Taking control of your healthcare is one of the most significant choices one can make. Navigating healthcare often feels like being in a maze with no direction and no easy outlet. I know, having dealt with both radiation and back surgery in one year. My guest today on Straight Talk Radio is Edward Leigh founder and director of the Center for Healthcare Communication. An a seasoned
healthcare professional with over 20 years in the field, Edward is an expert when it comes to navigating and explaining how you can take control of your healthcare needs. If you have questions that remain unanswered related to your healthcare, listen to this show. Edward Leigh offers incredible insight!
To hear the interview click here: Edward Leigh interview on STRAIGHT TALK RADIO.
Tired of traditional talk? People pontificating about this or that? The left or the right? Sometimes the truth is just off lost in the noise. Having learned life lessons the hard way, Chuck Gallagher, international speaker and author, cuts through the noise to share truth through transparency!
Nationally-known guests talk about what’s important to you – your life, your concerns and your success. So tune in, turn on to Straight Talk with Chuck Gallagher.
Now, here’s your host, Chuck Gallagher.
CHUCK: Well, this is Chuck Gallagher with Straight Talk Radio and it is such a pleasure to be with you. One of the most important decisions you will ever make in your life, now let me stop and let me restate that, one of the most important decisions you will ever make in your life is who you’re going to choose to be your healthcare provider. And [chuckles] if there has ever been a show that has been more timely, I guess it is perfect for me right now, because I am now 10 days in from recovering from a back surgery. It was kind of funny. I had no idea what took place, and why the back kind of went out, and why I ended up with a herniated disk, and I can promise you, I tried everything imaginable before surgery. My wife is, she’s very much into alternative medicine. I did alternative stuff. I did anything you could think of and ate all kinds of crazy things and nothing seemed to help.
When I got to the place where it was like okay, I’m ready for surgery considering the fact that I absolutely hate needles and abhor anything that has to do with invading my body, I knew it was time. I think we should have done this show maybe a little bit before that took place, because I have a sneaking suspicion that today you all are going to hear some really cool things about what we need to do to take charge of our healthcare. You know, how could you find the best doctors, the best hospitals, the best rehab centers? What questions do you ask the surgeon? That’s interesting since I interviewed surgeons before selecting the one that I wanted. How can you protect yourself from common medical errors?
Today’s guest is Edward Leigh. He is the founder and director of the Center for Healthcare Communication and he’ll answer all of these questions and more. He’s a seasoned healthcare professional with over 20 years in the field. He works with healthcare professionals to help better communicate with patients and he works with patients to help find the best medical care. He has appeared on The TODAY Show, MSNBC, The Learning Channel, The Discovery Channel, and can currently be seen on the Oprah Winfrey Network and it’s an honor to have him here with us on Straight Talk Radio. Eddie, thank you so much for joining us today. Man, I feel like I’m in the presence of a rock star! This is way cool. Thanks for joining us.
EDWARD: It’s my pleasure. Thank you for inviting me.
CHUCK: Now, when you’ve been interviewed by Katie Couric and Montel and now it’s Chuck Gallagher, Gosh, I just, you know, feel special. Look, let me start off with something. You know, it’s a little bit strange in one sense of the word, because I’ve had this year, this past year, let’s put it in perspective, 2014, going into 2015, 2014 must have been the medical year. I had some evidence of recurrent prostate cancer and ended up having some salvage radiation treatment. Went through a whole search to find out what to do, how to do, where to do and who to choose, and I found out in that process that sometimes, and I’m not saying all the time, but sometimes the choice that we make isn’t always what we want. It’s limited by what the insurance company seems to deem appropriate for us. So, I know it’s a strange start, but are we kind of hostage to the insurance company or do we have that ability to really make the choice in our care?
EDWARD: Well, actually of course it is based on your insurance and recurrence, but I do find that with insurance companies there is some flexibility. Like, for example, my mother’s insurance company said, you know, they had these rules, so I talked to them and I said, “Well, found this great surgeon and would my mother be acceptable?” and I filled out some forms. They took it to a committee and it was accepted. So there is always a process for– They might not always say yes, but there is a process for it, absolutely.
CHUCK: It’s interesting, because what I just heard you say was, and I’m not sure that most people do this, but what I heard you say was is you’re taking charge, you’re calling, you’re not just relying on the medical community or the insurance company. You’re actually interacting with them to decide, well, here’s where healthcare needs to go.
