We talk a good game in the health care system. We say we want to empower patients, but how powerful do we really want them to be? We say we want to give them enough information so they can make informed choices, but how do we deliver that information so that patients truly understand what is being said? As health care reform continues and open enrollment periods occur, encourage your employees to know that they are the key to this empowerment that everyone's talking about. Thus, it's important that they be educated about, and encouraged to exercise, their medical freedoms - specifically, the freedom to request the surgeon of your preference.

For example, a friend called me to report that his brother was flown from a small community hospital to a large tertiary-care trauma center for open-heart surgery.

Upon arrival on a Thursday, he was transferred into a critical-care bed and began the admission process. After undergoing a blood draw and other diagnostic testing, the patient was visited by a surgical resident who came to explain the patient's options.

Following that visit, the patient understood that Dr. Smith (not his real name) was scheduled to do the surgery the next day, Friday. After further testing revealed the patient had high blood sugars, the surgery was postponed until the following Monday. I asked my friend who would be doing the surgery and mentioned that the "go-to" surgeon at that facility (let's call him Dr. Jones) was highly regarded for both his surgical skill and clinical outcomes.

My friend and his brother requested that Dr. Jones perform the bypass, but were told that while Dr. Jones was booked through the month, Dr. Smith was able to perform the surgery on Monday. The family agreed that it would not be wise to put it off longer than that.

Although most patients in this situation may not know it, in a non-urgent or elective situation, patients have the right to ask for the surgeon they'd prefer.

In another instance, one of our clients had an emergent visit to the emergency room that led to him being admitted for bowel surgery. Two days later, he was prepped for the surgery, visited by the resident and taken to the operating room. As he was being wheeled into the room, he briefly met the attending surgeon who performed the operation. The surgery went well, but several weeks later he developed complications and reached out to us for help. During our discussion, he realized that since the previous surgery had not been emergent, he probably should have inquired which surgeons had been available.

Any system with its own bureaucracy has its own processes, and there are often policies and procedure manuals to which you can refer. However, there are no manuals or how-to guides for managing the bureaucracy of the health care system. But just as you would for your employees when they ask you for help in the business setting, encourage them to speak up when it comes to their health care decisions. No, they won't know everything they're supposed to ask, but the first step to patient empowerment begins with knowing that they can ask.

Contributing Editor Betty Long is a registered nurse and founder of Guardian Nurses Healthcare Advocates, a health care advocacy firm that has helped thousands of patients navigate the health care system.

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