THE IMPORTANCE OF BEING A WISE ADVOCATE FOR YOUR OWN HEALTHCARE & TIPS FOR HOW

In today’s world, being one’s own health advocate is vital.

Invariably, credible healthcare providers, services and healthcare professionals are the best tools at our disposal as the prime advocates for our own healthcare. However, being discerning when assessing our options is not always easy.

Between societal expectations and having preconceived ideas of what a credible doctor is and isn’t; the full picture is somewhat lost.

Every individual is ultimately in charge of their own health when it comes down to making healthcare decisions and ascertaining what options are best for them.

In an attempt to broaden the scope of healthcare for all, perceptual limitations and societal myths about healthcare providers are discussed below, followed by 5 tips for being a better advocate for your own health.

There is No Single Standard of Training

While insurance companies, accreditation bodies and governmental health boards worldwide have attempted to create more standardized metrics amongst healthcare facilities, there is no set global standard for the training physicians undergo.

The scope and depth of training differs both nationally and worldwide amongst different medical student training programs. [1]

Some comparative studies found differences even amongst international branches of the same UK educational institution, with overseas interns) having a lower chance of success for passing the standardized medical training examinations. [2]

New Information Takes Time to Update the Medical Syllabus

The way healthcare professionals are trained undergoes revision every few years to keep up with the latest trends in medicine.

This also means that older doctors may be slightly out of touch with the most modern practices in medicine - unless they keep up to date with the latest research and medical trends.

Newer doctors may be privy to newer information, but that does not necessarily guarantee a higher chance of success. Older physicians have a lot more experience to draw off of than newer physicians and as such can make better healthcare practitioners; provided they remain informed.

In this respect, doctors who keep up with the latest information while gathering years of clinical insight stand out in their careers. However, the reality is that many healthcare practitioners don’t have the time to keep current with the latest medical trends.

We’re All Biased, Including You and Your Doctor

No matter how a person wants to look at it, every human on the planet has biases, including you and your doctor.

A bias from either end could work in the favor of both parties or hinder the progress of treatment.

Doctor Bias

From the perspective of the patient, the doctor might be biased in the following ways:

1. Specialty/ Medicine Type

The field of expertise is always going to make a doctor biased.

It’s important to note that due to the holistic nature of the body, one condition may affect multiple bodily compartments and appear as separate conditions across the spectrum of specialists.

A neurologist, a cardiologist and an enterologist can all give you a different diagnosis and treatment for the same series of complaints, yet it’s up to you to be discerning enough to work out what is ultimately appropriate for you.

2. Outdated Medical Practices and Attitudes

If a doctor recommends therapies that are outdated, then you might want to consider a second opinion.

3. Gender Bias

There is a possibility that some doctors have gender biases. According to WebMD, Women are 50% more likely to be misdiagnosed with heart disease, even after having a heart attack, and 30% more likely to be misdiagnosed for strokes. Additionally, Doctors may be more inclined on average to diagnose medical issues for women as psychological issues than their male counterparts (with the same symptoms). [7]

Men have suffered from these attitudes too and have traditionally dealt with the other end of the same bias. In other words, a lack of a diagnosis where one is due can be equally as detrimental as an undue misdiagnosis.

The hallmark of a good doctor is somebody who can connect to their patients objectively to assess physiological imbalances before respectfully helping the patient achieve an optimal state of health. [9]

5 Culture, Nationality, Social Status and More

A person’s unique social bias is largely dependent on their culture, nationality and social standing within those settings. Both the patient and doctor may automatically have a biased opinion of one another based on these factors.

Amongst a survey conducted by Medscape, other factors can cause doctors to adopt biases about patients that may affect diagnosis and treatment. [10] These include:

• Emotional problems
• Being under or overweight
• IQ
• Language barrier
• Insurance coverage

 In light of this, it’s not fair as a patient to hold a pre-conceived judgment of your doctor, but merely to remain aware that potential bias (conscious or not) may interfere with diagnoses and treatment.

The best healthcare provider is one that can relate to your position in the world without bias. 

Patient Bias

The patient’s own bias can affect the success of the treatment, with two prime ones often being:

1. “Unquestionable” Authority

The patient all too often gives their one and only doctor an overwhelming amount of power over their decisions, even when straddled with doubts about treatment. This is a bias from patients which can interfere with a successful outcome, particularly where a second opinion could offer a broader perspective, delivering better results.

Since not every doctor will get it 100% right all the time, it is our responsibility to ask questions and form our own opinions on the state of our health in order to maintain an optimal quality of life for ourselves. The doctor’s responsibility falls within the scope of their ability to help treat your complaint, but the word of one doctor shouldn’t be a limiting factor on your options for treatment.