EDWARD: Yeah, and actually I learned the hard way. I learned the hard way. Even though I’m a seasoned healthcare professional, I’ve been in healthcare since ’89 and I tend to be extremely trusting of other healthcare people, and what happened was it was in the mid 1990s. I started to have soma abdominal issues. At first my doctor said, “Oh, it’s nothing serious, you know, irritable bowel syndrome. You’re young, you’re healthy, you’re in good shape. I think it’s probably irritable bowel syndrome,” but these abdominal problems continued. I said to him, “I think something’s going on,” so he says, “Okay, we’re going to do a test on you.” This was in early 1997 and he did a test called the sigmoidoscopy, it came out well. I thought, well, I’m fine so it must be this irritable bowel syndrome. But I was progressively getting sicker, slowly I was getting sicker and sicker, the abdominal issues, and every time I went back to him and he said, “Oh, you’re young, you’re healthy, the test was normal,” but my health continued to deteriorate over the next two and a half years. What happened was, in mid 1999, everyone in the family was on a certain health plan and they said, “Eddie, you’ve got to go on this health plan! It’s excellent. You and your wife Beth, you need to be on this health plan.” So we switched health plans. Not that we didn’t like the doctor–
EDWARD: We were thrilled with this new health plan. Then in the summer of ’99 I got very sick. Actually, we’re both a member of the National Speakers Association. The ’99 convention, I’m ready to go to the convention and I became very ill. Here I’m seeing a new doctor for the first time. He did some blood work, he said, “I think you’re okay to go to your convention.” Went to the convention, was in the hotel room sick during most of the convention.
CHUCK: Oh, no.
EDWARD: Got back from the convention and within an hour of being home there’s a call from the doctor’s office saying, “Something’s wrong with your blood work. You’re very anemic and young guys aren’t supposed to be anemic. We want you to undergo a test tomorrow.” And they said, “We want you to undergo a colonoscopy.” I said, “Oh, I think I had that test.” They said, “No, you had a sigmoidoscopy. That’s a different test.” I had the colonoscopy done. Wasn’t too bad, you know you, there’s some prep involved, but you know, you’re sedated so, during the procedure–
CHUCK: You say it’s not too bad I’m [laughs] not so sure about that, but that’s okay. Let’s go forward.
EDWARD: I sleep right through them so the prep is not the–
CHUCK: That’s the worst part. That’s true.
EDWARD: So I thought, okay, you know, I’m anemic. It’s probably a bleeding ulcer. I had the procedure done and when I came to, my GI doctor was standing there and he said, “I’m sorry, I’ve got some bad news for you. You have colon cancer.” I said, “What?!” I mean I was just– I said, “I had a test done two and a half years ago that came out normal.” He says, “Well, here’s the thing your first doctor didn’t tell you. The sigmoidoscopy is only a partial exam. It only sees the left part of your colon. The colonoscopy is a complete colon exam, sees the entire colon.” I had that test in mid, early ’97 and it came out normal, because it missed my tumor. My tumor was on the right and it only sees the left.
EDWARD: At that point I said, “I need to take charge of things,” because I was in healthcare. I was so trusting of people in my field and from that moment on I was in charge, I was my own advocate and what I noticed when I was going through, and I ended up having a stage III colon cancer. The cancer had spread to lymph nodes so I had a year of chemotherapy, and I noticed when I was undergoing the treatment and working with a lot of healthcare people, they would use a lot of medical jargon with me and never explain what it meant. You know, the people didn’t know I was in healthcare and I thought “What if I wasn’t in healthcare?” Like if I had one bone scan and the radiologist came to talk to me and he came in, this is what he said, “You’re unremarkable,” so I thought, oh, that’s wonderful! I was thrilled and I thought, wait a minute, if I wasn’t in healthcare, I wouldn’t know that unremarkable meant nothing is there, I thought maybe you would just think I’m bored.[Chuck and Edward laugh]
EDWARD: And also insignificant is a good word. In healthcare you want to be insignificant.
CHUCK: I hear you.
EDWARD: Insignificant, because nothing’s there. And also one other thing, I noticed empathy was not present. If someone used empathy, I think I would need additional medical attention, because it was so infrequent. So I thought, something has to be done. The communication skills need to be improved, the empathy needs to be improved, and at that time I switched, part of that time I was speaking, training primarily about employee engagement and I switched to helping healthcare professionals communicate with patients. So that’s how it all started.
CHUCK: Got you. Now, let’s talk about how to find the right doctor and I want to say it this way, back in 2004 I was diagnosed with prostate cancer, and we by the way are going to push a break here for just a second so I might describe this and then we’ll go into the break and come back and talk about selecting that right doctor, but I was diagnosed with prostate cancer and the doctor came, he said, “You have cancer. There are four alternatives,” and he explained the four alternatives. He said based on my age it should be surgery and he could schedule me next week. Now, I thought to myself, wow! I need a little time to digest this, and I ask him. I just had the presence of mind to say, “How many of these surgeries do you do?” and he said “I typically do one to two a week. I’ve been doing this for a number of years.” I said, “Well, I’m going to have to go talk with my wife.”
