In the News

As reported by the New Haven Register, September 10, 2006.

Prepping Patients: UConn Teaches How to Better Deal with Doctors

By Abram Katz

Doctors all go to medical school, so why shouldn’t patients go to patient school?

That’s what health-care workers at the University of Connecticut Medical Center in Farmington pondered.

It seemed like a fine idea. And so, a six-session program will commence in October. As far as UConn specialists know, this "patient school" program is the first in the country, and the university has been receiving inquires from other medical centers and other countries.

The first classes were held last year and a tweaked and improved upcoming series promises even more strategy and information. Classes will meet in Farmington from 6:30 to 8:45 p.m. each Thursday from Oct. 5 through Nov. 9.

The aim is not to give prospective patients a crash-course in medicine, but to equip them with the skills and tools to become better advocates for themselves, the program staff said.

"Life is more complex, doctor visits are shorter, treatments are more complicated and patients get information from the Internet. Medical decision-making is more difficult than it used to be," said Dr. Robert Trestman, professor of psychiatry at the UConn Health Center.

"We wanted to help people be better advocates for themselves, their kids or their parents; to negotiate medical care more successfully," he said.

Sharon Madsen, a West Hartford resident on the early side of middle age, said last year’s course was very useful.

Madsen said she saw a doctor for a chronic sinus infection. The doctors wanted to give her an expensive magnetic resonance imaging test or image her head with a computerized axial tomography X-ray machine.

She asked what the doctor was looking for and why. She received neither test.

"Several years ago, I just followed what the doctors said. I had blind faith. Now I’m familiarized with how doctors work and can ask ‘What makes you think this and why?’" she said.

The classes are restricted to about 30 people and involve a lot of give and take.

Medical philosophy is difficult to explain, but the practitioners also learn from the participants.

A physician may not believe that a patient wants to understand genetic testing, endoscopy, or MRI. Class experience shows that many do, Trestman said.

"There are better interventions that cost a lot of money and are confusing and scary," he said.

Included in the basic topics is "What to bring to a medical appointment?" A pencil to take notes is one answer. Doctors also benefit greatly from a patient-compiled medical history.

Charles G. Huntington III, assistant professor in the department of community medicine at UConn, plans to distribute templates to students this fall. Participants can fill out the form to the best of their ability, possibly allowing the doctor to make a much speedier and informed diagnosis.

For example, a patient who reports pain is asked when the discomfort occurs; whether it is constant or comes and goes; the pain’s severity; what, if anything, makes the pain better or worse; under what setting does the pain occur; and what additional symptoms accompany the pain.

More mundane information is also important — past medical history, illnesses, surgeries, hospitalizations, medications, family history and more.

"That’s the kind of information that the doctor wants to know. We’re teaching students what questions doctors are likely to ask during the diagnostic procedure," Huntington said.

This makes patients less likely to leave out potentially important details.

Students also learn that a medical history and physical exam may reveal the need for further tests.

The overall goal is to focus quickly on why the patient is seeing the doctor, Huntington said. "Doctors are generally extremely appreciative," he said.

The school is also a means to help create successful patients, said James Walter, associate vice president of communications at the UConn Health Center and a co-creator of the program. "The patient is gaining information. It struck us, as a medical school, to create something that doesn’t exist: How to be a better patient," he said.

Another element of the program is to teach students basic research techniques, such as "where to go for information and how to tell if it’s reliable," Walter said.

This is important because most patients scan the Web for information about their medical problems. Some is legitimate, but the Internet is full of bogus claims, commercial come-ons and other unhelpful dross.

Research methods will be covered in more depth and participants will be taught how to better fulfill their roles as patient advocates for children or aging parents.

Another improvement this year will be a segment on understanding the results of diagnostic and screening tests.

The huge topic of advance directives, end-of-life issues and decision-making is scheduled, too.

Insurance, billing and finances, and the provisions of the patient privacy are also in the curriculum.