The Patient's Playbook
Washington Hospital Healthcare System and Leslie D. Michelson, the author of
The Patient’s Playbook, are working together to better inform the community about how to navigate
and advocate within a complex health care environment. This page is your
source for the important lessons Mr. Michelson shares in his book about
lifesaving strategies and decision-making tools that patients and family
members can start using now to become savvy health care consumers.
June Blog Post
Medical Quarterbacks: Why you need this essential healthcare helper and
how to recruit one
By Leslie D. Michelson
Tips for getting in to see a physician sooner + Questions to ask your surgeon
Question: A specialist I need to see is booked for three months. I’m
desperate to get in earlier. Is there anything I can do?
Leslie Michelson: You’re not alone - this is a common problem, and I’ve got
a few tips. The first is, make friends with the front office. Be polite.
Let them know how difficult this situation is for you and how important
it is to see the physician. Ask: “Would you be willing to call me
if she gets a cancellation? I know how busy you are, maybe it would be
easier if I called you occasionally to see if an opening comes up?”
Every physician gets cancellations, and if you’re willing to drop
everything when that happens, you might just get in sooner.
Here’s another idea. Have a friend reach out to the scheduling assistant
and say, “I’m calling on behalf of my dear friend”—your
name—“and I’m so concerned about her health. Is there
any way we can get her in sooner?” I know this sounds a bit odd,
but it actually helps sometimes, because the people who do the scheduling
are human, and it means a lot that somebody else is taking their time
to help you.
Another approach is to ask your primary care physician if he or she can
call on your behalf. Or if you have a friend who’s already being
seen by this physician, ask them to call for you. The people on the other
end of the phone line really do care. So listen to them, get them on your
side, explain your fears, and ask if there’s anything you can do
to see the doctor sooner. Keep in mind, if you have a fast-moving disease,
like pancreatic cancer, the doctor’s staff knows you cannot wait.
You need to be seen quickly. For problems that aren’t life-threatening?
They know you can probably wait a little longer.
Question: You say in The Patient’s Playbook that when I’m interviewing
a surgeon, I should always ask how many times they’ve done my exact
surgery. How do I ask that? And how will I know if I’m hearing the truth?
Leslie Michelson: As with anything in life, practice makes perfect. We know this with great
athletes and talented musicians—so it follows that the same goes
for skilled surgeons. Many
studies show that for different types of procedures, the more operations a physician
has performed, the better they get at it.
Here’s how you might approach this question. You can say, “Dr.
Smith, I’m worried about this operation. And I’ve got to ask
you a few questions: How many of these surgeries have you done with patients
who are just like me? Can you give me a sense of what your outcomes have
You will know if you’re getting a genuine response the same way you
know whether anyone else is leveling with you: Look him or her in the
eye, consider your experience with this person thus far, and trust your gut.
So, what’s a good number to hear in response? That really depends
on the procedure. For example, with
prostate cancer surgery, studies show that a surgeon who has done a procedure at least a thousand
times will have better outcomes. This means they have performed a “high
volume” (as opposed to a “low volume”) of surgeries.
If you want to dig a little deeper, you can research the numbers for your
procedure online. You can type the phrase “volume-outcome relationship”
+ your condition into your web browser.
Finally, please don’t be put off if the doctor tells you about patients
that have had complications. Every physician who has been doing this surgery
long enough—which is what you want—will have a variety of
experiences under their belts. What matters is that they’ve reflected
on their outcomes. You want to hear a response that takes into account
the seriousness of your question and the depth of the physician’s
knowledge. If the response you get is a lot of hemming and hawing, and
it gives you pause—take that into consideration. Ask more questions.
Above all, you need to feel deep trust and respect for your surgeon and
his or her capabilities.
Leslie D. Michelson is the author of The Patient’s Playbook
and host of The No-Mistake Zone™ podcast. He is a highly sought-after expert who has spent the last
thirty years guiding thousands of people through our complex healthcare system.
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Six Steps to Finding the No-Mistake Zone
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