What I ended up doing was research quickly on the Internet and found out that, based upon the stage that I had, there was nothing urgent about what needed to be done, which gave me time. I began searching where’s the best place for urology and what’s the best surgeon, and, of course, Johns Tompkins was one of the places that popped up, and when I talked to them, what I found out was I could have the robotic surgery, which was less invasive, and the doctor I talked to had done 600 in two years. Now, I don’t know, but something said to me that cutting-edge technology, less invasive, and somebody that had done 300 a year, or 1 a day, fundamentally, was probably a better choice than somebody that does it twice a week.
EDWARD: That’s a great choice.
CHUCK: So, that said, we’re pushing a break. My guest today is Edward Leigh. Edward talks about taking charge of your healthcare and what we’re going to talk about when we come back from the break is how do you select the right doctor? What do you do? What’s the process? And how do you select that so we don’t become doctor enamored with the first person that happens to be referred to us or that we’re told to talk with? This is Chuck Gallagher with Straight Talk Radio. We’ll be back in just a moment.[Commercial break]
CHUCK: We’re back with Chuck Gallagher. This is Straight Talk Radio and my guest is Edward Leigh. This segment and what we’ve been talking about is taking charge of healthcare. I have found in talking with my wife and with folks in my family, it’s fascinating to see how little effort people put into selecting their healthcare provider. It’s almost as if we’ve got, I don’t know what you call it, this idea, this fascination that if somebody says, “Oh, you’ve got X, go see this doctor,” we just go blindly and don’t ask questions. And that makes no sense to me.
EDWARD: Yeah. People do more research on finding a new car than finding a doctor.
CHUCK: Isn’t it the truth? It’s the craziest thing! So tell us, Eddie, from your perspective, what’s the process a person should go through in selecting a physician?
EDWARD: Sure. And the first thing I did want to mention that I’m in healthcare, I work with healthcare people and the vast majority of healthcare people are wonderful, and caring, and they do a great job, but unfortunately, for us minority people things happen and that’s why we have to do some research. There’s a number of things that we could do.
The first thing actually we could do is go to Google, type in your state name, you know whatever state, Florida, South Carolina, Alaska, and then type in this word “state medical board”. So your state name, then state medical board, and then your state medical board pops up and you will have an opportunity to type in a doctor’s name and find out information about him or her.
EDWARD: You get a huge volume of information and it’s important to do this, of course, before we see this doctor and there’s been actually some tragic results. In 2007 the mother of a rap star Kanye West, she decided to undergo some cosmetic surgery. Sadly, she died shortly after the cosmetic surgery. What was discovered afterwards, and unfortunately people don’t think about this, but now we need to, is if someone would have gone to the California State Medical Board site, he had a huge list of violations including violations related to DUIs, issues with alcohol abuse, and also a huge list of malpractice cases. Now, if I saw that, I would say, “Maybe this doctor is not for me.”
EDWARD: But that came out afterwards, so that’s a sad example of why we need to be our advocate. There’s another place we could go, the Federation of State Medical Boards, it’s fsmb.org. They have an added service and it’s a small fee, it’s $9.99, but if you’re having a major surgery, this is a good place to check out, because if you go to the State Medical Board, you will get information for that state.
But let’s say you’re in South Carolina and you’re seeing a doctor in South Carolina, you go to the South Carolina State Medical Board and see everything looks good. But what if that doctor practiced for 10 years in Colorado and he or she had problems? You won’t know about it. So if you go to the Federation of State Medical Boards, fsmb.org, for a small fee $9.99, then you can do a comprehensive search, check out the doctor, him or her, in every state, do a comprehensive evaluation so you get a very thorough piece of information. So for $9.99 it’s worth it.
Also some other things, the American Board of Medical Specialties has a website called Certification Matters, so you can check is this person certified? I mean, here I’m seeing a surgeon, or I’m seeing this person, are they certified in this field? You could check that out.
Also, there is physician rating sites, but those are very subjective, very subjective. Say you see all these wonderful, you know, wonderful information about the doctor, keep in mind it’s very subjective, and what I recommend is you go to all these different sites, the State Medical Boards, Certification Matters, and also I recommend a general Google search. I’ve done some Google search on doctors, the first thing that came up was the multiple medical malpractice cases. So you look at all the information as a whole and then make a decision and that’s the best way to find top-quality physicians.
CHUCK: Now, one of the things, Eddie, that I found an amusing personal experience, and I’m going to say on the front end I’m a fairly healthy person, although I’m recovering from a back surgery right now, kind of a funny feeling when you’re 57, thinking you’re 39 and then all of a sudden you end up finding you have to have a cane to get from the bed to the bathroom and you feel like you’re 77. I’ve learned a little compassion now in finding folks that move slow through airports. I get the idea of doing the Google search and I get the idea of checking their credentials. The thing that strikes me is I want to know if they’re good at what they do. You know, I want to know do you have the skills?
