Tips and resources for empowered patients
Always ask your health care provider questions and take notes to help you remember the answers. For example, if surgery is recommended, always discuss your alternatives before agreeing to it. And if you do decide to have surgery, understand what you need to do to prepare for it.
Do Your Homework
For additional online health research, see Health Info Links. In addition, we offer the following articles to become a smart health care consumer.
What do you and your family take for pain and fever? Acetaminophen, including Tylenol and other brands, is one of the most readily available medications in the United States. It is often used to relieve pain and fevers in both children and adults.
While this medication can be very effective, it is important to remember that, if not used properly, acetaminophen can cause very serious side effects, including acute liver failure.
Unfortunately, overdoses of acetaminophen often occur by mistake. You may not know that a medication you are using contains acetaminophen. If you take it with another product containing this ingredient, you may be taking a harmful amount.
Acetaminophen is easily found as a single-ingredient medication, but it is also frequently combined with other ingredients. For example, acetaminophen is part of many cold remedies and other over-the-counter medicines. It can also be found in prescription compounds.
Be aware that acetaminophen can appear in numerous forms, including tablets, capsules, caplets, gelcaps, liquids, and suppositories. It's also important to know that acetaminophen may sometimes be abbreviated “APAP” on some medication ingredient labels.
Acetaminophen products also vary widely in the amount of medication included in each dose. In healthy adults, the total daily dose of acetaminophen should not exceed 4 grams (4,000 milligrams). Some acetaminophen products work immediately, while others have a delayed response.
Always know what your medication contains—both prescription and non-prescription. Check with your pharmacist if you are not sure of the ingredients and/or the strength of each ingredient in your medication. It is also a good idea to have your physician write down the directions for use, including the strength and formulation for any non-prescription drugs that are recommended to you.
Are Your Physicians Communicating?
Quality health care depends largely on physicians having accurate information. That's why it's important for your doctors to be in touch with each other regarding your care. When providers compare notes, you benefit in the following ways:
- Better outcomes, as practitioners have a clearer picture of other care you may have received.
- Increased efficiency, as time spent gathering information about you can be reduced.
- Safer care, as potentially harmful drug interactions may be avoided.
- Reduced costs, as duplicate lab tests are eliminated.
If you are seeing a specialist, make sure that your primary care physician is kept in the loop. The same goes for any emergency room visits or hospital stays. Always ask for reports to be filed with the doctor(s) who are responsible for your routine care.
Don’t Be Afraid to Ask!
CDPHP urges you to take an active role in your care. If you don’t understand the doctor, don’t be afraid to admit it. If you need support, ask a friend or family member to go to appointments with you.
In an effort to improve communications between doctors and patients, a coalition of health care organizations recently launched a program called “Ask Me 3.” The idea is to be sure and get the answers to the following basic questions during your appointment:
- What is my main problem?
- What do I need to do?
- Why is it important for me to do this?
Of course you should seek as much information as you can get. At a minimum, however, do not leave the doctor’s office until you understand the answers to the “Ask Me 3” questions.
How Long Will I Be in the Hospital?
It's a good question. Nobody wants to be hospitalized longer than necessary. Hospital stays are disruptive. You are at risk for antibiotic-resistant infections and medication errors. Immobility weakens people and can lead to life-threatening blood clots.
While your doctor is the chief decision-maker regarding your need to be in the hospital, CDPHP does compare member hospitalizations to standard guidelines. Our utilization management committee of community physicians has approved these guidelines. Hospital stays not meeting these guidelines will be reviewed with your doctor.
Hospital stays are shorter than they used to be. One reason is that getting up and moving can lead to a quicker recovery. Years ago, a hysterectomy meant a week-long hospital stay. Now, the patient may be able to leave the first or second day after surgery. Although this seems short and the woman may still have discomfort, mobilization will help her to recover faster.
If a patient has had surgery and is able to eat and move about safely with pain under control, that person is generally considered safe to go home. A longer stay will not be approved for non-medical reasons.
Preparing for Surgery
The first question you should be asking is: “Is surgery the right choice for me?” There are risks to any surgery, such as infection, bleeding, and reactions to anesthesia. Make sure it is worth taking these risks. There may be other alternatives.
Ask your surgeon to explain the surgical procedure to you. What is the expected result? Find out if there are different ways of doing the operation. One way may be more extensive than another. Which is best for your situation?
