Other books by Nancy Keene
[My book is] for anyone who has to see a doctor to remain
healthy or who is sick and is trying to get healthy again. But I also
think doctors can benefit from my book because the hundreds of personal
stories really put a human face on medical issues.
All my books have a philosophy of trying to enhance what I
consider the essence of medicine: the relationship between two human
beings. That's not just doctors and patients; it's also nurses and
patients, paramedics and patients; any medical caregiver who's dealing
with someone ill or hurt.
Make sure the doctor you choose has excellent technical skills
and make sure he or she is somebody you can talk to and whose philosophy is
in harmony with your own.
In the mid-1970s, there were only about six million people in
this country enrolled in managed care insurance programs. Now the majority of
people are in some sort of a managed care system - more than 70 million in
Keeping private what you tell your doctor has entered a new
realm. Does everything you tell him go into your chart and is it entered
into an electronic database somewhere?
Another hurdle not often acknowledged is the fear of reprisal.
People worry that if they're too much of a problem, or if they take too
much of the doctor's time, they won't get good care. That's especially
common in parents of sick kids and with older people.
What I do is prioritize the things I want to talk about on a list.
I always start with the biggies, then I'd say to the doctor, "If you need to
leave, let me know, and I'll make another appointment to finish items 6
Patients' rights don't exist in a vacuum. Patients have
rights and responsibilities; doctors have rights and responsibilities.
In October 1998, CNN reported that 18 million people sought
health-related content on-line last year, rivaling the number of people who
tapped the Internet for investment information.
An Interview with author Nancy Keene
By Lori Houston
Despite the headline-dominating forces of rising insurance premiums,
cost containment measures, and big business profits, author Nancy Keene
strongly believes the essence of healthcare still comes down to a
fundamental relationship between two human beings. In her book
Working With Your
Doctor: Getting the Healthcare You Deserve, Keene communicates a
framework to help the lay person build and maintain workable partnerships
with their physicians in any healthcare environment.
"It's an imperfect world. This book is about how to maximize the benefits
and get what good you can out of the health care system," says Patient
Centered Guides Editor Linda Lamb. "A lot of this has to do with people's
attitudes about doctors. The fact is, doctors aren't gods and they don't
have all the information, but they can be your best advocate for getting
the most out of your health insurer."
Keene's unique background gives her the ability not only to examine
patient-doctor relationships authoritatively from both the professional
caregiver's and the healthcare consumer's points of view, but also to
articulate them. She is particularly adept at globalizing what it takes
to get one's bearings, negotiate care, and work with healthcare personnel.
The author of several other healthcare titles including
Your Child In the
Hospital, Keene also participates in online pediatric
cancer discussion groups, serves as a patient advocate in the Childhood
Cancer Group (professional organization of pediatric oncology physicians,
nurses, and researchers), and is a member of the board of directors of
International Pediatric Cancer Alliance which keeps her on the front-line
in the shifting healthcare landscape.
"This is a non-hysterical, non-confrontational approach based on real
life situations," Lamb notes. "This book offers something for everyone:
- How to find the right doctor.
- Managing managed care.
- A range of options when your doctor has done something to upset you.
- Scripts for asking questions and raising issues.
- Web site resources.
- Who did you write this book for?
- It's for anyone who has to see a doctor to remain healthy or who is
sick and is trying to get healthy again. But I also think doctors can
benefit from my book because the hundreds of personal stories really
put a human face on medical issues. The doctors I know who have read the
book really love the stories because they give the view from the other side
of the bed.
- This isn't a new issue by any means. What other books about the
doctor-patient relationship are out there and what do you think distinguishes
your book from those?
- When I was asked to write this book, I did a literature search before
I began because I thought it was probably a pretty well-covered area. People
are very interested in doctor-patient relationships. Yet what I found
surprised me. The books available tend to fall into two broad categories.
One kind is what I call "patients-with-an-ax-to-grind" books. These are
doctor-bashing, and even the titles of many of these books are adversarial.
When you walk into any relationship with a chip on your shoulder, you're not
going to get very far. You're certainly not going to form a partnership.
The other type, written mostly by doctors, I call the
"watch-out-or-you're-really-going-to-get-bad-medical-care" books. Many of
these books contain a lot of useful information, but begin with the
assumption that as a patient, you have to defend yourself. I think that's
My book provides a much needed balanced view on patient/doctor relationships.
It is about two human beings forming a partnership to work towards a common
goal: good health. The relationship has to satisfy both parties to really
thrive. It is chock full of practical skills to help you make that more
likely to happen.
