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5 health care resolutions to make in 2014

Robert Pearl, MD
Physician
January 7, 2014
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This is the time many of us make resolutions about our lives — often tied to our health and wellness.

As the health care industry enters a new era of consumerism, people are seeking more and more ways to take ownership over their health and health care. While data about doctors, hospitals and health outcomes are becoming more available and transparent, we still have a long way to go.

Perhaps in a decade, all physicians will share electronic medical records so they can view all our medical information in one place. Perhaps by then, “big data” will allow patients to quickly and reliably compare physicians and hospitals. But until then, there are some things we can do to put health care in our own hands. These five simple New Year’s resolutions can change your health for the better — in spite of the limitations of the current health care system. In fact, these resolutions might just save your life in 2014.

1. Be the guardian of your medical information. Most physicians record information in paper medical records or enter data into office-based electronic health records. Either way, your doctor’s files are most likely disconnected from the records of the other doctors or hospitals you’ve visited. If you want to minimize the risk of error, you need to create a summary of your own medical records and bring them to every doctor’s visit or hospital admission. At minimum, keep a personal record of:

  • Your family medical history. You may be predisposed to many medical problems. Inheritable conditions can range from cardiovascular disease to cancer, from depression to other forms of mental illness. Detailed knowledge of your genetic susceptibility is very important to the doctor caring for you.
  • Your personal medical history. Do you suffer from diabetes? Do you smoke cigarettes? Have allergies to certain medications? Physicians need this information so they can hone in on the cause of a specific symptom or avoid post-operative complications. Keep this information handy, particularly when seeing a specialist who may not routinely ask for each of these details.
  • Your medications. Different drugs can interact with one another in negative and potentially deadly ways. Providing a list of your medications (including the dosage) at the start of each medical visit can reduce the chance of a problematic drug interaction. This is particularly important when the physician you are seeing works in a narrow specialty and may not be as familiar with the types of drugs you have been prescribed by other physicians.

2. Check publicly available information before making health-related decisions. Most of us assume the doctors we see and the hospitals we use provide excellent medical care. But do we really know? While the data on the quality of their outcomes is difficult to obtain, there is information available.

We know, for instance, that there are huge variations in quality based on the health insurance company you select. Patients over 65 who are enrolled in Medicare Advantage can obtain such data by checking the Medicare Star ratings. For younger patients and families, data on quality outcomes is published by the National Committee for Quality Assurance (NCQA).

Hospitals also deserve your due diligence. After all, hospital errors are the third leading cause of death in the U.S. Most states maintain public data on surgical outcomes, corrected for the severity of the health condition in the patients they have treated. But this information is only helpful if you use it to decide whether to have a major procedure in a particular hospital.  

3. Be prepared for your doctor’s visit. A “successful” visit to your physician occurs when your questions are answered and your concerns addressed. To prepare for a successful appointment, write down your specific concerns, a description of your symptoms, and any therapies that you have tried — especially if they were prescribed by another physician. These are the main pieces of data a physician uses to figure out what is wrong.

With this information in hand, you can have a more productive conversation with your doctor. When your physician understands exactly what is happening, he or she can provide a higher quality of care and you can be more confident you will receive the right treatment for your medical problem the first time.

4. Narrate your own after-visit summary. Do not leave the doctor’s office until you are certain that you understand what the doctor has said and what the plan is. This will allow you to take more control of your own health in 2014.

Before leaving the examination room, ask yourself some or all of the following questions:

Do I understand what I have been told about my symptoms or condition? Do I understand why diagnostic tests were ordered or why treatments were prescribed? What does my prescribed medication do and what side effects should I watch for? If referred to another specialist, do I understand why and what questions to ask? If undergoing a procedure, what are the potential risks? And how much experience does the physician have in performing the procedure? If the treatment does not work or if new problems arise, how and when should I communicate this to my physician?

5. Know your health status and take action. Certain actions can make a major difference in your health. Although serious medical problems can happen regardless of how diligent you are, there are steps you can take to reduce your chances of developing diabetes, heart disease, cancer or stroke. For instance, pay attention to age- and gender-specific preventive screening recommendations. Manage your weight with regular exercise. Stop smoking.

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The first step in any preventive health measure is to write down your goals. Make sure they’re specific, measurable and attainable. Take advantage of the programs and resources at your disposal. For example, some employers sponsor smoking cessation programs. Check out diet plans like the ubiquitous Weight Watchers program. Assess your progress every day and engage family and friends to hold you accountable.

The first few weeks are the hardest time for a lifestyle change. But once these activities become habits, they much are easier to maintain.

Own your health in 2014

What we want from our health care system is very different from what we can easily obtain today. Ideally, we’d our like physicians to have all of our medical information available. We’d like to know how competent our physicians are and how safe a particular hospital is.

Modern technology has equipped consumers with the knowledge and visibility necessary to make informed decisions in most areas of life. We easily can compare prices, quality and availability for retail products and automobiles. But we still have a ways to go before we can expect the same from health care.

Until these realities change, these five relatively simple steps can help health care consumers bridge the gap. Resolving to do each is a great way to start your 2014.

Robert Pearl is a physician and CEO, The Permanente Medical Group. This article originally appeared on Forbes.com.

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