A perfect example in the circumstance with the back surgery, before I ever got to the place of saying, “Okay, I need a surgeon,” one of the things that I did was look in the area and talk to other physicians, outside of, no, you know, not neurosurgeons or orthopedic surgeons, but people that are in other physicians that were friends and said, “Listen, if somebody was going to operate on your back, who would you choose?” and I had the same name keep coming up. I thought, okay. Well, there must be something if one person’s name keeps coming up. My stepson is a nurse anesthetist and so I ask him the question and he said, “Well, there’s this particular doctor.” I’m switching areas. By the way, I don’t think I should be limited to an area. So even though I live in Greenville, South Carolina, my surgery was done in Charlotte, but I was considering doctors in Raleigh, Greenville and Charlotte, because I wanted the best physician, but most of the time I was trying to find from medical professionals, who they would trust to do the work on them. Then call those doctors, schedule an interview, go in, talk with them, let them look at my MRI and tell me what they think needs to be done, because I think if enough of them tell me the same thing that must be true, and if I start to hear something kind of dramatically different, or someone’s surgery happy or they don’t do enough of them, I just need to pass on that surgeon.
EDWARD: Absolutely. Actually, you took the words right out of my mouth. I always say talk to family and friends, of course, and then talk to other physicians to get information about this person. Now, coming in, of course, we’ve already done our home works, so we already know where they went to school, where they did their residency.
EDWARD: We already know if they’ve had any medical, DUIs, or malpractice, or whether they’ve had some serious things going on. Talking to other physicians and then it sounds like, of course, then the next thing to do is coming in with a list of questions: How many surgeries have you done? I always tell people if the surgeon, say for example in this case, has issue, “Well, you know, that’s not important”, but if they start getting very defensive, that’s a red flag [chuckles] that you need to–
EDWARD: You need to exit. And also in addition you talked about I think your son-in-law being a nurse anesthetist?
EDWARD: That’s the one thing that people– I recommend about surgery, in addition to finding out about the surgeon, find out about the anesthesia. You know, who’s doing the anesthesia? What I do is I also do research on the nurse anesthetist or the anesthesiologist. What kind of record do they have? What kind of anesthesia is being used? Is it a general or is it a local? People sometimes forget to ask those questions. So you want to find out about them. Also, sometimes people don’t think about this, will the anesthesiologist or nurse anesthetist be present the entire time?
EDWARD: Will they be there for the entire time? So these are also questions to think about. And once again from all of these questions, from the State Medical Board site, once again I always recommend you want to look up all the information together. If there’s one little blur, one little something, you have to think about, what about all these good things, so you always have to look at all the information together before you make a decision.
CHUCK: You know, Eddie, one of the things that I thought was kind of interesting, and I’m flipping back and forth a little bit with–
CHUCK: Some of the medical issues, but back in 2005 when I had prostate cancer surgery up in Johns Tompkins, my stepson, the nurse anesthetist, he said, “Okay, I’m going to recommend these two drugs for you.” Now, I’m going to tell you on the front end and then on the show, I don’t remember what they were, I’m not a drug person, but he said, “I’m just going to suggest these two.” And I said, “Okay. I appreciate it.” He said, “One, you’re not going to remember a thing, which will probably be good, and two, the other particular drug will likely keep you from having un unpleasant experience after surgery, you won’t be sick.” So I go to Johns Tompkins and the anesthesiologist comes in and says, “Okay, we’re going to get ready to administer the anesthesia,” and I said, “Look…” and I handed him a piece of paper and I said, “I want these two drugs.” He said “Who told you about them?” I said, “My stepson. He’s a nurse anesthetist.” He said, “Well, that’s the good stuff,” he said. “Now, since you’ve requested it, we can use it. We normally don’t, but since you’ve requested it, we can.” And I was like, well, you know, if someone hadn’t told me, I wouldn’t have known and I’m assuming that that probably means I had at least, through the surgery and following, perhaps a slightly better experience than I might have had.
CHUCK: it’s absolutely fascinating that what you’re advocating is someone take control of asking the questions and not get enamored with just what you’re told.
EDWARD: Right. Being your own advocate. Also what I recommend is, for example, after I was diagnosed with colon cancer. What I immediately did is I started getting in touch with colon cancer organizations, non-profit groups. What they did is on their site they had lists of questions about before you select an oncologist, before you select a gastrointestinal surgeon, these are the questions you need to ask, these are the things you need to think about in terms of medications, in terms of recovery. When I walked in, I had those questions typed out, ready to go and I left space between questions so I could write things down and, like you said at the beginning, you know, I was pretty thorough with the questions and my doctor says, “I wish all my patients were this thorough.”
