Navigating the Health Care System
Advice Columns from Dr. Carolyn ClancyFormer AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.
New Initiative Urges Better Communication between Clinicians and PatientsBy Carolyn M. Clancy, M.D.
Even with heart disease and diabetes, Bill Lee didn't see the point in asking questions about his medical care. After all, his doctors had the expertise, not him. And if the medicines they prescribed for his conditions didn't make him feel better, what could he do?
After having 10 heart attacks and feeling sicker, the 55-year-old Baltimore resident knew he had to get serious about his health. Bill began doing something important: He asked his doctors and nurses questions and he let them know which medicines worked and which did not.
Today, Bill credits his change of attitude to feeling better, getting healthier, and even saving his life. “If I had not started asking questions of my doctor, I honestly think I'd be dead today,” he says.
Examples like this are why my Agency, the Agency for Healthcare Research and Quality (AHRQ), urges clinicians and patients to communicate with each other. Research shows that good communication can ensure safer care and better health outcomes. This is especially true for patients with diabetes and other chronic, or ongoing, conditions.
Based on this, AHRQ worked with the Ad Council to develop a national public education campaign in 2007 called “Questions are the Answer.” TV, radio, print, and Web ads encouraged patients to ask questions of their medical team.
We know that good communication is a big help in getting better outcomes. But our health care system is very busy and often confusing. As a result, communication between patients and clinicians is often interrupted.
Now, a new phase of our earlier initiative from AHRQ reminds clinicians of their role in listening to patients' questions—and making sure they understand the answers. Public service ads, which will be published in many medical journals this fall, tell clinicians that a “simple question can reveal as much important information as a medical test.” For example, a patient's question about side effects of a blood thinner medicine could alert her doctor to change the dose or prescribe a different one.
The new campaign includes a series of videos on the AHRQ Web site that feature actual patients, including Bill Lee, and clinicians discussing why sharing information is so important. Several patients describe how their conversations helped them avoid medication errors or get a correct diagnosis.
But even when patients have a lot of questions, the average time for a doctor's visit is often less than 20 minutes, according to the Centers for Disease Control and Prevention. That's why this initiative includes customized note pads that AHRQ distributes to medical offices and clinics to help patients identify their top three questions to ask during their medical appointment. Clinicians in the AHRQ videos say this is a good way to make sure that they have enough time to answer their patients' questions completely.
Other elements of the initiative include:
- An interactive "Question Builder" lets patients create and print a prioritized list of questions based on their health condition.
- A new brochure helps patients be more prepared before, during, and after their appointments.
I'm excited about the work that AHRQ is doing to continue to encourage patients and clinicians to work as partners in finding the best treatment options. Learning about the experiences of patients like Bill Lee and the clinicians who work with patients each day convinces me that we are on the right track.
I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.
Agency for Healthcare Research and Quality
Questions Are the Answer
Patient and Clinician Videos
My Questions for This Visit
Be More Involved in Your Health Care: Tips for Patients & Families
Centers for Disease Control and Prevention
National Center for Health Statistics. Ambulatory Medical Care Utilization Estimates for 2004. Available at: http://www.cdc.gov/nchs/data/hestat/estimates2004/estimates2004.htm
Understanding the benefits of coronary revascularization procedures among patients who are offered such procedures. American Heart Journal, 2007 Oct; 154(4):662-8.