November 21, 2013

Why Some Patients Resist Becoming Empowered

This is not an easy thing to assess, but many patients do not attempt to learn or become knowledgeable about why they see the doctor. This attitude may be costing them money, but they seem to care less. As long as the doctor can give them a pill, which enables them to get on with life, they are satisfied.

Here are some of the types of patients that will not work at or attempt to become empowered.

#1. Lazy or apathetic patients
These patients are generally not patients the doctors wish to see in their exam rooms. Doctors know that these patients can promise anything, but they will walk out of the office and forget about it. Their apathy prevents them from even thinking about why they saw the doctor in the first place. They are number uno in being non-compliant and this is why they cancel appointments or don't even show up. Doctors soon become tired of them and discourage their office visits.

#2. Patients who engage in nonsense thinking
These patients believe that all they have to do is show up for an appointment, then fill a prescription, and they will be as good as new. These patients may be easy for doctors to care for, but they may not be listening to the doctor, may not be taking their medication, and are not doing themselves or their doctors any favors. They generally are in denial of the important role they can play and this will have negative consequences in their well-being and their relationships with their doctors.

#3. Patients who are too trusting
While most doctors are reluctant to admit this, for many, this is their favorite type of patient. These patients are quite adherent, make their doctors god-like, and feel that the better behaved they are, the better care they will receive. Many patients, especially the elderly, have existed a lifetime trusting that their doctors will provide them great advice in their best interests. Even if these beliefs have been disproved time after time, these patients will never make their own decisions, question the doctor's decision, and will continue doing just what they are told to do by the doctor.

#4. Patients who are too ill or incapacitated
These patients generally are not healthy enough to be able to participate in their care to say nothing about becoming empowered. These patients generally need an advocate to speak for them. Whether the advocate is a family member, friend, or a professional advocate, good doctors appreciate an advocate’s role in helping patients that are unable to act wisely on their own behalf.

#5. Fearful patients believing they can't receive safe and/or affordable care
These patients have in the past have suffered a medical error or have experienced egregious behavior by a provider. They, or a loved one, may have been injured by or violated by a doctor, or they may have been treated by a doctor who was drunk or high. It is no wonder that these patients want to avoid the doctors. Some of the patients who avoid care do so because of modesty issues. Many of these patients suffer post-traumatic stress, which further inhibits their ability to seek care. With these patients, they know intellectually that avoiding care may make them even sicker, or will exacerbate an injury.

#6. Patients who fear retaliation
For whatever reason, these patients are afraid to stand up for themselves fearing retaliation and poor care from the provider. For some reason they lack the confidence to advocate for themselves. Most of these patients don't realize they can question the doctor in a polite way to get the care they need. They need to realize that doctors will not provide substandard care in reaction to empowered patients who practice respectful empowerment. The key is “respectful,” because best empowerment practices require respect from all participants. No doctor is worth seeing at all if he or she retaliates by providing less than stellar care to a patient who asks good questions and makes considered decisions.

#7. Patients that are healthcare illiterate or illiterate
These patients are troublesome to many doctors.  Often doctors are not even aware of the problems these patients experience. It is a wise doctor that discerns this problem in patients. Most of time, as long as the bill is paid, no one may be the wiser. My blog here describes what can happen when an illiterate person asks for help. When doctors become aware that the patient is healthcare illiterate or illiterate, most will ask that they bring a family member or friend to help them. Some will even take extra time to explain what is necessary and make sure they understand what is happening. It is a poor doctor that knowingly ignores a patient with this problem if they are aware of it.

#8. Patients that will not believe anything the doctor says and then head to the nearest holistic healer or health food store
These patients are the bane of most doctors. All they are interested in obtaining is a name for what they have and then they tune the doctor out. They will take prescriptions if given them, but will never have them filled. Most of the time these patients just want information to describe what they need from the health food store or holistic person. The doctors can only hope that they don't need an operation or have something serious as even these are often refused.

There are probably more types of these patients that have little or no respect for gaining knowledge about helping themselves. Granted the illiterate are a special case because they haven't the skills to become empowered, but given encouragement by their doctor can progress a long way toward this. I included them because they do need legitimate help, but often the office staff ignore them unless the doctor makes them help.

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