CHUCK: Right. Well we’re getting ready to come up on a break. I will say to you with modern technology, and I know this is a little bit weird, some people might find it offensive, but with modern technology when I went in most recently to interview doctors and determine what was going to take place, I put my phone on record, so when I had the conversation with the doctor and walked out, I could replay it and hear it again to make sure I knew what the answers were, because I wasn’t going to take time to write it down with pen and paper. But, you know, the nice part about it is I was able to have a really great conversation and become comfortable with the person I selected.
EDWARD: Absolutely, that’s great. The only thing, for people who are listening, is you always have to, if you’re going to record, you always have to make sure it’s okay with the person that you’re–
EDWARD: Having the conversation with.
CHUCK: Right. That is absolutely true. This is Chuck Gallagher with Straight Talk Radio. We are talking about taking charge of your healthcare. We’re coming up on a break so stick with us. We’ve got a whole lot more to talk about on this very important subject. My guest is Edward Leigh and we’ll be back in just a moment.[Commercial break]
CHUCK: Well, we’re back with Straight Talk Radio and my guest is Edward Leigh. Edward is a seasoned healthcare professional with over twenty years in the field. He’s been on shows like The TODAY Show, MSNBC, The Learning Channel, The Discovery Channel and Gosh, he’s on the Oprah Winfrey Network, which I think is awesome, and he talks about the importance of taking charge of your healthcare and he is the founder and director of the Center for Healthcare Communication.
Now, we’ve been spending time talking about selecting the right doctor and, Eddie, I think it’s, well, I’m going to say it’s normal for me but maybe weird for people, because I literally interviewed three different doctors, two of which thought they were going to be my surgeon, before I selected the one who ultimately performed surgery. I have to be honest, I looked at it as this was my body and it ultimately was my decision and although I am sure the two that I rejected were fine people, they just weren’t the right fit for me. So, what do you do whenever you fire your doctor or you decide you want to select someone else?
EDWARD: Well, let’s say– Often times I have adult children contact me, “My dad’s doctor isn’t very good and I don’t know what to do about it. He loves him, but, you know, what should I do?”and the first thing I always ask, “What is the issue? Do you have a concern about the doctor’s clinical skills or is it more of a communication issue? What’s the issue going on here?” Now, if it’s clinical skills, that’s a big red flag.
EDWARD: If it’s communication skills people would say, “Well, he might not have good bedside manner or she might not be very pleasant, but she has good clinical skill,” but the thing is communication skills actually tie into potential errors, because if people don’t listen very carefully, they miss parts of the history and they could put you at risks. So the communication skills is more than touchy-feely bedside manner.
But let’s say you’re with this doctor and you’re not very happy and it’s time to move on, before you [chuckles] move on to a new doctor, make sure you have, before you move away from the old doctor, make sure you have a new doctor waiting in the wings. You don’t want to just suddenly leave and not have anyone new. And then people always say, “Do I have to talk to the new doctor and tell him or her that I’m leaving?” Well, that’s a personal decision. I’ve talked to people who have just found a new doctor and just left without any word, but I always recommend if you could, as a learning opportunity, either talk to the physician, or talk to an administrative professional, say the leader of the practice and voice your concerns, and of course be prepared that they’re going to tell you, “Oh, things will change. We still want you,” so you have to be prepared. But I always recommend letting them know what the issue is and also, if you do have a concern, I always recommend the ABC rule – Always Be Courteous. You know, always be pleasant saying, “I just don’t feel this is a good fit and I found a new physician…” Just always be pleasant, always be pleasant about it, but it’s your right. If you’re not happy, because I fired my first oncologist and the reason I fired him is because everything I mentioned he would just brush me off. I’d say, “Welly I heard about this new medication.” “Oh, no, that doesn’t work. Don’t even think about that.” “Well I’ve heard about this.” “Oh, that doesn’t work.” So after the second visit I decided to see– Plus, his communication skills weren’t very good. He never gave me a prognosis, but he would give me clues, like he once said to me, “Is there a place you’ve always wanted to travel to?[Chuck laughs]
EDWARD: Now’s the time to go.” And I thought, [chuckles] oh, this is not good. When they’re telling you to take your big trips [chuckles], I thought, this is not good news. After that– But at the time I didn’t tell him I was seeing a new doctor. After that I found a new doctor and it was time for another visit. I saw this new doctor. It was actually within the same oncology practice, but I just found a new doctor and we had a great rapport, great experience.