- What are your "credentials" on this subject, and how did the book
- I was asked to write this book because of my extensive medical
experiences and my "friendly advocate" philosophy. I've been a patient and
a caregiver for over twenty years. I had a serious bicycle/bus accident in
the 1970s that crushed my leg and my arm. I spent a lot of time in the
hospital and in rehabilitation. I've also had numerous surgeries -- major,
life-threatening procedures as well as many minor ones. Then my daughter
was diagnosed with leukemia in 1992. For a few years we dealt with the
medical world on an almost daily basis, either as outpatient or inpatient.
Now our visits are much less frequent.
I've been on the other side, too. Although I've never been a doctor or
walked in their shoes, I financed my way through the University of Virginia
working in a hospital. I've worked in CCU (Critical Care Unit), the
emergency room, and a blood bank. I also worked on a phlebotomy Team and an
IV Team. I was a volunteer for many years on a very busy rescue squad running
about 5,000 calls a year. I rose through the ranks there as an Emergency
Medical Technician, Shock Trauma Technician, and then I became one of the
first nationally registered paramedics in the country. I also taught advanced
life support classes for several years. I've taken care of a lot of
patients, both inside and outside the hospital.
I've spent much of my life thinking about medical issues, and one of
my reasons for continuing to write about them is that I'm a big believer in
the magic of a therapeutic relationship. It can sometimes make a difference
between life and death, and always between comfort and fear. I try in my
own way to help people discover and nurture that. All my books try to
enhance what I consider the essence of medicine: the relationship between two
human beings. That's not just doctors and patients; it's also nurses and
patients, paramedics and patients; any medical caregiver who's dealing with
someone ill or hurt.
For those dealing with life-threatening or chronic illnesses, having a good
relationship with a doctor means the difference between living with fear,
worry, and anger, or feeling cared for physically and emotionally. If you've
never lived through that, it's hard to describe what a difference this makes,
but it's an extraordinary difference.
- What do you think of the following statement as a summary of your
book: "To get optimum health care as a patient in today's environment, you
must shift from a passive to an active consumer role, determine exactly what
you expect from your doctor, and equip yourself to make sure you're getting
it or find another doctor if you can't get it."
- That's accurate. The first step is to examine who you are and what you
need. A little self-reflection is necessary. For instance, I am an
information seeker and I ask a lot of questions. I don't do well with
doctors who prescribe without explanation. When I'm meeting a new doctor, I
don't go when I'm sick, I go when I'm well. I tell him or her, "I just wanted
to talk to you and see if we'd be able to work together well." I always say
in the first visit what I need to be comfortable, that I often ask a lot of
questions, and that I like to have a human relationship. Some doctors are
just horrified. But there are a lot of doctors for whom medicine is an
intellectual and emotional passion. On an emotional plane, they want to help
people. Intellectually, it's fascinating and challenging for them. Those
kinds of doctors enjoy patients like me because they get to explain the whys,
they enjoy challenging, thought provoking questions, and we usually laugh
Here's an example of how I operate: The second day we were in the hospital
after my daughter was diagnosed with leukemia, the doctor came in and said,
"Is there anything I can get for you?" I asked him, "What pediatric oncology
textbook do you and your students use?" He told me and I said, "I'd like a
loaner, please." He just looked at me, so I said, "I'm not kidding."
When he gave it to me, he smiled and said, "It's pithy! If you have any
questions, let's sit down and talk them over." Later, when I read my
daughter's chart -- and I always read the chart -- he had written: "Mother
asks innumerable appropriate questions." He always answered
all of my questions. He would pull out the textbooks and show me, or he
would pull out journal articles for me, and he always explained what he did.
He treated my daughter with respect and kindness. He was a wonderful match
for my family.
- What advice would you give to people who are not "fighters" or
"information seekers" by natural inclination?
- This book is not just for fighters or seekers, it's for everybody. I
included strategies for all kinds of patients. For those who aren't fighters
or seekers, I have two primary suggestions.
The first is: Take time to choose your physician very carefully. Do your
homework. Make sure the doctor you choose has excellent technical skills
and make sure he or she is somebody you can talk to and whose philosophy is
in harmony with your own. For instance, if you have a life-threatening
disease, you may find someone who is very aggressive and wants to try all
possible treatments, then explore experimental treatments regardless of the
impact on quality of life. If this is what you want, then you have a good
match. If, however, you would rather opt for a shorter, but possibly more
pleasant life, you would not be comfortable with this type of physician.
