dialogue leading to a detailed agreement can be very helpful. Exercise: Make an appointment with your primary care physician for the sole purpose of discussing your expectations of the relationship and how you want to participate. Make yourself available to answer any questions your doctor may have. |
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