Under the auspices of the Lucian Leape Institute of the National Patient Safety Foundation, forty experts got together to talk about how health care professionals and patients could work together to improve the results that patients get from care. Their report noted, “Too often, standing in the way is the health care system itself – whether by intention or not – because of its fragmentation, paternalistic professional culture, abundance of poor process design, and lack of experience on the part of health care leaders and clinicians [doctors, etc.] with practical methods of engaging patients.”

They go on to lay the responsibility for fixing the problems at the feet of health care professionals:  “Many of the barriers to engagement faced by patients and families – such as lack of access to their health records, intimidation, fear of retribution, and lack of easy-to-understand tools and checklists for enhancing safe care – can only be overcome if leaders and clinicians support patients and families to become more confident and effective in their interactions with health care providers.”

Their report recommends educating care providers to work as partners with patients and involving patients in designing all aspects of research and care, among other steps.

Their seven recommendations for patients will sound familiar to readers of this column:

• “Ask questions about the risks and benefits of recommendations until you understand the answers.
• Don’t go alone to the hospital or to doctor visits.
• Always know why and how you take your medications, and their names.
• Be very sure you understand the plan of action for your care.
• Say back to clinicians in your own words what you think they have told you.
• Arrange to get any recommended lab tests done before a visit.
• Determine who is in charge of your care.”

A few points about getting lab tests before a doctor’s visit follow.

First, this step works only if the tests you need are known ahead of time, typically meaning that they are standard and routine, such as an annual HbA1C test for people with diabetes, or a CBC (Complete Blood Count) test often done as part of an annual check-up.

Second, you will need to have an order for the test from your doctor to get it done.

Third, it’s important to find out the test reporting lead-time.  Will the doctor’s office get the results the day after you have the test?  Ten days later?  With this information, you can plan ahead to have the test in time for the doctor to have the results when you visit.

 Having tests done ahead of time means that you and the doctor can discuss the results and the next steps – instead of simply scheduling another appointment to discuss the test results later.