2009-03-13 / Columnists

PHC Health Talk

Take Control Of Your Healthcare (Part 2)
Commentary by Howard L. Sussman, Md. / Chief of Surgery, Peninsula Hospital Center

DR. SUSSMAN DR. SUSSMAN Managing the day to day issues of your health or your various medical conditions can be confusing, it is even more intimidating contemplating admission to a hospital. Most people visit the hospital for emergency treatment due to an injury or a sudden change in their health. Since emergencies are unpredictable, it is prudent to be prepared for that urgent trip to the hospital by reviewing the suggestions included in the first part of this series.

To quickly review: keep a health journal listing all of your medical conditions, test results, doctors' names, medications and dosages, allergies, and surgical procedures. Keep your insurance cards close at hand.

If time permits, call your physician before leaving for the hospital. Your doctor can alert the local Emergency Department that you are coming and what he suspects may be your problem.

Your doctor may be able to direct you to a hospital that she works at so she can supervise your care while you are in the hospital. The Emergency Department physicians may determine that you need to stay in the hospital to treat your illness.

An admissions clerk will collect your demographic data: name, birth date, social security number, address, telephone number, who to contact in an emergency, and your insurance information among others. You will be given a large collection of papers to review.

Hopefully, you won't be in the hospital long enough to read through the entire packet!

The packet will include information about advanced directives including health care proxies, a patient's bill of rights, how to complain to the Department of Health or Joint Commission for Accreditation of Healthcare Organizations, and disclosures of business relationships that the hospital has with other healthcare organizations.

Who do you trust to make decisions about your medical care if you were to suddenly be unable to make those decisions for yourself? New York State law allows you to designate someone as your "healthcare proxy". This can be anyone who knows your wishes about healthcare and that you trust to act in your best interests. The only person who cannot be your proxy is your physician.

Your proxy is empowered to make decisions for you when you cannot act for yourself. There are special provisions on the Healthcare Proxy form that allow you to specify whether the proxy can withhold hydrating fluids or nutrition, if that is appropriate for your condition.

Make sure that whoever you appoint as your proxy knows that you have entrusted them with this responsibility and take the time to be sure that they understand your wishes. Also, let your family know who you have designated and what you have discussed with the proxy.

It is not uncommon that hospitalized patients are sicker than they think and become unable to make critical decisions and no proxy has been identified. This leaves the doctors and nurses to work with a potentially large number of family members to determine who has the authority to make these decisions. A living will is another way to express your wishes to your family. A written document or letter to your loved ones can make your desires clear. This will limit any disagreements among your family members about what you want and may help to reduce the guilty feelings that come from making difficult decisions without your guidance.

Good communication is important to a productive and safe healthcare journey. Our next article in the series will discuss patient safety in the hospital environment.

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