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Saturday, June 20th at 10a.m. -11a.m. Jeff appeared on FoxBusinessNews distinguished panel of 4 discussing the Healthcare Reform draft proposal by President Obama. The lively TV show took call-in questions and discussion amongst the panelists.

Much work and negotiating on both sides of the aisle are needed before a final reform is passed. Neither party is going to be completely satisfied in the final outcome but by working together a bipartisan healthcare much needed healthcare reform is finally likely.

Again, it was reiterated that patients and doctors need to work closely together-consumer  empowerment in healthcare. Healthcare consumer literacy is so vital in this whole process. We can no longer be oblivious to all that has and is going on in the healthcare arena.

Have you ever found yourself in a new situation, within a new building, in front of new people you’ve never met before? Sure you have. We all have.

Wasn’t it just wonderful when everything went smoothly and those you interacted with were friendly, open and willing to listen, ready to assist with whatever the question or issue was at the time, and who made you feel welcome and “wanted?” Sure it was. It’s an experience we hope will be emulated each and every time we end up in front of people like bankers, lawyers, educators, and especially doctors.

But how often – even among physicians you’ve met with numerous times, this isn’t the case. In fact, for many patients, a visit to a doctor’s office, clinic or hospital end up being anything but the scenario described above.

What is it with the persona that some doctors “wear” – the self-induced image that comes across so often smug and arrogant? Why are so many people that we look up to, respect and regard as experts so aloof and unable or unwilling to communicate with patients. What possible justification can there be for people acting like prima donnas, demigods and dispassionate roadblocks?

Well, this was the most frequently-asked question during one of my latest radio call-in show. People of all ages and backgrounds wanted to know “how to overcome their arrogance?” And, “how can we help them (the doctors) change?”

My first response was: “is that a conceivable possibility?” My second thought was “what is the effect such arrogance has on the patient/doctor relationship?

I firmly believe that this subject may have a direct relationship to the considerable amount of misdiagnoses and treatment that is occurring around the United States.

Look up the word “arrogance” in a dictionary and you’ll find “an attitude of superiority in a manner or in presumptuous claims or assumptions”

I have never seen arrogance totally succeed in any business or social situation. It’s a “turn-off” to say the least. Dr., Mr. or Ms. “know it all” doesn’t work and is a dangerous stigma to throw about – when there is only one “right” – and that person is always the doctor – a doctor unwilling to address questions, consider “other” ideas or approaches, and who looks down on patients as something less than themselves. Tell me that doesn’t happened daily across America.

However, an arrogant doctor interfacing with a patient can bring a patient to the point where we are more than likely to succumb to the (drop “arrogant” here) attitude because we automatically presume their knowledge base is so much more than our own and we are deserving of their attitude of superiority. They are going to cure us – therefore, we will tolerate the arrogance. This is WRONG!. We are more likely to receive an incorrect diagnosis, possibly the wrong treatment or not get the time and attention we need or deserve.

Arrogance has become a truly dangerous barrier to reducing errors and the creation of an environment that will improve the relationship between patients (who must become consumer-patients) and doctors (who should be true service providers)

We don’t accept arrogance in retail stores but we do accept arrogance – SOMETIMES – with doctors. It is decreasing, because we cannot tolerate it any longer.

“The single most important thing to prevent mistakes is allowing people to be assertive in asking questions and for physicians to not feel threatened in answering them”
(Arrogant Doctors Stifle Quality Drive, Sarah A. Webster in The Detroit News)

This image that doctors portray in today’s world has become all too common. Just because doctors have expensive, sophisticated training that was originally for the purpose of helping us; taking on a pompous air without listening to 101 in humbleness. The concept of “listening” apparently gets shifted to a minor class and isn’t given much consideration by the medical schools. What a great way to get diagnoses correct – by listening! If doctors (as a whole) actually listened (which many don’t do), be respectful (which seldom occurs), rude (which happens much of the time), and admitted their errors and made amends…what a better patient-doctor environment we could have. As it stands, who are we? We are the ones taking all this pompous stuff and our bodies deal with the consequence.

The phrase I like is, “I am sensitive and caring.” Not a bad phrase for doctors to wear on their white coats. Can you imagine seeing: “I am sensitive and caring.”
I saw an article the other day from Europe where, in order to avoid medical errors the phlebotomist wear aprons with the phrase “DO NOT DISTURB I’M BUSY.”

