Changing or Choosing Your Doctor / Personal Care Assistants
You've been injured a while, but for one reason or another you have to change doctors. Perhaps you've moved, your doctor has retired, you're in a new health plan and you need to change doctors, or you're not convinced that your doctor is doing the best for you. You need a doctor who has had some history with or interest in SCI or related conditions.
Beverly Kievman in her book, For Better or For Worse: A Couple's Guide to Dealing with Chronic Illness suggests that your primary doctor can be your quarterback. Depending on your level of injury, severity, and complications, you may need to see a variety of specialists and therapists over your lifetime. Therefore, the quarterback of your health care team is critical.
How to Select Your Top Draft Choice:
As an SCI survivor, you need a doctor who helps you take care of yourself, listens to you, learns about spinal cord injuries and long term consequences of these injuries, and is concerned about your needs and concerns. Kievman suggests that you assess your needs so that you know exactly what you are looking for.
- What does the doctor know about SCI? Does the doctor have experience with SCI or related conditions such as spina bifida and post-polio syndrome?
- Is your doctor related to a hospital or rehab center that treats SCI or related traumas?
- Does your doctor work with specialists who have had a history with SCI?
- What is your doctor's attitude about your role in your health care? Is he or she willing to receive input from you?
- Is your doctor willing to take time for an interview before you make your choice?
- Is your doctor willing to work with other health care providers in partnership with you?
- Is your doctor's office accessible and is the staff trained to lift you onto exam tables?
Not every doctor will meet all your criteria. Ultimately, you will need to decide which questions are most important or which are negotiable.
Your Scouting Report:
Because your relationship with your doctor will be long-term and possibly frequent, it is important that you feel comfortable and trust your doctor and his or her associates. If you are in a rural area or in a health care plan that offers few alternatives, you need to do some homework. Who are the specialists, where is the nearest hospital, and how quickly can you be transported or admitted if an emergency occurs?
Take time to know your doctor and specialists. Are they team players? Make it known you want to hire the best help possible.
If you already have a doctor but need to make a change, what do you do? Some people think they must stay with their present doctor, but people change doctors all the time. Your goal is to find someone you can trust, work with, and develop a team relationship with. As Kievman suggests, a combination of knowledge, caring spirit, professionalism, and emotional "rightness" will provide you with a "quarterback" you and others can work with.
The Long-term Game Plan:
You are looking for someone you can work with over the long haul. Does he or she talk with you and/or your caregivers as equals? Will the doctor explain all tests and procedures in advance? Do you feel that he or she genuinely cares about you and your caregiver or family? Is he or she aware that you and other health care persons are part of a team?
You need to find someone who "fits" you, your needs, and your injury. He or she needs to be aware of what might be going on with you and your family and be sensitive to those concerns. In his book, Healing Words, Larry Dossey says that you should ask yourself a crucial question: "Does my doctor make me feel better or worse when I'm around him or her?"
The doctor-patient relationship is a key to making things work, because it is not just the doctor who is going to do the healing. The doctor, you, your family, and other health care professionals all contribute to your long-term health care needs. You are the best judge of how you feel and what is going on in your body, so, you must actively participate in the process. You cannot be a passive patient who shares little, or who is not heard by your doctor. Your caregiver, spouse, or other family members must also be active partners in your health care.
Remember the Game Plan:
The following are four things to do:
- Assess your needs
- Interview and choose your physician
- Think long term
- Develop a team approach
For more information read:
For Better or For Worse: A Couple's Guide to Dealing with Chronic Illness by Beverly Kievman with Susie Blackmun. Chicago: Contemporary Books, 1989.
Building a New Dream: A Family Guide to Coping with Chronic Illness by Janet Maurer. Reading, Mass: Addison-Wesley Publishing Company, 1989.
Healing Words: The Power of Prayer and the Practice of Medicine by Larry Dossey, M.D. San Francisco: Harper Collins Publishers, 1993.
This is one of more than 20 educational brochures developed by Craig Hospital while it was a federally-funded Rehabilitation Research & Training Center on Aging with Spinal Cord Injury. The opinions expressed here are not necessarily those of the funding agency, the National Institute on Disability and Rehabilitation Research of the US Department of Education.
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