Reprinted from "Medications" issue of Visions Journal, 2007, 4 (2), pp. 29-30
I can’t speak for everyone, but I’m a lot happier when I feel I have an active role in my own health treatment and am not just a “helpless” patient. I have a lot of confidence in my doctor and the health professionals I deal with, but realize that I only get to see them once in a while. I’m the one who has to manage my health on a daily basis. Also—and this is the most important reason—I know that whether I do well or not depends on my own behaviours. For example, do I take my medications the way I am supposed to?
We are the ones who manage our health, but there are ways that health providers can work with us. These days, doctors attend “self-management” workshops to learn skills, strategies and techniques that promote our role as active participants. In fact, the new philosophy at the BC Ministry of Health is “patients as partners.” Well, it’s great to have acknowledgement that we patients have knowledge and expertise in managing our own health!
How to be active in your health care
The following tips are useful for any kind of questions you may have for health professionals, but can be especially useful for inquiring about medications.
The next time you go for an appointment, let your doctor know that you want to be a partner in managing your health. Make sure you take a written list, in point form, of your concerns and questions. Don’t just tell the doctor what is happening right now, but also include what’s been happening during the last few weeks and what you’ve been doing to cope.
It’s always good to give your doctor a copy of the written list, because sometimes things that may not be obvious to you may mean something else to the doctor, especially if the doctor sees the whole list.
There may not be enough time to deal with all your questions during a visit, but a follow-up appointment could be made. Tell the receptionist that you have quite a few things to discuss and that a longer appointment time may be necessary.
Always make sure you clearly ask the doctor what you want to know. Oftentimes, people don’t get the information they are after, don’t understand the information they get, or are simply overwhelmed by it. For example: clearly say, “Doctor, I want to know why I feel so badly after I take this medication, and isn’t there a different type that doesn’t make me feel so sick?”
After you get the information, always repeat it back in your own words. In this way, both of you can be sure you’ve understood what was said. Sometimes people ask a friend to come to the appointment with them.
Have a plan
Another really important way of being a partner with your doctor is to ask your doctor to participate in making an action plan with you. This is a simple but effective technique for getting started on making changes.
Start off by telling your doctor something you want to accomplish in the next three to six months or so. Next, make a small, doable, “bite-size” action plan of what you are going to do in the next week to start working towards this goal. For example: “I am really unhappy with my weight, and my six-month goal is to lose 20 pounds.” Everyone knows that it’s not easy to lose weight, especially when you consider lifestyle factors such as medication. An action plan could be as straightforward as: “During the next two weeks I am going to go for a walk 10 times, for at least 30 minutes each time.”
Then, tell your doctor how confident you are that you’ reyou’re going to accomplish your action plan goal. Use a “0” to “10” scale, where “0” is very uncertain and “10” is completely certain. You should be a “7” or higher on the scale, because the more confident you are, the greater the chance you will accomplish your goal.
This technique is really effective, because success builds on success, and each step is a step in the right direction. Soon you may find yourself using the method in other areas of your life.
Try the interactive problem-solving wellness module at www.heretohelp.bc.ca/skills
Another technique you want to use with your doctor is problem solving. Sometimes we have problems and have difficulty figuring out what to do to solve them.
There is a step-by-step process to problem solving, and when you follow these steps, you can usually overcome the issues you have. Problem solving is not a technique to be “used on you”; it is a process they can teach you to “use on yourself,” to deal with problems as they arise.
Let’s say, for example, that you are having a problem understanding the information your doctor is giving you. Here are some steps you could take to solve this problem:
Step 1: Clearly identify the problem (e.g., can’t understand what my doctor is telling me).
Step 2: Make a list of ideas that may solve the problem (e.g., ask for written information; take a friend with me; tell the doctor I don’t understand; look up the information on the Internet; ask friends; etc.).
Step 3: Select one of the ideas to see if it solves the problem (e.g., decide to take a friend with me when I visit my see my doctor).
Step 4: Assess whether this idea solved the problem. If it did—you’ve succeeded! But, if you still have the problem, try another idea from your list. The nice thing about your list is that you can keep adding new ideas whenever you think of them.
If you’ve tried all the ideas and still can’t solve the problem, it’s time to ask for help from someone you think can help (e.g., a family member, friend, health professional, a counsellor, etc.).
Lastly, ask your doctor about resources in your area. Programs such as the Chronic Disease Self-Management Program may be useful to you.
Chronic Disease Self-Management Program
This is a free group course offered throughout British Columbia to anyone experiencing chronic health conditions. It is delivered by the Centre on Aging at the University of Victoria and supported by the BC Ministry of Health.
Led by pairs of trained lay leaders, the course runs for six weeks in a row, and each week’s session is two and a half hours long. Content includes: how to develop a suitable exercise program, using your mind to manage the disease symptoms, healthy eating, breathing exercises, problem solving, communication skills (with family, friends and health care providers), use of medication, and how to deal with the emotions of chronic illness (e.g., anger and depression).
To find out where the Chronic Disease Self-Management Program is offered and to register, call the toll-free line, 1-866-902-3767, or visit the website at www.coag.uvic.ca/cdsmp.
About the author
Patrick is an Associate Professor with the University of Victoria’s Centre on Aging. For 25 years he has focused on education for people with chronic health conditions. He has researched and implemented self-management programs for diabetes, arthritis, osteoarthritis, and tuberculosis, and has trained health care professionals in self-management support techniques.