Perhaps doctors should study or take a course on Southwest Airlines or at Disney, where overcrowding is standard, but people still get treated as human beings – not like cattle.

Doctors: Don’t exaggerate you own importance…the white coat and stethoscope no longer impresses us. We see you today as a human being with all the good and bad. But you remain an instrument of healing and that’s it. You are not a God!!

Maintaining an open mind can be a challenge for anyone. It is not only consumer-patients that have to succumb to arrogance but so do the nurses and other healthcare workers. But another dangerous consequence of an arrogant doctor is the lack of trust and respect for the ideas of the nurses they work with – not to mention those of the patients that come to see them. Nurses are often scared of doctors and when they see mistakes they are closed-mouth – destroying team spirit.

Doctors, do you know or have you forgotten what an open mind is? Can you accept the questions and suggestions from your co-workers with an open mind? Can you respect the questions posed to you by your patients? Being open-minded and allowing the asking of questions can open avenues that might just lead to the avoidance of errors. With all your education is it possible for you to understand some of the basics of human nature and logic.

I talk a lot about consumer-patients being prepared before meeting with the doctor. I believe that we must force the issue of spending more effective time with the doctor, to talk things over, reviewing questions. We should leave as satisfied customers, knowing what is going on and understanding the process. We know all about being a satisfied customer from our retail experiences, and we should expect that from the healthcare provider. We should have a feeling down deep in side that we are being heard, we are getting the best possible treatment (and just being hustled off), and we’re receiving empathy. That’s not really too much to ask.

Some of us are becoming much more used to “calling the shots” or interacting with our healthcare providers – or we walk away. Its the only way the arrogant ones will learn. Also, we just might save a life by helping to teaching them a lesson. The more we tolerate unacceptable behavior, the more we accept the risks and outcomes.

Do doctors like having their authority questioned? Of course not. Who really does? However, the issue isn’t “authority.” It is “care” and “diagnosis” and “treatment.” In the real world, people are questioned on their decisions every day…in every line of work. Today’s consumer-patient who does their homework, makes their list o questions, respectfully asks about alternative approaches, and shows they are prepared, should be given the courtesy of being heard. A prepared patient shouldn’t be a threat to an equally prepared healthcare provider. As it stands, we no longer are we going to sit by and take it.

Enthusiasm is great. Demonstrating commitment is admirable. But when you stop listening and cease to consider another point of view, you are being arrogant.

Just a few points to consider:

• Doctors you need to be more humble.

• Stop talking; take a breath; and listen.

• Doctors, when you have heard what we have to say, acknowledge our input.” Say something such as, “That’s an interesting question. Can you say more about that? Where did you pick up that information?”

Probe a little further. Don’t stop with the first thought that crosses your mind or seems to fit the scenario.
Don’t take it personally if a patient asks a question you didn’t expect to hear from them. It is not an evaluation of your personal abilities.
(Extrapolated from “Overcoming Arrogance” by Catherine Kitcho-Launch at Doctor.com)

As consumer-patients, we cannot accept Dr. Arrogance any longer. It is not so much a question of arrogance being a big “turn-off”– but more importantly we cannot afford to have our bodies exposed to the dangers that this arrogance creates: misdiagnosis, a refusal to admit errors, and a ignorance of the need to be more humane.

Doctors who still have act out this complex need to get over it. Otherwise they’ll have to find a profession, whatever that maybe, where they can continue being arrogant but not put people’s lives at risk.

Let me know about your “Dr Arrogance experiences.” Tell me about those who have changed for the better and those “genuine, humble doctors” that don’t need changing.

In conclusion, of course there are non-arrogant doctors out there. Nevertheless, it appears that it is a condition that we must not allow to grow – not if we are vigilant consumer-patients.

~Stay Well My Friend

Our grandmothers could have written portions of the following commentary. Read on and you’ll see what I mean.

As an author, it’s a great feeling when something you believe in so strongly is reinforced by a source that you respect. That recently happened to me.

I picked up the Sunday, July 13, 2008 issue of the Orlando (Florida) Sentinel and read the front-page headline: “Killer Bug Plagues Hospitals.” In a dramatic story written by Sentinel medical writer, Robyn Shelton, a subject that I really push in my newly published book, Navigating the Healthcare Maze: What You Need to Know, was validated.

