Dr. Julian 1959

Alison’s father, Dr. Julian Orleans, with a tiny patient in 1959.

In the early 1960s, my father was an old-fashioned pediatrician in suburban New Jersey. Once, my brothers and sisters and I went with him on a house call. We sat in the car while he went in and saw his young patient. For years afterward, whenever we drove down that street, we pointed out the “sick baby’s house.”

Back then, when parents were worried about a baby’s teething pain, they talked to grandma or the neighbors. If they did go see a physician, they followed “doctor’s orders” without questions. This was an era, after all, when patients couldn’t research diseases on the internet or easily discover alternative medicine practices.

These days, we know that taking a more active role in your preventive care or treatment is actually good for your health, especially if you are facing a chronic health problem like diabetes, heart disease or high blood pressure.

When you take a greater role, you may feel more in control over your situation and less overwhelmed in the face of an illness. It may also result in better outcomes and better overall health.

Patient-Centeredness at the Hospital

Bonnie Irvin, BS, MPA, is vice president of patient experience at Allegheny Health Network (AHN). Under that wide umbrella of a title, she helps AHN doctors and employees develop processes to put and keep the patient at the center of care.

“Hospital practices traditionally revolved around the doctor. Now we are focusing on what is important to the patient,” Irvin said.

Doctor answers patient's questions

If the “doctor’s orders” don’t quite make sense, ask questions until they do.

“This is a different day and age,” she said. “Patients will research everything and they need a provider who understands that. Patients will ask questions and want answers. If we dismiss their concerns, they will find another provider.”

She said that people are looking at health care as they do other consumable services, like hotels and restaurants, and expecting greater transparency.

“With the newer health plans, members pay differently; they have more ‘skin in the game,’” said Irvin. “They think about their care differently, and may question treatment plans.”

Coordinating Communication With Patients and Physicians

“This year, we are connecting the disconnects in physician – patient communications,” said Irvin. This can involve better listening skills, so that doctors hear what is important to the patient.

At AHN hospitals, good communication is essential to coordinate care. For example, an inpatient’s care is overseen by a hospitalist, but a cardiologist and surgeon might also be involved. “These physicians must talk to each other and coordinate care,” said Irvin. “The primary care physicians should also be included.”

“With good communication, patients will be more likely to stick to the treatment plan because they will understand why they should follow recommendations,” Irvin said.

There are steps providers can take to reduce people’s anxiety involved in navigating the health care system. Irvin suggested that even simple changes like shorter wait times for appointments and clear directions to an office can help.

“For example, with joint replacement, an itinerary is in place so patients know exactly what to expect every step of the way. Patients attend Joint Camp, where they get a clear understanding of what is going to happen to them. This reduces the stress and anxiety,” Irvin said.

Another AHN best practice is having nurses review a patient’s plan of care with them, at bedside, when the nurses change shifts. “This lets patients know what is happening. It keeps them included as part of the process. Patients can question anything that they don’t expect or understand,” Irvin said.

“The most important thing we can do is to make a connection to each patient as a person. While we are doing medical tasks, we can also have a conversation to help relieve the patient’s worries about how their cat, or their children, are doing while they are in the hospital,” she said. “It is these little touches that can mean so much.”

Patient-Centered Care Is a Two-Way Street

Under the patient-centered care model, you need to be fully informed. If you have a chronic condition, learn all about it. And if the information on the internet is confusing, ask questions.

Doctor answers patient's questions“Don’t be afraid to ask questions until you understand the answer,” said Irvin. “Advocate for yourself, or bring someone to your appointment to advocate for you.” She recommends making a list of questions or changes in your health that you want to report. “In the heat of the moment, it is easy to forget,” she said.

If your health is generally good, you are still in charge of keeping it that way. Is there room for improvement in your diet, stress levels or exercise? Ask your doctors what tests and immunizations you need to keep you healthy as you age.

Share Your History and Opinions

Make the most of your time with your doctor. As a patient, you should keep track of symptoms — such as a headache or fatigue. You can also:

  • Write down all the medications you are taking.
  • Share any changes in your medical history: surgeries, allergies and diagnoses.
  • Question any orders that don’t seem to make sense.

If you are a Highmark member, you have a personal health record on your member website. You can also use one of many apps, or an online health record associated with your hospital, such as My Chart from AHN. A personal health record will help you keep track of your doctors’ visits, test results, medications and immunizations. You can view it on a mobile device, to refer to during an appointment.

Other online tools can help you review your day-to-day activities, and even make a report for your doctor. This will let your doctor quickly understand:

  • The effects of a new medication or different dose
  • Your ability to function, work or care for family
  • Your appetite, sleep and energy levels
  • Any pain, dizziness or problems concentrating

You have the right to an opinion, so be outspoken about what is working and what isn’t in your care. After all, if you are at the center of your care, you should be ready to take center stage in your own life.