A Patient Advocate’s Medical Treatment Manifesto
Patient empowerment: How can it go wrong?
As an associate editor for JACR (and an empowered patient with a lot of recent experience with imaging tests), I recognize the strong contributions made by radiologists. My goal is to help radiologists understand how they can connect and help their most vulnerable patients.
Some of you may wonder what approach a maximally empowered patient advocate takes when undergoing medical treatment. I wanted to share my recent experiences with hip replacement surgery to provide a guide for medical professionals to help them in understanding the increasing number of empowered patients. This is meant as a tongue-in-cheek account of potentially being a little too empowered. You decide.
- Ask to live tweet your surgery when you find out you're getting spinal anesthesia.
- Take your entire medical file with you to the hospital and share the 10-page summary with everyone who asks you a question you've already answered more than once.
- Ask the PACU nurse to take a picture of you the minute you wake up after surgery. Live tweet it so all of your followers know you are still alive
- Ask for a print-out of all of your imaging and lab results and decline treatment until you get it. Live tweet a complaint when you can't.
- Make sure to review any informed consent in detail and insist on more information before signing, especially at 3 a.m. when nobody is available. This is especially good for "routine" medical procedures like blood transfusions. Bonus if you tell the staff you are a member of the hospital Institutional Review Board.
- Advise the nurse what pulse levels to set in the pulse alarm and tell him, "I told you so" after he doesn't listen and the alarm goes off every five minutes without requiring corrective action.
- Instruct the nurse on how to place a bedside commode over the low mini toilet hidden in a cabinet in ICU to make sure you don't violate your hip restrictions.
- Geek out: Have a detailed discussion about the load-bearing capability and durability of your hip prosthesis with your orthopedic surgeon's partner in ICU.
- Give everyone you meet your business card and lung cancer screening brochure, especially the medical students and residents in their 20s. Tell the male nurse who just quit smoking he is at high risk for lung cancer and needs to get screened.
- Take pictures of your imaging results when shown to you on the computer then post on social media.
- Ask for the names and the dosages of all of the medications you are given then ask for the spelling as you type them into your phone.
- Spill water all over your bed at least once a day.
- Make sure you have 10 pillows that need to be strategically placed around you on the bed every time you get in.
- Ask to get up and go to the bathroom every two hours.
- Ask to get cleaned up and dressed at shift change.
- Refer to the roving phlebotomists as vampires.
- Show the cute young PA the pitting edema on your now elephant-sized hips and thighs to try to convince him to stop giving you more IV fluids after you gain 18 lbs. from swelling and 72 hours of continuous IVs.
And finally, most important, make sure you thank the wonderful medical professionals for taking such good care of you and returning you home safely to continue healing.