CHUCK: It’s interesting, and I want to move to the question about hospitals, but it’s interesting, I’m not sure the words I want to use, Eddie, but the tribe mentality and here’s what I mean by that. I not long ago had gone in for an epidural. Now, that’s something that I never in my wildest dreams thought I would do. The idea of a 10-inch needle stuck in my back was just–[Chuck and Edward chuckle]
CHUCK: Just didn’t suit it, because I hate needles, but, you know, to get rid of the pain, “Okay if that’s the process, I’m good with that,” and I again, found the guy who everybody said, “This is the man. He is really good at what he does.” We struck up a conversation and I said, “If it goes to surgery, who would you choose?” and his comment was very interesting. He said, “Well, in Greenville, I’m going to use our location, there’s two factions, there’s two tribes so to speak. There’s one associated with hospital A and others associated with hospital B. Now, I’m associated with hospital A, so if you stick with this, then the person in this tribe would be,” and he named the doctor. He said, “However, in the other tribe with the other hospital, here are the two people I would recommend,” and I thought number one, I appreciate the fact that he wasn’t just pigeonholing me into the group that he was associated with, that he was willing to give me the information across party lines, so to speak. Kind of like republicans and democrats, he was willing to go on both sides of the isle.
But I guess it’s interesting from a hospital perspective, the doctor you choose typically is associated with the hospital, which generally means that’s the hospital, that’s the de facto hospital of choice. So what do you do whenever you think to yourself, man, I found the right doctor, but then you know you’re stuck with the hospital. If you don’t like the hospital, are you concerned?
EDWARD: Yeah, well, what I recommend is actually getting objective data in addition of course to talking to family and friends. A place you can get objective data, and once you get into this, it’s easier to do a Google search. You go to Google and you type in “hospital compare” and that will take you to a website where you could type in the hospital name and you get incredible data. You get patient satisfaction data, you get data on the information about how many deaths they’ve had, how many infections, how many errors. So this is where you get a great deal of information about the hospital. Also another place to go is, go to Google and type in, let me make sure I get it right, “US news and world report best hospitals” and you get information about the hospitals.
There’s one hospital, I thought it was very interesting, my wife and I talked about it. They’re considered the top hospital for a certain type of care. However, when I looked closely at the hospital, they give ratings for medical error rates, five being good, very little errors, one being very poor. They were number three. So if you’re in the top in this area, but for medical errors they are number three, so you know, that was a red flag for me. Once again, you have to look at all the data together. You talked to family and friends, you talked to other doctors, you looked at this website. So you have to look at all of the data together and then make a decision based on that. That’s what I always recommend; not just one piece of information, you want to gather all this data.
CHUCK: That’s interesting, hospital compare. I guess it’s kind of like doing a comparison for cars. Like you said, we spend more time searching for the right automobile than we search for our healthcare. I also assume, Eddie, and help me a little bit with this, it seems that perhaps the type of insurance we have might determine the hospital we can select. Is it becoming more restrictive with the Affordable Health Care Act or is it more open?
EDWARD: Yeah. The thing is there is restrictions and designations, but what I find is if you talk to the insurance company, like with my mother, she had to be this place or that place and I said, “But through my research and through interviewing other physicians we found this particular surgeon that I think would be a good fit,” and I wrote letters, and went to a committee. So with enough push you could, you know, get things to change. People sometimes don’t think that, they say, “Oh, okay, according to my insurance I can only this, this and this, so end of discussion.” But if you move forward, you state your case, you say, “This is the surgeon I want, or this is the physician I want, this is the center I want,” and in many cases you could work it out, but it takes that effort.
CHUCK: Now, let’s just assume for the moment we’ve done our homework, we know that we’re going into a hospital for some form of procedure or so, how do we prepare for the hospital visit?
EDWARD: Yes, once again, we’ve already done a lot of our homework: we’ve talked to the surgeon, we’ve talked to people involved, so the first thing that I would do is get information, in terms of preparing, asking about, “How long am I going to be here? What will happen? I want to know every step of the way. What’s going to happen on day 1? What’s going to happen on day 2? What’s going to happen on day 3?”
Also, I recommend, if we’ve had surgery, we’re going to be a little groggy, who in the family or a friend is going to be your advocate while you’re groggy? Who’s going to be the designated person? It could be a spouse, it could be an adult child. Think ahead who’s going to be the advocate? Who’s going to be checking on everything?
Also, I always recommend asking people what medications are you going to be getting? And also, I always double check when I walk in. I go over everything very carefully. Like for example with my mother, I’ll say, “These are my mother’s allergies. These are the medications she’s taking. These are the dosages,” so I go over all of that with them. Now, people assume that you’ve got that information. Well, I’ve found quite a number of errors. Go over all of the medications, go over everything and then you ask, “What’s going to be happening? How long will everything take? When am I expected to be back in my room? When am I expected to be discharged, assuming everything goes well?” So you want to know the entire story.