So, you need to choose wisely so that you can feel secure that leaving all
of the decisions up to the doctor will result in medical care that makes
The second suggestion is to get an advocate. If you're not going to be
pushing for yourself, then you need somebody to push for you, and not just
when you're in the hospital. I think everybody should have a Living Will and
a Medical Health Care Power of Attorney. Copies of these documents should be
given to your health care advocate, each of your physicians, and members of
your family. Do these when you're young and healthy, not when you're sick or
upset. If you have decided in advance what type of medical care you want,
your advocate can make sure your wishes are respected.
- Can some of the issues between patients and doctors be attributed to
generational differences? In other words, would you have written the
same book 10 years ago?
- That's an interesting question. I've been on both sides of the medical
field for 25 years now, and I have to say that I think everything in this
book would be the same except for the chapter on Managed Care, and portions
of the chapter on "Questions to Ask About Tests, Drugs, and Surgery." Some
of the information about confidentiality is also treated a bit differently.
- Can you elaborate on those?
- In the mid-1970s, there were only about six million people in this
country enrolled in managed care insurance programs. Now the majority of
people are in some sort of a managed care system - more than 70 million in
1997. Prior to managed care, in which the tendency is to provide fewer
services to increase profits, most people had a fee-for-service system. The
insurers paid for whatever tests or surgeries the doctors ordered and they
provided no oversight on services. There was no incentive to contain costs,
and the tendency was to over-treat, because the insurance company was not
involved in the doctor's decision to recommend, prescribe, or order treatment.
That was between the doctor and the patient.
Doctors over treated for one of several reasons. Sometimes they were trying
to cover all the bases to give the best care possible. In some cases, they
were paid according to the number of procedures they performed. And, as
malpractice litigation increased, doctors over-treated to protect
themselves. Thus, many factors came into play.
If I had written the chapter on "What Questions to Ask About Tests, Drugs,
and Surgery" prior to managed care, the questions would have covered how to
determine the risk-benefit ratio for suggested treatments, such as asking
"Do I really need what my doctor is suggesting, and why?" With managed care
on the scene and insurers calling the shots, the general tendency is to
provide fewer services to increase profits, and doctors often have no say
For example, insurance companies frequently determine which tests and
surgeries doctors can order, which drugs can be prescribed, and they dictate
how much time doctors can spend with patients. Many times doctors are under
gag orders written into their contracts that allow them to discuss only those
options covered by the insurance company. Sometimes, doctors are given lists
called "formularies" that list which drugs they can prescribe. Their
salaries, and sometimes even their jobs, are on the line if they don't toe
the line for the insurance company. It's a completely different system from
Therefore, the questions patients need to be asking have changed, such as:
- Are there any other options?
- If insurance company constraints were not an issue, what would you be
- Do you think I need a referral for this procedure?
- If not, what's your training and how many times have you done it?
These are things we never would have asked 10 or 20 years ago, but they're
very important to ask now.
Doctors are, in some cases, being pressured in new and horrible ways by
managed care organizations. Imagine what it is like to go into a profession
because you truly want to help people get well, but now your salary is tied
to keeping costs down (not offering services), gag rules in your contract
(can only tell patients the approved treatments, not all of the options),
limits on referrals to specialists, limits on the amount of time you can
spend with each patient, and what drugs you can prescribe. Add in the
increased amount of time spent on paperwork and telephone calls to
non-medically trained utilization managers, and you have a recipe for massive
Many patients have no clue that this is happening. They still assume that
their doctor has only their best interests in mind when she makes
recommendation. Hence, the need for this chapter on managed care. It was not
meant to be startling, just accurate. If you know what the pressures are
then you can stay alert, ask good questions, get the facts, and find the care
you need, not the care your insurance group thinks you should have.
The other issue that has changed is confidentiality. Fifteen years ago,
confidentiality issues would have centered on whether your doctor discussed
your case publicly. Now information is now exchanged electronically, and is
therefore not necessarily secure. Keeping private what you tell your doctor
has entered a new realm. Does everything you tell him go into your chart and
is it entered into an electronic database somewhere? To whom does it go? Most
of us sign release forms giving permission to send information to an
insurance company. This means a lot of really private information is being
released electronically. Could this be used by insurance companies to
determine whether or not they want to continue to insure you? Or could it be
used by an insurance company in the future?