2. Dr. Google and the Glorious Internet

It is not only doctors to whom we give unquestionable authority but also the glorious, little, pocket search engine that seems to have replaced dogs in terms of being man’s best friend.

We live in an age of information where anyone can become an expert in a matter of minutes. On the other hand, this also means we live in an age of disinformation, where the volume of information – whether true or false – is purely overwhelming, and discerning the facts for ourselves becomes more trouble than it is worth.

Just as one should be discerning of bias in themselves and their doctors, the wise health advocate is also discerning of the way in which they educate themselves.

While looking at online reviews of hospitals and doctors is worthwhile, remember to read the good as well as the bad. If possible, ask someone you know about the doctor, not just depend on online reviews.

3.  VIP Syndrome

VIP Syndrome occurs when a very important person is admitted into a healthcare facility.  The stress of treating high profile clients might lead to mistakes. Additionally,  research has found that celebrities might demand more from doctors. This in turn might lead to doctors bending rules and providing care that might not be in the best interest of the patient.

Lab Tests Are Not Foolproof or Finite

While humans are biased and everyone has their ups and downs, not even laboratory equipment is completely free of similar limitations. Here are some points to consider every time you receive the results of your next blood test from the path lab:

1. Double negatives (or false positives)

Some tests doctors often use offer slanted results with the equipment picking up on a certain percentage of false readings.

A classic example would be ELIZA testing, which senses antibodies in the blood in order to ascertain what the body is reacting to at any given moment in time and is usually applied to ruling out food allergies. Since many antibodies are physically very similar to one another with overlapping functions and the body can also continue to make antibodies long after the threat is already dealt with, it is difficult to find the main offending foods through these results alone.

Additionally, different labs might give slightly different results. The differences need to be kept in mind when comparing various results over a long period of time.

A good doctor will understand the limitations of test results and will only take appropriate action when they have a comprehensive picture of your health.

2. The wrong time for testing

If you’re going to have your blood pressure levels tested after eating a meal with a high glycemic load or excessive salt content, the results are bound to be skewed in favor of a higher blood pressure. Combine that with some dehydration, lack of sleep, overall inactivity and perhaps a moment of stress just before getting your blood tested - now your chances of having hypertension are +99% where they were at -10% the day before.

In this way, testing can be easily misinterpreted because the results can only reveal a snapshot of the body’s processes at any given time.

Be sensible about when you choose to test for your health, but make sure you regularly check.

It’s obvious to avoid days where your health would be affected temporarily, however make sure you understand the difference between a temporary and continuous state of illness. In other words, don’t avoid checkups if you permanently feel ill on the basis of the fact that it’s not the right time for the test – that defeats the purpose.

3. Subject to Interpretation

The doctor’s interpretation and your eventual interpretation of both the doctor’s view and the tests are further variables to consider. The results of a test are as good as the test as well as the interpreter.

As far as most healthcare practitioners are concerned, you are healthy until the numbers on your tests reach a certain level and your medical history and symptoms match up with the results. This interpretation could be flawed for any number of reasons and second opinions are always an option. It’s also useful to build your own understanding of your natural rhythms, so that you can ascertain with your doctor whether test results reflect an abnormal snapshot of your overall health or not.

Misdiagnosis is a Common Accidental Disease Prescription

Perhaps one of the most prevalent non-communicable pandemics on the planet would be misdiagnosis.

Gathering from our history in this department, humanity is not very good when it comes to admitting that we might be wrong.

Unfortunately, symptoms amongst various states of disease often overlap and can be troublesome to diagnose. In medical professions in which there is minimal detective work and maximal guesswork, the patient is often at the mercy of the doctor’s perception of the symptoms and thus the chance of misdiagnosis is far greater.

A good example would be psychiatry, in which relatively few tests are conducted and the prime site for the imbalance (the brain) is virtually ignored by the physician; who attempts to guess the patient’s state based on their symptoms and behavior.

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5 Tips for Becoming a Better Healthcare Advocate

Everyone is very quick to get upset about prior medical injustices and our limitations as human beings. However, a happy way forward for all will not be found in waving a finger at the dark ages, nor can it be made through ignoring our collective faults and repeating our past mistakes.

In spite of the history, medicine, technology and standards of equality have advanced at a rapid pace in the last few decades. Thanks to the internet, it is now easier than ever to drop false notions and proceed with a better degree of autonomy in making healthcare decisions, provided one can keep the limitations in perspective.

Here are five tips for doing just that in order to become a wiser healthcare advocate for your own healthcare.