It can’t be a revelation to any of you that Americans are often at risk when they place their bodies into the hands of hospitals. The image of our ill, our elderly, and our newborns immersed in a gentle and totally prophylactic environment has been shattered by recent facts that can be downright scary.

Are you aware that nearly 500,000 hospitalizations annually in the United States are linked to bacteria (the killer bug) known as Clostridium difficile? Of these, some 30,000 victims actually die.

Sounding like some killer that might have haunted the dark cells of poorhouses of Victorian England or stalked the wounded troops lying on Civil War battlefields, this enemy is as tough to kill as the proverbial cockroach that survives a nuclear attack. The truth be known, these guys can be taken care of by some of the most simple measures – specifically one our grandmothers would have approved of: washing hands.

As I stress numerous times in Navigating the Healthcare Maze, requesting (demanding, if necessary) that all persons performing services for you and upon you in hospitals (and nursing homes) wash their hands with soap and water (not rinsing with water) isn’t too much to ask. At the same time, this doesn’t allow your family and other visitors off the hook. This may sound like a wimpy request. But with the numbers quantified by the likes of the Centers for Disease Control and Prevention (CDC) and individual state departments of health, this bug demands vigilance – if not by your healthcare providers…by you. And, if you become the spokesperson (advocate) for a member of your family, be sure that hospital staff comply with your request and take appropriate precautions.

Alcohol-based gels that we’ve all become familiar with do not kill the spore form of the bacteria. And the disinfectants often used by hospital cleaning staffs do not kill them either. Bleach, however, has proven effective when used to kill them. However, infectious disease experts are quick to point out that the traditional methods used to clean hospital rooms aren’t designed to annihilate them.

If you are diagnosed with Clostridium difficil, be sure to insist that the staff isolate you from the general patient population. Every caregiver should make use of disposable gloves (even disposable gowns aren’t out of the question). Ask your doctors to use the lowest dose possible of antibiotics when treating you. Should you require antibiotics for a prolonged period of time, susceptibility to the bacteria could increase.

The bacteria in question are hearty souls. They can survive for very lengthy periods of time. Clostridia are found everywhere in nature and are especially common in soil. They can be found everywhere in hospital rooms: the support rails in hallways, the telephone, the nurse “buzzer,” TV remote, the side-rails of your bed, the toilet – basically anything touched by a patient, healthcare provider or visitor (that just about covers everyone). The most common way to contract Clostridium difficil is by transmitting the spores by hand when eating.

After treatment is begun, difficulty can increase if the antibiotic regimen kills off too many of the digestive tract bacteria (often called by laypeople as “good” bacteria). At that stage, Clostridium difficil become active and begin producing toxins that lead to diarrhea (which can become severe), dehydration and weight loss. If the colon becomes seriously infected, surgical removal can become necessary. Regardless of how the infection plays out – no matter how serious it gets, it typically leads to the further deterioration of the patient.

Mistaken doctors have historically thought that attacking situation with antibiotics would take care of the diarrhea and related overall sickness and patients would recover quickly without complications. The CDC recognizes that the associated illness can be extremely debilitating. Since Clostridium difficil isn’t a “reportable disease,” there are no exact numbers on occurrences.

However, we do know that in Florida studies conducted since 1997 show a striking infection rate – rising from 6,254 hospitalizations that year to 23,370 in 2006 (Florida Department of Health). Across the U.S., hospital discharges for Clostridium difficil-associated disease doubled from 82,000 in 1996 to 178,000 in 2003 (CDC).

Within the past two years, a new strain has been identified. Like other strains of Clostridium difficil, this new strain can be detected in the stool of infected patients by using laboratory tests that are commonly available in most hospitals. However, none of the commonly available tests differentiate between the various strains. Fortunately, because the control measures for outbreaks of any strain of Clostridium difficil are similar, identification of the specific strain is not imperative for controlling outbreaks. It is apparent to the experts that as our society depends more and more on the use (including the over-use) of antibiotics, bacteria will continue to become more resistant and deadly.

Bottom line: most of this could be controlled by the washing of hands.

Don’t be embarrassed. Don’t be afraid or intimidated by hospital staff. As an educated and alert consumer-patient, it only makes sense that one of the first steps toward healthcare independence and personal control is to begin asking the simple questions. One of those questions should always be: “Would you please wash your hands with soap?”