Patients, take control of your health, professor advises

McClatchy Newspapers (MCT) - As a child, Cyndy King tagged along with her physician father and watched the way he calmly and tenderly talked with patients.

That model served King well when she became a nurse practitioner and knew the importance of taking time to understand the physical and emotional needs of patients.

But as a patient herself, King has been stung by frustrating encounters with some doctors and nurses.

She even signed herself out of a hospital once, against medical advice, disappointed that caregivers weren't listening to her.

With those experiences in mind, she readily agreed when a publisher of medical books asked her to write one on how patients can communicate better with their health care providers and become better advocates for their own health.

King, a nursing professor at Queens University of Charlotte since August, wrote "100 Questions & Answers About Communicating With Your Healthcare Provider" with her now-retired father, Dr. John King, 85, of California.

"He's had his own share of health care providers who don't listen and don't have communication skills," said King, 51. "This was really a topic that we are both very passionate about."

PICKING A PROVIDER

The Kings' advice ranges from how to pick a primary care doctor to what questions to ask about medicines, test results and diagnoses. The book includes charts to track medicines and pain symptoms, a list of normal values for common laboratory tests, and an appendix with helpful Web sites and phone numbers.

First, the Kings describe various health care providers. They're not just doctors and nurses anymore. Physician assistants and nurse practitioners can diagnose, treat and write prescriptions under supervision of physicians. And they often spend more time with patients than doctors can.

"If you cannot communicate with your (health care provider), try another one," the Kings write. "Sometimes, two people just do not see eye to eye."

BE ASSERTIVE, NOT AGGRESSIVE

King feels no guilt about "firing" a doctor who doesn't listen. In her short time in Charlotte, N.C., she has already changed specialists because she wasn't pleased with the first one. Be assertive, she added. For instance, she hasn't been reluctant to use her connections as a doctor's daughter.

In the 1990s, she was recovering from major abdominal surgery at a large hospital in another city.

She asked to be given her prescribed sleeping pills at 9 p.m. so she could follow her usual pattern of early to bed and early to rise. Night shift nurses refused, preferring to wait until 11. They wanted her to sleep past 7 a.m. so the day shift nurses would be responsible for helping King shower and get cleaned up.

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The hospital's administrator was a friend of King's father and had visited King at the hospital. She called him at a dinner party, and he ordered that she get the medicine at 9.

On another occasion, after knee surgery, King was having difficulty getting pain relief and had objected to a noisy roommate in her semi-private room. She said the hospital refused to move her even though it had empty rooms.

"They weren't listening to me as a patient," she said. "I told them I could recuperate better at home."

She left the hospital _ after signing the required papers to acknowledge she was leaving against medical advice.

"Be sure the health care provider you have is the correct one for your personality and needs _ and if not, switch," King said. "Be assertive, not aggressive. ... Another way to put it is to be an active participant in your care."

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5 OF KING'S SUGGESTIONS

1. Assess your health care provider's communications skills by observing written, verbal and nonverbal cues. Look for someone who will treat "the whole you" rather than just physical symptoms, take time to talk and explain treatment plans, be willing to let you ask questions and give thorough answers, and be available by telephone.

2. Keep a notebook organized in three sections _ questions before appointments, notes during the appointments and questions, notes and symptoms when you are home.

3. Don't use leading questions that indicate the answer you are hoping for, such as "Have you done a significant number of these operations?" More effective: "How many of these operations have you done in the last 12 months?"

4. Many doctors' offices now have electronic medical records, and it may save time for them to type your symptoms and comments while you are talking. If this makes you uncomfortable, let them know you'd rather have them face you and make eye contact. Ask them if they can type the information after you have left.

5. To find a primary-care provider, ask friends or the local medical society, consult your insurance company's in-network list, or use Web sites such as AMA Physician Select (http://webapps.ama-assn.org/doctorfinder/home.html), the American Board of Medical Specialties (www.abms.org), or the Best Hospital Finder from U.S. News and World Report (http://health.usnews.com/sections/health/best-hospitals). "100 Questions & Answers About Communicating With Your Healthcare Provider" Jones and Bartlett Publishers, $18.95, 800-832-0034, www.jbpub.com/medicine/patiented.

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© 2008, The Charlotte Observer (Charlotte, N.C.).

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