CHUCK: It’s interesting when you were saying what medications and so forth, most of the time, most, I have found in the experience that I’ve had is that they always want you to fill out new paperwork and so forth. I’ve had probably the best experience with OrthoCarolina where I had my surgery, because most everything is online so I can fill out my name one time, thank God, my social security number one time, and just answer online questions. It goes into their system and when I get there, they have all the details and data. Now, I know from what they’ve told me, not everybody likes that, but I thought it was awesome.
CHUCK: Now, I have to say we’re running up again on a deadline. Taking charge of you healthcare is important. I started off by saying this is one of the most important things in our lives that we can do. My guest is Edward Leigh. We’re going to take a short break and we will be back to talk about medical errors and what to expect and what not to expect and where we can go from there. This is Chuck Gallagher with Straight Talk Radio.[Commercial break]
CHUCK: Taking charge of your healthcare is a critical thing for any individual to do whenever you’re facing any types of healthcare issues. This is Chuck Gallagher with Straight Talk Radio and my guest is Edward Leigh. Before we move forward, I want to make sure, because I know from some of the little popup notices that I’ve received, that people are interested in where they can find you, Eddie, so it is communicatingwithpatients.com. Let me repeat that, communicatingwithpatients.com or you can call Edward at 800-677-3256.
Eddie, I want to kind of branch off from the hospitals for just a second. My mother-in-law is an assisted living facility and when she went in, it seemed to be the right fit. Unfortunately, she has started to experience dementia and perhaps the early stages of Alzheimer’s and it’s caused us to raise some questions about the facility. Seems to be a great place, but they don’t seem to keep records. The only records they seem to have are what the doctor says, but there aren’t records on file that says she’s been wandering the halls, wandered outside the facility etc. So how do we choose the right nursing home or assisted living facility to make sure we got the right fit for the person that’s there?
EDWARD: Yeah, there are a number of things and it’s very similar to selecting hospitals. I always mention check in with family and friends, of course, but once again it’s very subjective with family and friends.
EDWARD: To get objective data, go to Google, type in “nursing home compare” and then you get a website, and you type in a nursing home and you get incredible data, incredible data. You get information about staff, and you get information about safety. Just an incredible volume of data and I’ve known several people that actually switched long-term care facilities, they switched rehab facilities. We actually, with my mother, we switched facilities based on that because we weren’t very happy with the first place and we went online and we were horrified by what we saw. We said, “No wonder she’s having a bad experience,” and we switched her to a facility that had excellent ratings on that site and now it’s a dramatic turnaround.
CHUCK: You know, it is fascinating to see what can, I guess, what can be found on Google and so many people—Frankly, I wouldn’t have thought about the compare. I think the hospital compare and the nursing home compare is some of the best advice that we’ve heard on this show, to be able to sit down and to look at something side by side and make the right decision. For us it was a challenge whenever my mother-in-law literally knew the code to get out of the building, but forgot the code to come back in.
CHUCK: Which happened to be the coldest day of the year, this year, thus far, and had someone not seen her, we don’t know what the outcome could have been. Now, that doesn’t mean that the nursing home is deficient or defective, but it does raise some fairly serious questions when you think you have entrusted your loved ones’ care to a place that will keep them safe. So, the idea of a compare is great. But what happens–
EDWARD: Yeah, I think–
CHUCK: I’m sorry, go ahead.
EDWARD: And also I want to mention this one other thing. With every place there’s always some level of risk.
EDWARD: What you want to do is you want to minimize the risk. Like, my mother’s in a wonderful facility now, but we’ve had some small issues there, but they were minor compared to the first place.
CHUCK: Well, and that makes sense, and you’re never going to find the perfect situation. I would assume probably every hospital is going to have some challenge with the patient and there may be an error, we are human beings and the likelihood that everything is going to be perfect is not there. But what happens whenever there is an error? And by the way, what are the most common errors?
EDWARD: Yeah, the most common error, people are often surprised at this and this is 80% of medical errors based on an organization called The Joint Mission. They accredit hospitals, they let them stay open for business, 80% of medical errors are due to miscommunication when a patient is handed off from one group of healthcare professionals to another group of professionals, and I classic example is someone is in a traditional hospital, we call it in the healthcare “acute care hospital”, a hospital, and they go to a rehab center. That is known as a handoff. What I think about is when we were kids you probably, I played this when I was a kid, a game called Telephone.
EDWARD: And you whisper into a kid’s ear and then the message goes all the way around in a circle and by the time the last kid hears it, it’s a completely different message. So, when you’re kids it’s a lot of fun, but you don’t want telephone game results in healthcare. So, people always say to me, “But I’m not…” Say if you’re dealing with your adult parent, “But I’m not there during the handoff. I don’t have any control.” However, we might not be there, but we should know every bit of information that is being handed off.