Although there is legislation attempting to address this issue, what will
happen when you try to get insurance again in the future? Given the
universality of electronic information exchange, keeping what you tell your
doctor private is becoming increasingly problematic.
There is also an explosion of knowledge in the field of genetic information,
which is wonderful for treatment but horrible for insurance. Let's say you
inherited the gene for Huntington's disease. If your insurance company or
a potential insurer finds out there is a 50 percent chance you could
develop this disease, they're probably not going to want to insure you. You
can see that confidentiality is a much bigger issue now, and there are some
aspects that were never an issue 10 or 15 years ago.
- It brings whole new meaning to the term "preexisting condition."
- Absolutely! As a matter of fact, I'm currently writing a book for cancer
survivors and I've talked to a lot of people who suspect they may have a
genetic tendency toward cancer given their personal and family history.
However, many of them are afraid to get tested because they don't want to
lose their insurance.
- I'm aware that there's been a lot technology developed around electronic
record keeping and records exchange. Is there anything patients can do
proactively about mitigate negative implications?
- You can say to your doctor, "I'm going to tell you this, but I don't
want you to release it." Or you can carefully read and amend any release
form you sign regarding your medical information. One doctor whom I
interviewed for the book recommends that his patients tell him what they
want on-the-record and off-the-record.
Patients have to be able to tell their doctor the whole story in order to
get appropriate care. I read an essay recently in the Journal of the
American Medical Association written by a doctor about developing a
vision for healthcare in the next millennium. On the issue of
confidentiality he said: "We must have a system in which a patient can
disclose his or her most intimate secrets without fear that those will be
used against his or her interests or for the personal profit of another."
- I was startled by one piece of advice in your book pertaining to dealing
with the realities of managed care. You write: "Never stay in a hospital by
yourself." Tell me why you wrote that?
- I wrote that because the squeaky wheels get the grease. When you're
sick or hurt, you sometimes can't think or communicate clearly. You may be
on pain medication. You need an advocate, somebody who will go down to the
nurses' station and say, "You know, that pain medication is wearing off. Can
you bring some more?" Just having somebody there to help with the bedpan,
answer the phone, or to limit visitors helps a lot. The need is greater now,
since cost containment is king. Nurses have more and more patients to take
care of, and there are fewer RNs and many more health care workers with less
training working in hospitals than there used to be. Some insurance companies
try to discharge you before you are ready to leave, and your advocate can go
to bat for you.
However, despite managed care and confidentiality, the doctor/patient
relationship is as old as time. We had shamans who were healers a millennia
ago, and a lot of the basic issues are still the same. Most of the book
deals with these basic issues.
- Could you summarize or highlight some of the biggest barriers in the
doctor-patient relationship, from both sides?
- First, from the patient's side, a major hurdle to overcome is poor
communication. People often don't give the whole story, or don't have time
to give the whole story. This is particularly true when it's something
intimate. It's just human nature not to bare your soul five minutes after
Another hurdle not often acknowledged is the fear of reprisal. People worry
that if they're too much of a problem, or if they take too much of the doctor's
time, they won't get good care. That's especially common in parents of
sick kids and with older people. They don't want the doctor to get mad at
them and they think that the doctor's time is more valuable than their own.
There's also a cultural problem of people viewing doctors as authority
figures. It's hard to be straightforward and tell the whole story if you
feel like a lesser human being. This can lead to big communication problems
and getting the care you need.
Lack of time to develop a good relationship with your doctor can also be
an issue. Some doctors spend a lot more time with patients than others. The
Medicare pay/fee schedule pays doctors a lot more for doing procedures than
it does for talking to people or doing a basic physical. In some managed care
environments, doctors are required to see a certain number of people per
hour. Group practices with rapid doctor turn-over also prevent developing an
ongoing relationship with one doctor. And, of course, if a patient goes in
with an adversarial attitude, its going to be very difficult to establish a
- And from the doctor's side?
- Again, poor communication is a major issue. One study videotaped doctors'
visits and found that patients were interrupted 69% of the time within the
first 90 seconds of the visit. Then, when the patient answered the question,
only 23% of people went back and tried to finish their thought. Very few
people got to complete what they wanted to say.
Lack of time is a problem from the doctor's side, too. If you've got "x"
number of patients and you've got a lot of things to discuss with each,
that's a problem. What I do is write out a prioritized list of the things I
want to talk about. I always start with the most important, and if time is
running out, I say, "If you need to leave, let me know, and I'll make
another appointment to finish items 6
If the doctor has a paternalistic attitude and you don't care for that, there
is an automatic barrier to forming a good relationship. There are many such
reasons for poor matches. I know people who like to get in and out of the
doctor's office quickly, with little discussion and a prescription. If you
go to a doctor who likes to give explanations and discuss issues with you,
it just is not a good match.