1. Being Open with your doctor.

If you want your doctor to provide the best care, be open about your lifestyle. As an example, if you smoke, make sure to tell your doctor. If you are taking any herbal supplements, it’s important you tell the doctor about that as well. A doctor has to have all the information possible to help provide the best treatment plan.

2. Choose the right doctor(s)

All of the limitations discussed above are informative when choosing the right doctor (or doctors) for you. Ultimately an experienced physician that is free from all biases and knowledgeable in the latest medical trends will make for the best healthcare professional – this is a rare and unusual scenario in reality, yet one should be able to find a close approximation that works for their case.

The main message here is not to limit your options and to understand that different doctors, specialists and even different systems of medicine may be more appropriate for your case.

3. Don’t Fall into the Trap of Multi-Pharmacy

The combination of no clear understanding of what one is doing and the idea that one knows better than any doctor is dangerous!

While being a wise health advocate demands weighing all options in terms of healthcare providers, medical advice and treatments; it does not necessarily mean one needs to partake of multi-pharmacy to achieve the best healthcare outcomes.

In fact, multi-pharmacy (the act of frequenting multiple doctors and multiple treatments) often comes with severe consequences that impact health negatively. Aside from generating unnecessary confusion and longer lists of pills to take, every doctor is going to tackle your health from a different perspective. Being caught in the crossfire of two or more completely different treatment protocols is not only a waste of time and money but also runs a high risk of permanently damaging your health.

When going about choosing the right doctor or team of medical professionals to work on your case, it is important to commit wholly to only one protocol at a time to prevent multi-pharmacy.

In the event that you require more than one doctor to work on your case, then it is imperative that there is communication between these doctors to avoid protocol conflict and treatment complications. This is why many of the top medical institutions in the world tend to work with teams of leading medical specialists who have experience working together in a holistic fashion in order to treat patients (especially complex cases).

4. Keeping Informed (with a pinch of salt)

As with conceding to multi-pharmacy, running around the internet and playing the role of medical data-junkie is often not useful.

When educating oneself about healthcare, it is important to review all information with a pinch of salt. Invariably, for every argument there is an equally good counter-argument and again, everyone’s health standards and requirements are unique to them.

Try as much as possible to learn through integrating your experience with credible sources (science papers or equally-referenced educational resources) and taking tips from credible healthcare providers who offer the experience to support the science.

The root word for doctor actually means ‘teacher’ and doctors should accordingly make the most valuable educational assets when learning about our health. When in consult, don’t be afraid to ask questions and to engage your doctor in conversation, particularly about decisions that involve you and your future.

5. Know Thyself

You are the only factor in the healthcare equation that you have any degree of control over - which is precisely why being your own healthcare advocate is, to some degree, a requirement for a happy life.

Clarifying the following about yourself will improve your ability to be more discerning in your healthcare decisions:

• Your baseline state of health
• Your inherent biases, expectations and limitations regarding health
• Your personal healthcare needs
• Your own experiences and the objective value they impart to you 

Conclusion

In the same way that a building will crumble rapidly without a proper foundation, we need a firm grasp of ourselves in order to be better self-healthcare advocates.

To navigate the world of healthcare options presented to us, it is important to adopt a fairly open perspective and to be discerning of all the medical inputs we receive, whether from a healthcare provider, the internet or our own experiences. Biases, societal expectations, interpersonal limitations, information exchange and general ignorance are the main challenges presented to us as advocates for our own healthcare.

Knowing honestly where you stand within yourself can greatly help you to know what to look for in a good doctor, as well as how to navigate your healthcare decisions appropriately. Part of this entails maintaining a healthy lifestyle as much as one possibly can, informing oneself at every possible opportunity and doing away with outdated modes of thinking (collective or otherwise).

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Source:

• [1] https://discovery.ucl.ac.uk/id/eprint/1473277/1/Assessment%20at%20UK%20medical%20schools%20varies%20substantially%20in%20volume,%20type%20and%20intensity%20and%20correlates%20with%20postgraduate%20attainment.pdf
• [2] https://www.rcpjournals.org/content/clinmedicine/14/5/500
• [3] https://acem.org.au/getmedia/b87ed5ff-7210-450f-b676-9649bd86d6de/EFarmer_Report.aspx
• [4] https://www.utoledo.edu/library/canaday/exhibits/quackery/quack4.html
• [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140088/
• [6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3480686/
• [7] https://www.webmd.com/a-to-z-guides/news/20171018/survey-patient-bias-toward-doctors-nurses
• [8] https://www.theatlantic.com/sponsored/netflix-2017/how-victorian-women-were-oppressed-through-the-use-of-psychiatry/1607/
• [9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1124230/
• [10] https://www.webmd.com/a-to-z-guides/news/20160113/doctor-bias-treatment#1

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