For example, my mother, this was 2009, my mother has dementia. Now she’s in long-term care, but when she was in the early stages, she was walking with her friend down the street and suddenly she starts to feel faint and starts falling on the ground. They call an ambulance, my brother and I rush to the emergency department and in the emergency department they said, “Your mother has a heart condition called atrial fibrillation and she’s going to be admitted,” and we said “Okay. We know what’s going on here.” So I spoke to the doctor on the floor and he said, “What’s really going on here is your mother’s dehydrated and when a person is dehydrated, it affects the rhythm of their heart and that’s why your mother has this condition called atrial fibrillation which has to do with the rhythm of the heart. When she’s well hydrated, we feel that her heart rhythm is going to be normal.” So she was well hydrated. In three days she was out of the hospital. Her heart rhythm was normal again. I’m talking to the discharge nurse and she has her papers in front of her and she says, “Okay, your mother has this going on, and this going on, and this going on,” and then she said, “Do you have any questions?” and I said “Yes. What about the dehydration?” She said, “The what?” “The dehydration. The doctor, after my mom was admitted on the floor, he said dehydration. That’s the issue.” And she says, “I’m sorry, I have no record of that.” That is a classic case of a botched handoff. The information that he told us for whatever reason never got into my mother’s medical record and that was the major issue! That was the issue.
EDWARD: So had we not known that, had I not been listening very carefully and taking notes, Mom would have gone back home, been dehydrated and would have been back in the hospital. And dehydration among, especially among the elderly, is very serious, so we set up a plan. We had four water bottles marked with dates and Mom had to have each, she had to go through those four water bottles.
Another classic example is my mother’s at her doctor’s office, a family physician. We get the call, “I think this atrial fibrillation is coming up again. I’d like to have your mother taken to a local emergency department and also, your mother’s one leg is very swollen. We think she has a blood clot in her leg. So we’ve got two issues, we’ve got atrial fibrillation, potential blood clot.” My brother and I call the emergency department, we fax over information about my mother, her history, like a two page summary, we said, “We’ve got two issues: the blood clot, atrial fibrillation. We’ll be there in ten minutes.” I get there and they’re helping Mom, get dressed and I said, “Wow! This is incredible! I mean, you checked for the atrial fibrillation and the blood clot so quickly. I mean, this is very efficient,” and then the nurse said to me, “What are you talking about blood clot? Yeah, we checked for atrial fibrillation and the doctor respectfully disagrees, he doesn’t think there’s atrial fibrillation, but what are you talking about a blood clot?” I said, “If you look at my mom’s leg…” and then, “Oh! Your mom’s leg is big and swollen.” Then she says, “Oh, my God!” They did check on her and, fortunately, she did not have a blood clot, she had cellulitis, it was an inflammation in her ankle which made it look like–
EDWARD: Swollen and red. The thing is, what if she did have a blood clot? A blood clot could travel through the lungs, cause a fatal pulmonary embolism. Once again, the doctor called the emergency department, said, “We’ve got two issues,” I called, said, “We’ve got two issues,” but once again, that information was never properly handed off. Now, the reason I was able, I don’t want to say how wonderful I am saving the day, but I knew what the issues were, I knew what information needed to be handed off, so when I got to the emergency department, I knew exactly what the issues were. That’s why even though you might not be physically present during a handoff process for yourself or a loved one, you need to know what is being handed off so you would know if a botched handoff occurred.
CHUCK: We’re at the end of our segment and we’ve been talking about taking charge of your healthcare and I think, Eddie, you have shared with us a number of things that are absolutely critical, but the thing that I think out of this last segment that really strikes me is be aware of your situation and don’t allow the medical community, with the good intention, but don’t allow them to take you in a direction that doesn’t work for you or that ignores potential problems.
I started the segment by saying, or I started this show by saying, the most important decision you could probably make in your life is who’s going to provide you healthcare and I stick by that statement. My guest is Edward Leigh. You can reach Edward at 800-677-3256 or visit his website communicatingwithpatients.com. I’m seeing some of the comments where people have asked you questions and you’ve responded. Eddie, thank you so much for being a guest here on the show and talking about taking charge of your healthcare.
This is Chuck Gallagher with Straight Talk Radio and it is a thrill to be able to serve you and to provide information that can be helpful. As I recover now from a herniated disk surgery, I appreciate the conversation that we’ve had and I know that I did a lot of things right and could have improved in some areas. So, stick with us. We’re going to have a future guest on Straight Talk Radio that will bring you exiting and wonderful information just like we have had here with Edward Leigh. Edward, thanks for the show, buddy.
EDWARD: Thank you again for inviting me.
CHUCK: It’s a pleasure, and everybody remember, every choice we make in life has a consequence, so let’s make wise, intelligent choices. Thanks for joining us on Straight Talk Radio.
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