When we or our loved ones are faced with illness and the accompanying vulnerability that illness engenders, advocating for the best possible medical care can be a life-altering challenge. In the midst of writing this guide to becoming a "take-charge patient", Martine Ehrenclou herself became a patient of the American healthcare system, and the lessons that she was attempting to impart to her readers became, in essence, lessons that she herself needed to learn and actualize in the real world.
Aside from telling her own story of illness, powerlessness, frustration, empowerment and eventual recovery, Ms. Ehrenclou uses the majority of the pages of "The Take-Charge Patient" to offer her readers a relatively comprehensive and user-friendly guide to proactive self-advocacy when faced with illness, medical treatment, and medical providers who sometimes are less than thorough and less attentive to our unique situation than we would like.
Communicating her hopes for readers of her book, Ehrenclou writes:
A take-charge patient needs the strategies in this book, but she also needs persistence. Persistence is the key to finding solutions to both simple and complex medical issues. Even if you are healthy, you need persistence to get the kind of medical care you deserve. I hope this book helps every single one of you.As I stated above, the author is not talking from some abstract notion of what patients need. She shares her personal story--frustrations and successes--and she sincerely communicates her desire for others to have similarly positive outcomes.
Ms. Ehrenclou also describes the current healthcare climate quite succinctly:
It's time for us to step up to the plate and take charge of ourselves as patients. Not because all doctors are falling down on their jobs (although some are) but because doctors no longer can function in the way they once did in the time of Marcus Welby. And neither can we as patients. The health care system has changed radically and has become increasingly complicated. Forty years ago doctors made house calls and many patients had only one doctor who managed their medical care. Doctors didn't have health insurance companies to haggle with over the their patients' medical treatments. If a doctor wants to stay afloat today, she must compromise in ways she might not feel comfortable with.This is the stark reality of 21st-century health care, and the author makes it clear that if patients want the best care they can get, then they must take the reins of their own care and guide it towards their goal.
Although there are many lessons that I, myself, have taken away from "The Take-Charge Patient", one of the greatest lessons of all is to have in my possession a complete record of my medical history. Armed with information, the take-charge patient can walk into any doctor's office, coherently and intelligently outlining the highlights and issues that are most salient to the goal of that visit. Ehrenclou wisely states:
A take-charge patient can go anywhere in the world and get medical treatment because she has her medical history, complete health file, medical records, and a list of medications and allergies to medications at her disposal. She does not need to call any doctor or pharmacist to find out which drugs she is taking, which medical conditions she has, and which tests, surgeries or procedures she has undergone. She has it all in her possession.Being prepared is the cornerstone of Ehrenclou's call to arms for the take-charge patient, and preparation is not necessarily limited to one's medical history, although this is the central aspect of the take-charge patient's arsenal.
In addition to extolling the virtues of having your own personal copy of your complete medical records and history, the author recommends having the following components of such a file:
- Your health history
- Medical conditions and diagnoses
- Family history
- Surgery and procedure history
- Your medical records
- A personally designed custom health summary
- A consistent and up-to-date medical journal
- A list of doctors and providers and what they see you for
- Complete health insurance information
Additional helpful and valuable information in "The Take-Charge Patient" includes: how to prepare for a doctor's visit; dealing with specialists; managing medical errors; researching your conditions; communicating with providers and their staff; and navigating the hospital, tests, procedures and surgeries. Ehrenclou also covers urgent care centers, retail medical clinics, the emergency room, concierge doctors, and telemedicine and telehealth. The book includes blank checklists for the reader's use, and many helpful resources.
In a subsequent edition of "The Take-Charge Patient"--or in a separate book altogether--I would like to see an expansion of Ehrenclou's short chapter on the patient's relationship with the doctor's staff, especially nurses, Nurse Practitioners and Physician's Assistants. With changes in the authority and autonomy of Advanced Practice Nurses in many states, it would be helpful for patients to more fully grasp the scope of practice of these clinicians, and learn how to utilize their significant skills to their own advantage. The advent of the "Doctor of Nursing Practice" (DNP) is also certain to confuse health care consumers, and Ehrenclou is perfectly positioned to explain these changes and developments clearly and succinctly.
It would also be interesting to hear Ehrenclou's advice and opinions on the growing ubiquity of health and wellness coaches, nurse coaches, and other professionals who can assist the take-charge patient in self-advocacy.
Finally, a detailed chapter or separate book on nursing homes, assisted living, home care, hospice and palliative care would be enormously edifying, especially with Ms. Ehrenclou's expertise and deep knowledge of the health care system.
Martine Ehrenclou is a talented writer and an advocate for patients who wish to take charge of their own medical destiny. She can be found at her personal website, on the website of The Take-Charge Patient, as well as on Twitter.
Of note, Ms. Ehrenclou will be our esteemed guest on RN.FM Radio on Monday, September 17th at 9pm EST. Please join us for this live call-in discussion, or listen to the archived recording which is available immediately following the broadcast on both our Blog Talk Radio website or as a free podcast on iTunes.
We look forward to Ms. Ehrenclou's continued contributions to the canon of literature on patient advocacy, medical literacy and patient-physician relationships. Her work is a gift to the public and the medical community alike, and we can only hope she will continue to bring us her wisdom and insight for years to come.