Written by Deborah Levine, Editor

Margo Corbett, M.A. has a passion for helping people receive the best healthcare possible and prevent medical errors. Her Partner With Your Doctor System is based on the knowledge she gained from patient advocacy and three personal life-threatening experiences combined with 40 years of medical-related reading and research. She has a B.S. in Medical Technology and is a retired Total Quality / Knowledge Management Consultant. She offers a variety of health care seminars, speaks nationally at conferences, a variety of health and civic organizations, nursing colleges and support groups. She developed and teaches a patient course,  "How to Be an A-#1 Patient" based the Partner With Your Doctor (PWYD) System found in her book, Lead Your Way to Better Healthcare.

I asked Margo why patients need to protect themselves increasingly against medical mistakes. In a 1999 report titled “To Err Is Human” the deaths due to mistakes in hospitals was cited as between 98-100,000. Her response to my question was eye opening. The increasing numbers of medical errors are largely due to medical system changes and growth over the past 50 years. We have many different players in the medical system today: our primary care doctor, numerous specialists, hospitals, insurance companies, laboratories, pharmacies, and the government. Each player grew and changed on its own, optimizing itself in the process with no one entity overseeing the coordination of all these players for efficiency or effectiveness. Further, they have not grown gracefully or to the benefit of the patient. We now have a faulty system in which even the most intelligent person cannot do a good job.

Looking back to Once upon a time, our physician took care of our family, from birth into our old age. Medicine was very simple compared to now. Starting in the 80s, specialists began to proliferate and the continuity of care was broken. Specialists know an incredible amount about one part of the body but often don’t think in terms of the whole body or about how a problem in their area of expertise impacts other parts of the body and vice versa. It’s impossible for the primary care provider to know everything a specialist knows so is not always be able to tie all of the pieces together for timely diagnoses and overall good health care management. Further, they get only a small summary from the specialist, a summary that doesn’t include all of the questions and shared information leading to loss of potentially valuable information.

In the nineties, lawsuits for medical errors became more frequent and the courts were giving huge awards. Patients were suing like crazy, doctors ordered tests like crazy to cover themselves and insurance companies tried to get the sky rocketing costs under control. Drug companies began advertising, which led to the increased use of drugs add to that we pay huge amounts for the same drugs sold for less outside the US. It seems that greed had taken over all the players in the system and doctors and patients got caught in the middle. This led to insurance companies micromanaging doctors, making rules about testing and which doctors one can use.

Patients need to know more about their health in order to help the doctor get the right diagnosis. You need to get your doctor’s attention in the first 15-17 seconds and then you have about 2 minutes to tell your story and get a proper diagnosis. If you don’t get the doctor’s attention, he will interrupt and start asking questions about what he thinks is wrong. He will order tests, medications with his original assumption. If you’re not an educated patient, you will go along with his assumptions and valuable information will go unnoticed. (See HEALTH for Part 1)

               Margo gave the example of her husband who had an underlying condition for 6 months before collapsing with kidney failure.  When his blood pressure went up, another blood pressure medicine was added.  “All in your head” was the doctor’s response, a familiar refrain when a doctor assumed you are the nervous type.  Despite the fact that he had an out-of-whack kidney function test, it was considered a laboratory mistake.   She urges patients to make sure there is follow up.  

Doctors are generally good, dedicated people. What could account for the lack of follow up? Margo referred to a bit of history in answering this. In the nineties, the courts were awarding huge awards and drug companies were charging huge amounts of money. It seemed that greed had taken over all the players in the system and doctors and patients got caught in the middle. Patients were suing like crazy, doctors ordered tests like crazy and insurance companies tried to the sky rocketing costs under control. Insurance companies starting micromanaging doctors, making rules about number of tests, when and who can be tested. The quality of care is now subject to some very difficult medical decisions based on insurance coverage. Her next book revision will give more information about the pressures effecting doctors today.

Given the environment of medical care today, it is imperative that patients take ownership of their health. They must educate themselves and be full partners in their care. You can’t meet your doctor as an equal if you don’t educate yourself. Margo’s book, Partner With Your Doctor System, contains 40 forms to complete about your medical history and she suggests creating a notebook with them that you take to every appointment, every procedure and any emergency room visits. Most people keep better records on their house and car. When a child leaves home, parents should give them all their medical records.

Margo notes that the future could get worse before it gets better. One of the reasons is that the baby boomers are getting older and will eventually swamp the medical system with their increased needs. The elderly will increase and live longer. Doctor appointments will be harder to get. Some physicians are responding by charging an annual premium to patients who will then be guaranteed service. This is their way of bypassing insurance companies, having less patients and taking better care of them. The system is out of control and until patients do their part to fix their part of the system, it won’t get fixed.

Some have called Margo’s book, the missing piece in controlling health costs. The current situation is going to have to change. Doctors will be overwhelmed, but patients will have choices. Insurance companies will steer people into choices. For example, insurance companies have offered disease management programs, helping chronic diseases patients, and lowering costs. The programs help patients learn how to manage their disease, like diabetes. They need disease management and they need to keep accurate records. They need to be partners with their doctors, to be knowledgeable enough to ask helpful questions. Help your doctor help you by giving intelligent and organized information about what is going on with you. If your doctor gets annoyed with you, ask yourself if you have done your homework and can participate in reaching a diagnosis.

        For more information on Margo Corbett go to her website at www.pwydhealthrecord.com.  Sign up for her monthly newsletter and get started on your new PWYD health system today.