Patient Responsibility

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Within the NHS there is now an expectation, in certain areas, of increased responsibility on the part of the patient, facilitated largely by technology.

Here is one example. Karen, a fifty-year-old woman in Suffolk attends her local Diabetic clinic.

In previous times Karen had to make frequent visits to her local GP practice in order for a nurse to take a blood sample to check her sugar level. The dose of medication would be adjusted accordingly by a medical professional.

Currently, in a successful development, Karen has been taught to carry out her own finger pricks for tiny blood samples which can just as accurately record the blood sugar level. With fairly simple instruction Karen can now modify her own treatment as necessary with an occasional check-up visit to the surgery.

The advantage of this approach is that Karen takes direct responsibility for her own care with trusted backup close at hand if needed.

From the clinic’s point of view, the investment of time and care in instructing Karen in blood sampling and management of her own medication is immensely timesaving.

In summary this approach which encourages the patient to take some responsibility for her own care ensures continuing vigilance by the person most affected. It is clearly in Karen’s interest not to disregard important warning signs which a busy clinic could miss.

Here is another instructive case of diabetes.

Margaret recently returned from Kenya to live in the U.K. A year before the move she was diagnosed with Type 2 Diabetes, late-onset diabetes. She was started on Metformin (the standard treatment in this situation) and given some dietary advice.

Margaret also set out to learn from the internet as much as she could about the management of her condition. In her research she read about a trial in Newcastle to study the effect of diet on reducing fat storage in the abdomen and around the liver. She read the information on their website and felt confident enough to volunteer for the trial. She followed the diet meticulously and was asked to send in her weight and blood sugar results regularly and to undertake an annual review. Her GP was kept informed.

After a year her GP called to say that the Newcastle trial considered her case so successful that she could come off the study. They were delighted to tell her that her case was rather exceptional. Given the same advice most people fail to follow it! They suggested that she discontinue the medication and continue to monitor her weight and blood sugar levels. These have stayed under control.

To me this is an excellent example of how taking an initiative can be thoroughly rewarding as long as you have the sense and discipline to follow the advice given.

In Summary: A guiding list for patients of things they should do or know.

  1. Accept personal responsibility.
  2. Research sensibly and with guidance for information on the internet.
  3. Keep notes of what is said and ask questions to clarify.
  4. Keep results of investigations in calendar order.
  5. Keep in personal contact with support staff: get to know their names, email addresses and phone numbers. Become part of your own care team.
  6. Listen carefully and ask questions.
  7. Be polite but insistent.

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