November 23, 2015
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The Patient's Playbook: How to Save Your Life and the Lives of Those You Love by Leslie D. Michelson
If you've been following along with my more recent Business of Life posts, you'll know that my family has recently been hit by a health crisis. My husband has leukemia, and in a few short weeks, he will be getting a bone marrow transplant which, we hope, will elongate his life. The particular leukemia he has is aggressive, so he's been put on the fast track to a new immune system. As you might imagine, this occurrence has been a staggering blow to how we live our family life. That said, if you've been following along with my posts, you'll know this isn't the first health crisis I've faced. My son has a neurological disorder that's primary symptom is seizures. My mother died when I was young, her heart having been battered by years of diabetes that caused her grief from her childhood. And I was born with an infection in my leg that led to numerous surgeries and adaptions throughout my childhood, and has left me with mobility challenges as an adult.
So, you might think that I have a pretty good sense of how the healthcare system works. But like everyone else in the world, I have a certain paralysis when it comes to navigating the healthcare system. What should I do when I or one of my loved ones get sick, and who should I believe? Are we asking enough questions? Are we asking the right questions? Have we pushed enough? Have we trusted enough? How much control do we really have over our outcomes?
Thank goodness we, and you, have Leslie Michelson's new book, The Patient's Playbook, as our guide. This really is a must-keep book for anyone to have in their home, because we all, at some point or another, will find ourselves intimately involved with the healthcare industry as we advocate for our own care and for the care of those we love. Michelson is the founder, chairman, and CEO of Private Health Management which helps people obtain optimum healthcare.
Via the media, we're inundated with messages about our healthcare system. Whether it's complaining about the politics, blaming the prescription drug manufacturers, or indulging in the daytime talk shows which highlight only the worst cases of malpractice, neglect, or other wrong-doing, we don't have a lot of trust that the system is actually there to protect us, and not to harm us. But as Leslie Michelson says in his new book, The Patient's Playbook, when we get sick, rarely do we have more than one chance to get it right, and so we are left trusting doctors but not really knowing what our role in our own diagnosis, treatment, and healing is. We all long to take control of our health, but we simply have to put our lives in the hands of experts. Yet, Michelson says, by employing a certain methodology, we can in fact take more control than we think, and his book, The Patient's Playbook, offers a wealth of information and strategies for utilizing the expertise of our medical professionals, while not becoming disempowered in the process.
Michelson agreed to participate in this Q&A which, I hope, will elucidate why this book is a must-read for everyone. Why? Because healthcare is a business, and as Michelson writes, insurance companies have "the financial whip-handle" so most of the time we don't even get to choose the service that we are being provided. Michelson hopes to make us smarter consumers, more powerful advocates for ourselves and our loved ones, and empowered to make choices from a position of security rather than a position of submission or acquiescence.
Q: It seems as though in writing this book you've a strong commitment to insuring that people realize doctors are human, with as many presuppositions and influences and biases as any professional. In your introduction, you write in regards to the demands on primary care physicians: "No matter how charismatic, empathetic, and effective a doctor is, he or she cannot care for a human being in fifteen minutes." Yikes! I think most of us can think back to our last doctor's visit, whether 15 minutes or longer, and wonder just what was missed. How does planting this seed of doubt in the process (dictated by insurance companies) help empower patients? And do you think it is key that you aren't an MD, so you can raise such questions?
Q: You advise that "[f]orging a strong partnership with a caring and committed primary care physician is one of the most important first steps you can take in protecting your health." Isn't that easier said, than done? Many of us are forced to see nurse practitioners or physician's assistants instead of ever getting to see a doctor. I know that my son hasn't seen his primary neurologist for years now, and while we very much like his physician's assistant, it certainly has done nothing to strengthen our relationship with his neurologist, and if something traumatic were to happen, that doctor wouldn't know, hands on, much about my son's past few years. How do we go about asserting our need for an attention-giving PCP when the system seems to be moving further and further away from enabling such a relationship?
Q: My husband, who was diagnosed with leukemia mid-summer, was mis-diagnosed with three different issues over 3 months, before taking himself to the ER where he was admitted to the ICU and it was immediately apparent that he had an astronomical white blood cell count. A friend, upon hearing this, said that it's not unusual for that to happen because doctors don't look for cancer in an otherwise healthy, moderately young person. But in some cases, it seems, that the new "Google-fication" of self-diagnosing is bringing about a public of paranoids, so if my husband had gone into the doctor asking them to check for cancer because he was feeling rundown, would they have done so? He certainly felt like he was taking charge of his illness by making appointments with his neighborhood clinic, but he never thought it was cancer, so he didn't push for that diagnosis. Shouldn't we be able to trust in the expertise of our medical providers to see what we can't see?
Q: I know this is a tricky question, but I started to wonder, as I read your book, how much someone who doesn't have a lot of schooling or a lot of money or maybe has very little exposure to healthcare can benefit from the advice in this book. Most of the anecdotes included have to do with people who instinctively know something is wrong with the diagnosis or advice they've received. And the concept of concierge health care often feels like something only accessible to people with a lot of wealth. Unfortunately, we aren't all able to come at our health from such an advantageous position. What can that person who will need help navigating the system do to insure he or she gets good care? I think the answer to that question might lie in how you've written this book. What I like so much about it is the simplicity with which you lay out the questions to ask, and then you reiterate those questions, in checklist form, at the end of each chapter. How can we educate people to learn these methods?
Q: What is the value of obtaining your medical records, and why isn't that a standard part of care?
Q: When people are ill is often when they are feeling their least capable; how does a person force themselves to jump through hoops and be stubborn in finding the right specialist, or "Who is/are the best doctor(s) to administer that treatment/perform my surgery/oversee my therapy?" And, I suppose it must be asked, does it take money to find that person, or can that right doctor be found within a patient's insurance network?
Q: I have been in situations when one of my family members is in the hospital and I'm astonished that there seems to be no continuity of information sharing. I've often thought there should be hospital provided patient advocates, perhaps like doulas, who are there to assist and speak for the needs of the patient or family as needed. That doesn't seem like something insurance is going to pay for, so you advise that someone other than the patient become "quarterback" during treatment. In our case, I'm my son's quarterback, and my mother-in-law is serving as my husband's quarterback. What are the benefits of having a support person like this at hand?