Patients, you too can make a difference.

“Jaded Julie, after spending last week talking about how health care workers can make a difference, let’s consider how patients can make a difference in the care that they receive. The link between Lean and this topic is rather tenuous, but this is too important to neglect.”

“Curmudge, you have been reading again.”

“Right, and in addition I have also been talking with my favorite physician.”

“But why write about it here? Most of our readers work in health care. It will be like preaching to the choir.”

“That’s better than not preaching at all. Maybe Mrs. Curmudgeon and my contemporaries will read what we write. Much of my generation’s health care knowledge is out of date except for what we have learned the hard way—by experiencing illness and injuries. And younger people tend not to think about health at all until they are blind-sided by a crisis in mid-life.”

“On January 29 we suggested ways by which patients might avoid nosocomial infections, and on February 19 we mentioned how the patient can help achieve a correct diagnosis. Is there more to the story, Curmudge?”

“There certainly is, Julie. Let’s start with a bad example. Some people seem to be oblivious to how they are mistreating their body and to what their body is trying to tell them. They don’t seek help until the problem is serious, and then they show up in the ED expecting a magic wand. If the ED doc arranges an appointment with a specialist and the patient feels a bit better in the meantime, she becomes a no-show. Then if she takes a turn for the worse, she’s back in the ED again. Some people just don’t understand.”

“You’re right, Curmudge. I’ve seen patients who are not only clueless about health care; they seem to be clueless about everything except possibly procreation.”

“The plight of the uninformed, totally passive patient will be even worse in the future, Julie. Health care delivery is changing fast, and many of the changes will be beyond our control. The one thing a patient can control is his or her involvement. The savvy patient knows that her health is best served by forming a partnership with her primary care physician and when necessary, an appropriate specialist.”

“As you recommended, Curmudge, I read Marie Savard’s book (1). She spells out in eight steps what a patient should do to manage and control his/her health care, including collecting and studying copies of one’s medical records. Here is her summary: ‘Nothing will ever replace trusting your intuition, keeping providers abreast of all your health information, being well informed yourself, establishing an interactive rapport with your doctor instead of cowering in his presence, taking part in decisions about your treatment, teaming up with a health buddy especially when you go to the hospital, and safeguarding your health by living right.’”

“Here’s one to add to your list, Julie. ‘Patients should acquire a general knowledge of the symptoms of afflictions common to their age group. Then they can respond appropriately to observing or experiencing the initial stages of a stroke or heart attack.’”

“I presume, Curmudge, that you know the initial symptoms of ‘dying of old age.’”

“Of course I do, Julie. It’s just like your needing to learn the symptoms of insidious impertinence and pernicious chutzpah.”

“(I have no idea what he said; but I’d better learn, because I think it was directed at me.) By the way, Curmudge, you have said that you talk occasionally with your favorite physician. Do you call him (or her) Doctor?”

“Normally I address physicians as ‘Doctor’; I figure that they have worked hard to earn that level of respect. But I always call my very favorite physician by his first name.”

“That’s interesting. Why do you do that?”

“Because he calls me ‘Dad.’”

Affinity’s Kaizen Curmudgeon

(1) Savard, Marie. How to Save Your Own Life. (Warner Books, 2000)