Find out about the side effects and recovery from the operation. Ask how your pain will be controlled, and what you can do to help the healing process. Will you need any special supplies or equipment to aid your recovery at home?
If you still don't know for sure whether surgery is the right choice, consider getting a second opinion. If you do decide to see another doctor, make sure to request your records from the first physician so you do not have to repeat any tests that have already been done.
Make sure the surgeon that you and your primary care physician (PCP) select has been thoroughly trained in the procedure and has sufficient experience doing it. Ask your PCP to discuss the surgeon's qualifications with you. Don't be afraid to ask your surgeon directly about his or her success record, too.
Ask about your anesthesia, and the professional who will be administering it. You may request to meet with this individual. Be sure to provide details on any allergies and previous responses to anesthesia you may have had.
Finally, understand what you should do to prepare for the surgery. For example, aspirin and many other substances can thin the blood and must be discontinued prior to surgery. Your doctor should give you specific written instructions about your medications, diet, and other steps you may need to take. Follow these directions carefully and report to surgery fully prepared, confident that you have done everything you can to assist your medical team in delivering safe, effective care.
Antibiotics are powerful drugs, and using them inappropriately can harm your health by encouraging the growth of drug-resistant bacteria.
Each time you take an antibiotic, germs are killed. Some survive, however, and become stronger. When you take an antibiotic improperly, you increase your chances of developing bacteria that are no longer killed by antibiotics.
It is estimated that one-third of the 150 million prescriptions for antibiotics written each year in the United States are unnecessary. Drug-resistant bacteria are rapidly becoming a public health issue. Some problems—like tuberculosis, wound infections, and pneumonia—that used to be relatively easy to cure are now much harder to treat.
Use antibiotics wisely:
- Antibiotics do not work against viruses. If you have a cold or the flu, antibiotics are not appropriate.
- Acute bronchitis is almost always caused by a virus, so an antibiotic may not be the right choice to treat that, either. Coughing and wheezing in an otherwise healthy person may be a sign of asthma.
- Sore throats generally do not require an antibiotic unless a test shows that you have strep throat.
- Don’t insist on antibiotics if your physician does not think they are necessary.
- If your doctor determines that you do need an antibiotic, be sure to take it exactly as prescribed.
Help Prevent Medical Errors
In response to public concern about medical errors, the Quality Interagency Coordination Task Force—a partnership of federal agencies formed to improve consumer awareness and health plan quality—has come up with a patient fact sheet called the “Five Steps to Safer Health Care." The steps involve your responsibility, as a patient, to ensure that the care you receive is as safe as possible.
- Speak up if you have questions or concerns.
- Keep a list of all the medicines you take.
- Make sure you get the results of any test or procedure.
- Talk with your doctor and health care team about your options if you need hospital care.
- Make sure you understand what will happen if you need surgery.
More information on the five points can be found at www.quic.gov. A Spanish language version is also available there. Another helpful Web site on preventing medical errors is provided by the Agency for Healthcare Research and Quality at www.ahrq.gov/qual/errorsix.htm.
Preventing Infections in the Hospital
Infections can occur after many types of medical procedures. This is particularly true if you are having surgery.
To help prevent infections in the hospital:
- Wash your hands carefully after handling any type of soiled material, especially after you have gone to the bathroom.
- Do not be afraid to remind doctors and nurses about washing their hands before working with you.
- Likewise, if you have a dressing on a wound, let your nurse know promptly if it works loose or gets wet.
- If you have any kind of catheter or drainage tube, let your nurse know promptly if it becomes loose or dislodged.
- If you have diabetes, be sure that you and your doctor discuss the best way to control your blood sugar before, during, and after your hospital stay. High blood sugar increases the risk of infection noticeably.
- If you are overweight, losing weight will reduce the risk of infection following surgery.
- If you are a smoker, you should consider a smoking cessation program. This will reduce the chance of developing a lung infection while in the hospital and may also improve your healing abilities following surgery.
- Carefully follow your doctor’s instructions regarding breathing treatments and getting out of bed. Don’t be afraid to ask for help, advice, or sufficient pain medications!
- If possible, ask your friends and relatives not to visit if they themselves feel ill.
- Don’t be afraid to ask questions about your care so that you may fully understand your treatment plan and expected outcomes. You and your family/friends will be able to better facilitate your recovery.
Reprinted with permission from the National Patient Safety Foundation