April 7 was World Health Day and the theme for this year centred on the rights of people accessing health services and how we can better empower health consumers.
As I awaited sedation for a health procedure a few weeks ago, I was reminded how vulnerable we are as ‘patients’, even for those of us who understand how the health system works.
There is something about being face-to-face with a specialist doctor in their consulting room or lying in a hospital bed, that impacts our confidence so that we become lost for words or passive and compliant.
As an article in the British Medical Journal noted more than 20 years ago: “Patient comes from the Latin ‘patiens’ from ‘patior’ which means to suffer or bear. The patient, in this language, is truly passive – bearing whatever suffering is necessary and tolerating interventions of the outside expert.”
I remember my grandmother being admitted to the hospital for a breast biopsy and then waking up to find that a radical mastectomy had been performed. While she was still coming to terms with what had occurred, she had the consultant surgeon and five medical trainees at her bedside in the morning discussing the surgery as if she wasn’t there. Not surprisingly she burst into tears.
The surgery saved my grandmother’s life and she went on to live into her late nineties. However, it took her a long time to recover from her experience.
Thankfully much has been done over intervening years to strengthen the patient voice and protect the rights of consumers receiving health services. However, take a moment to think about the last interaction that you or your whānau had with health services.
If you were awaiting a significant diagnosis, chances are that you had a high level of anxiety, and when the specialist said “We need to do more investigation” or “I recommend surgery” or “You have cancer”, you found it difficult to concentrate from that point on.
About two-thirds of people leave a doctor’s office and realise they’ve forgotten to ask the questions they intended to ask, according to a survey undertaken by Wolters Kluwer Health. And of that group, 19% think of new questions to ask their health care professional after their visit, the survey found.
One thing that New Zealand’s Code of Health & Disability Service Consumers’ Rights advocates for is your right to have a support person with you. Having someone alongside you who can take notes and prompt you if you forget your questions, can be invaluable.
It’s also important, given our multicultural society and diverse make-up, that we remember all patients have the right to interpreter services. Every consumer should be able to receive effective communication in whatever form, language and manner that can help them understand the information provided.
The code also mandates your right to effective communication and comprehensive information, so that you can make informed choices and give informed consent for treatment.
The curricula of medical schools in both New Zealand and Australia identify communication skills as a core competency required by doctors and provide specific training on this topic.
However, effective communication is a two-way exchange, which suggests we need to lift the skills of healthcare consumers as well as health professionals. As an organisation that supports the health and wellbeing of everyday Kiwi workers, UniMed wants to help.
We have developed a guide for people to navigate the unknown terrain of medical land and ask the right questions.
When my grandmother saw her specialist and consented to treatment, she thought she was just having a biopsy and didn’t understand that if an issue was identified the doctors would operate immediately. If she had known what questions to ask, she would have been better prepared for what awaited her when she came out of anaesthesia.
As usual, I’d love to hear your thoughts or observations on this important issue, please drop me an email at ceo@unimed.co.nz.
Ngā mihi,
Louise Zacest
Chief Executive
UniMed