- In your book you include a discussion of rights and responsibilities
for both sides. What led you to this approach?
- I started out trying to cover patients' rights, but I was very
uncomfortable trying to write the chapter that way. Patients' rights don't
exist in a vacuum. Patients have rights and responsibilities; doctors have
rights and responsibilities. So I decided to do both. Conflict tends to occur
if either party focuses only on their rights and what they feel they're due
rather than what they need to do to contribute. I chose to start first with
doctors' rights because I believe most people overlook them.
For instance, every doctor has a right to be treated with courtesy and
respect. Why should doctors have to see a succession of people all day long
who are nasty to them? People who are sick are sometimes not at their best.
If they're not even making an effort to be polite, it makes for a very
difficult workday for doctors.
Doctors also have a right for patients to tell them the whole story. They
have a right to expect patients to comply with a mutually -- that's the
important word -- mutually acceptable treatment plan.
There are a lot of ethical codes for doctors but there aren't any ethical
codes for patients. I think that would be an interesting topic for someone
to write about.
- I understand that you once organized a conference between doctors
and patients to address some of these issues.
- Yes, I did. The last day of my daughter's treatment for leukemia, I
asked the doctor how soon I would get the results of her bone marrow
aspiration, which may determine whether or not the treatment was successful.
If there's no cancer there, you can go home and celebrate because you're
finished with treatment. If there are cancer cells present, then you don't
celebrate because it didn't work. So you really need to hear the news as
soon as possible.
When I asked the doctor, she told me this was at the bottom of the
pathologist's priority list, therefore I wouldn't hear for several days.
That's a long time to a parent. But I don't engage with people like that.
Instead, I went over to the clinic to see the director. I asked her if she
would look at the results if she had time because I needed to be able to eat
and sleep. "Absolutely!" she said. She called me that afternoon to tell me
that the cancer was gone.
After I thanked her, I asked her if she had another minute and we ended up
having an hour and a half conversation about my views on how both the doctors
and parents were letting children down. My comments were centered around pain
and communication. "You know, this facility is seriously behind the times in
treating children's pain," I told her. "You're doing bone marrow aspirations
and spinal taps and torturing little kids, when there are excellent,
short-acting and very safe pain-killing agents that you could give them to
take away that part of this experience. The reason why you probably don't do
this is because you don't know how terrified these kids are and how much the
pain impacts their daily lives. And there's two reasons for that: you're too
busy to ask, and we're too traumatized to tell. So both of us are at fault. "
Then I offered my suggestion (I try to never complain without making a
suggestion). I offered to get a group of educated, articulate parents
together at the facility for a conference with the whole oncology staff. Her
initial response was, "I'll see what I can do, but I don't know if they're
going to go for it." But she set it up and it was very well-received. Five
parents came and we just talked about our experiences with our children. Then
we made suggestions. And the clinic changed their pain policy. They started
evaluating every kid and sedating those whom they felt needed it for painful
procedures, which was almost all of them. I think this really opened their
Afterwards, I had coffee with a couple of doctors who asked me if I realized
what a chance they were taking by coming to the conference. "We thought you
were going to come and attack us." I was surprised and sad that they felt
threatened. I explained that I felt it was a joint problem and that if we
worked together to address it, the kids would benefit and all of us had the
same goal: to help the children survive and thrive.
- Have you done anything else like that since?
- I still go and talk at hospitals and conferences occasionally, but most
of the time I try to reach out through my writing and through interviews. I
am also a daily participant on several Internet support groups. I'm one of
the old-timers on the first lists for parents of kids with cancer. About five
years ago there were very few groups online discussing cancer. But the
numbers swelled dramatically. The
Association of Cancer Online Resources currently offers over 70
cancer electronic support groups. More than 600 families from all over the
world participate in the pediatric oncology cancer lists.
- Do doctors ever participate in any of the Internet discussion groups?
