What should patients do when their doctors have differing opinions and they feel like nobody is listening to them? It’s a problem that is being reported more commonly lately.
Over the past several years, there has been a shift in how health care is run. Family doctors have become the linchpin in a system where imaging or specialists are recruited for a variety of investigations, depending on symptoms. Health care has become a fine orchestra of specialized medicine, composed carefully, with the general practitioner (GP) as the conductor. Often, patients can feel lost in the system, or don’t know who the right specialist is for their concerns.
Their task becomes even more harrowing in more insidious conditions, such as oncology, concussions, headaches and organ disturbances. Patients often want to seek a second opinion, more information or an explanation, and find themselves at a loss for where to go. This is where the grey area begins. What happens to patients who don’t fit a black-and-white mould of what we expect a condition to be?
Montana Skurka, a Toronto-based patient advocate, deals with this problem every day. A patient herself at a young age, Skurka has unique experience to offer from both a professional and patient perspective. “The fast pace and isolating nature of modern society can be quite detrimental to our emotional, psychological and spiritual well-being. Our current health-care system was built to manage acute medical conditions and emergencies. An increasingly fragmented and specialized system is not equipped to view us holistically or guide us towards a life of wellness,” says Skurka.
In fact, in a report published by a group of patient advocates, in 2017, patient values were highlighted as an important aspect of care. The report recommended that patient values be included in every framework for evidence-based medicine. In actuality, patient values sit right at the core of evidence-based medicine, which is built on three tenets: best research evidence, clinician experiences and patient values.
Skurka notes that as more Canadians have become patients, death due to chronic diseases has increased at a rate of 14 per cent per year, and suicide rates are currently at 4,000 per year, or about 11 per day, on average. As well, she notes that three out of five Canadians above the age of 20 suffer from a chronic illness, while four out of every five Canadians are at risk for a chronic illness.
Research databases are filled with peer-reviewed literature highlighting the importance of patient perception on surgical outcomes, but it’s not far-fetched to apply this to conservative interventions. Chronic illness has quickly risen in our health-care system. Applying this research may indicate that patients advocating for their care and values is a strong predictor for successful treatment.
“It can be difficult for those who are not living with an invisible and chronic illness to comprehend the extent to which it can interfere with a person’s life and sense of self. It is common for patients to report that their loved ones and doctors do not adequately understand or validate their experiences,” says Skurka.
This takes a toll on mental illness as well. Skurka believes that another fundamental aspect of patient advocacy is “educating others on the mind-body connection and their own innate power to care for themselves.” Her practice involves encouraging equality between physical and mental illness and understanding that health and well-being cannot be neatly divided into these two categories. “There are significant resources dedicated to understanding and treating pain. However, pain and suffering are not the same thing. When our health-care system focuses on treating pain and ignores the suffering of patients, this can have devastating results.”
What can patients do to overcome this? The answer, as with most health dilemmas, lies in education. Education in health situations creates confidence, including the confidence to ask questions and have one’s voice heard. Building a relationship with a health-care professional that you know and trust is a great way to create a space where you can ask these questions and get the knowledge to have your voice heard.
Montana Skurka is a patient advocate in Toronto. She can be reached at [email protected]
Dr. Deborah Mechanic is a doctor of chiropractic and acupuncture provider practising in Toronto. For questions or care: [email protected]