May 10, 2019

3 key lessons about American health care, from one of its most influential journalists

Daily Briefing

    Sarah Kliff has been reporting on health care for years, but over the past year, she's interacted with the health care system more than she ever has before—and it left here with three "important" lessons, Kliff reports for Vox.

    What your patients expect from their care—from millennials to the silent generation

    Kliff writes that, over the course of the past year, she had two major surgeries—a Cesarean section to deliver her son last June, and an operation on her foot to remove a bunion this past December. Kliff writes that she also experienced the first ED visit of her adult life this past year, and spent a month in physical therapy healing her foot.

    Here's what she learned from the experiences.

    Lesson 1: Be picky about your doctors

    Kliff writes that she met with three different surgeons while exploring how to treat the chronic pain in her left foot. She writes that she "treated each of these visits like interviews, arriving with a list of questions."

    Her most important question, she writes, was taken from Ezekiel Emanuel, who has written in the New York Times that the best predictor of a surgeon's quality is the volume of work they've done. So Kliff asked each surgeon, "How many times have you done this surgery?"

    Asking the surgeons questions was "a bit uncomfortable for me and the doctor" at first, Kliff writes. "I always felt a bit sheepish pulling out my notebook," she writes, adding, "They were the ones with medical degrees, after all. Who was I to question their treatment plans?"

    But Kliff writes that, eventually, she realized that, as a patient, she had a right to question the surgeon who would be operating on her. "I was the person who was having a foot cut open, and the person who cared more than anyone else about my surgery going well," she writes, "and that motivated me to work through the awkwardness and have some pretty long discussions about the best treatment plan."

    Kliff writes that she decided on a surgeon "who took a lot of time to answer [her] questions in his office and over email." The most impressive thing about this surgeon to Kliff was that he "didn't shrug … off" things other surgeons had told her that conflicted with his own advice. "Instead, we scheduled another appointment to talk through the difference of opinions—and even incorporate some of the other doctors' advice into his plan," she writes.

    Lesson 2: Try to spend as little time in health care settings as possible

    While Kliff acknowledges that hospitals are "places where fantastic, lifesaving work happens each and every day," medical errors still cause more deaths than AIDS or drug overdoses, not to mention the other risks associated with hospitals, "like infections and bed sores."

    As a result, Kliff started taking those risks into consideration when discussing her own care, she writes. This particularly was the case last summer, after Kliff's obstetrician recommended she be admitted to the hospital for a "breastfeeding infection that had gotten especially severe," she writes.

    Kliff writes that she pushed back against the doctor. "I questioned whether the treatment they could give me in the hospital was worth the risk of infection that my newborn and I would face staying there," she writes.

    Eventually, Kliff and her doctor decided that Kliff would have imaging done in the ED and spend the night at home rather than in the hospital. "It was an outcome I don't think I would have pushed for if I hadn't been thinking about the risks of medical treatment," she writes.

    Lesson 3: Be realistic about the constraints of modern medicine

    Kliff writes that, in many ways, she is "astounded" that her surgeon was able "to cut [her] foot bones in two places, put in five screws and a metal plate, and give [her] back the ability to have closer to normal mobility for someone [her] age."

    At the same time, Kliff writes that she's also "frustrated and more acutely aware of the limits of modern medicine." For example, Kliff writes that she used to be an avid runner, but she can't do that now, as her risk of reinjury is high and her physical therapist advised against it.

    Kliff writes that, through her reporting, she's seen several limits of modern medicine, but one that "drove home" for her was a podcast episode on the opioid epidemic. Reporting for her podcast, called "the Impact," Kliff talked to chronic pain patients who had used opioids to treat their conditions, and learned that the patients were turning to opioids "because modern medicine didn't offer any safe, effective treatment for their pain." These patients were "left with their chronic pain, no treatment to eradicate it, and doing their best to live within the constraints of their disease," she writes.

    Kliff writes that, overall, "[h]uman bodies are fickle, complicated things. And [her] own experience with medicine has really driven home that there is still a lot we don't know, especially when it comes to treating pain." She concludes, "I'm really grateful for what medicine can do but also cognizant of what it can't—and still working day by day to accept those limits in my own life" (Kliff, Vox, 5/6).

    What your patients expect from their care—from millennials to the silent generation

    Millennials, Gen X, Baby Boomers, the Silent Generation—what exactly do each of these groups want from their health care?

    We surveyed thousands of consumers across the United States to find out. Download this infographic to learn how to tailor your messages and target your investments to each generation.

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