- Yes, they do. And since we recognize that doctors don't have very much
time, we've instituted categories on the subject line. If you're talking
about coping, you put "Cope," or if it's a general matter, like jokes or
just chatting, you put "General." For medical questions we have "Med," and
most of the doctors only read and respond to those. The doctors don't
give medical advice or prescribe, but they often answer general questions in
I've also talked to several doctors who never participate but they read,
which is just as effective in my book, because they're still getting the
- Are there any larger organized efforts to address the doctor-patient
- There have been several pieces of patients' rights legistlation in
congress recently. The book contains a draft of "The Consumer Bill of
Rights and Responsibilities" formulated and presented in November 1997.
We as a society need to recognize and accept that there are limited resources.
We need an evidence-based, compassionate system to allocate those resources.
Everybody can't have everything.
Anything we can do to strengthen the doctor/patient relationships and get
the insurance companies out from the middle will help. I do think
consumers are going to push the changes. It's not going to trickle down
from the top. I'm expecting the pendulum to swing the other way as the baby
boomers age and interact with the medical system more. We're more
opinionated, we ask more questions, and we demand more services. We're going
to see insurers forced back from this maximizing profits stance toward
balancing health needs with reasonable
- What is your next book about?
- I'm writing two books and they each have co-authors. The first is
Cancer: A Guide for Parents of Children with Solid Tumors
(August 1999). This book has a lot of technical information in
easy-to-understand language blended with stories from more than 80 parents,
kids with cancer, and their brothers and sisters. They talk about their
experiences, what they learned, and share what worked for them. The book
gives a lot of information, yet it's also very comforting.
I'm also collaborating with two medical professionals on a book for survivors
of childhood cancer called Childhood Cancer Survivors: A Guide to the
Future. We're writing this for the quarter of a million survivors of
childhood cancer in this country. The numbers are increasing by leaps and
bounds because rates of childhood cancer have dramatically increased in the
last twenty years, and the rates of cures also have gone way up. There are
thousands of people out there with a lot of late effects from cancer, both
emotional and physical. The majority of them are not being followed by
health care providers who specialize in the late effects of cancer treatment,
and so they really need information.
I'm very excited about this book. We're putting a passport in the back that
people can take to their treatment facility. The caregiver can log every
treatment the patient has ever had. The survivor then has a permanent record
of their treatment (how much radiation they've had, which parts of their
body were treated, and what their dosage history is with chemotherapy). This
is essential information for all subsequent medical care givers. The book
also has tables listing which types of follow-up tests at what intervals are
needed for different drugs. This way, even if the survivor is not under the
care of somebody who has spent a lifetime learning about the late effects of
childhood cancer, they can carry that information with them to advocate for
- What are your thoughts about
and these kinds of books in general?
- I think that they are the right books at the right time, because there's
an upswell of interest in medical information. People are demanding more of
a voice in their care. One indication that these books are answering a need
is the number of librarians who tell us that medical books are one of the
biggest growth areas in their collections. The largest number of items
checked out of most library collections are health or medical information
books. I think people are becoming more aware that they can't assume somebody
else is watching out for them or for their best interests. Given today's
world, the kind of information the Patient-Centered Guides presents -- basic
information anyone can understand, plus emotional support -- really helps
people in their medical journeys. Most people seek advice from others who've
walked the same path, the veterans. So I think the future is bright for these
- It sounds like technology and communications will play increasing
roles in information gathering and patient networking, too.
- Just look at the Internet and you can see what is happening in our
culture. In October 1998, CNN reported that 18 million people sought
health-related content on-line, rivaling the number of people who tapped
the Internet for investment information. The Washington Post (February 16,
1999) reported that as many as 60 million adults used the World Wide Web
last year to find information about health care, according to a poll by
Louis Harris & Associates.
That's an amazing number of people looking for information. People are
hungry for it, and they're in great pain. Not just physical pain, but
information pain. People want answers right away. For example, if you are
diagnosed with a chronic condition or disease, you usually will have been
recommended a course of treatment. You might want to research the condition
itself, the recommended treatment, or emotional support for your predicament.
You may also look for information sequentially. A woman with breast cancer,
for example, may first want help understanding the disease and learning about
standard treatment. She may want to learn about clinical trials, and later
might want information on coping with side-effects. Then later still she
might want to try visualization, or learn about a support group.
There is a lot of good news, too. The technology and medical care available
now is unparalleled in history. What can be done to treat illnesses and
injury is just mind-boggling. There are new drugs, gene therapy, amazing
machines used to diagnose and treat, and exciting new tools for doctors.
On the human side, there are a lot of wonderful doctors out there, who are
smart and really care about their patients. They're doing everything
they can to form partnerships and give good care. If enough of us do our part
to develop and nurture that, change will occur.