How Can You Receive the Best Health Care?

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Ueno.jpgBy Danielle Walsh, Morgan Welch Inflammatory Breast Cancer Research Program and Clinic

TED (Technology Entertainment and Design) is a global set of conferences curated by the American private, non-profit Sapling Foundation, formed to disseminate "ideas worth spreading." TEDxTokyo 2011 - Enter the Unknown was a symposium of more than 30 speakers focused on exploring "practical and inventive ways of rebuilding and renewing Japan" following the March 2011 earthquake and tsunami. This event, streamed live online in May, brought together experts in sustainability, finance, health and social change with musicians and entertainers to address issues related to human coexistence, solutions, life of purpose and forward thinking.

Naoto Ueno, M.D., Ph.D., executive director of the Morgan Welch Inflammatory Breast Cancer Program and chief of the Section of Translational Research in the Department of Breast Medical Oncology at MD Anderson, was one of the invited speakers. Although he was speaking to the people of Japan, the lessons he shared with the audience are applicable to patients everywhere.

Wearing a T-shirt that says "I'm not a doctor," breast medical oncologist Naoto Ueno, M.D., Ph.D., engaged an audience at TEDxTokyo 2011 in a presentation on mutual empowerment in health care. Who better to address this paradigm of the patient-physician relationship than someone self-described as "The 3 C's": cancer doctor, cancer researcher and cancer patient? Ueno's unique perspective can help others seeking the best care for oneself or for one's patient.

Best is in the eye of the beholder
"How can you receive the best care?" is the million-dollar question when you come down with an illness, whether it's a toothache, the flu or cancer. However, before you can answer that, you have to understand what "best care" means. 

According to Ueno, there's no one answer,-- it's different for each individual. In the patient-physician setting, a physician perceives best care as providing care founded on proven science and knowledge. Physicians treat patients knowing the certain predictable effects of treatment regimens. Meanwhile, the patient's idea of best care is focused on needs, which may include quality of life issues like increasing comfort or minimizing time away from work or school.

Often, these differing opinions contradict each other, and both a patient and a physician become dissatisfied with the care. Thus, Ueno suggests that best care and highest satisfaction are achieved when best knowledge (physician) and best needs (patient) align. 

Patient power
Patient empowerment is the key to aligning the stars, so to speak. A patient's power resides in being the center of care and having knowledge of his or her illness. Interestingly, some patients don't know their disease name, don't know the medicine they're taking or are unfamiliar with their medical history.

These individuals have zero ownership of their health. If you want to know what's going on with your health situation, Ueno recommends bringing good, probing questions to ask the doctor and a recorder to document the conversation. This way, when you get home after a long day of appointments and realize you can't recall exactly what the doctor said, you can listen to the dialogue with confidence.  

Also, take time to confirm with your care provider that you're receiving the standard of care for your diagnosis. And if not, find out why. Co-existing conditions, like diabetes, may impact your treatment options and require deviation from treatment standards.

Patients also can empower physicians to provide them with the best care. This is achieved through openly communicating desires about what you want out of treatment. Is your goal to get out of the house and back to work? Or maybe you want to not feel pain? Are you seeking the cure or do you want to improve your quality of life? 

Ueno suggests you should challenge your care, especially if you are dissatisfied. It's OK to be angry but constructive criticism will better serve you and the physician versus screaming and yelling. At the same time, a passive approach of just nodding your head in agreement with the doctor won't help, either. 

Health care is a mutual thing. The patient and the physician must rely on each other to actively participate in an effort to achieve best care and ultimate satisfaction, no matter what your goals.  According to Ueno, patients should practice empowerment in all health situations, including colds and headaches. "Because if you don't do it then, you won't do it when you get cancer," he says.

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