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Working together with health professionals, the engaged patient becomes empowered to meet the challenges of their illness with knowledge, confidence and energy.

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Role of the Patient In the Management of Rheumatic Disease Patient centered care is the hallmark of quality health care. It is important to understand the risks and benefits associated with different medications or treatment approaches Work with your providers to create a care plan together. Ensure they understand your family and home situation so that it is considered in the plan Invest in the relationship with the team, be honest and open about your symptoms and level of adherence to recommended treatment to make sure you get the right diagnosis and treatment Be respectful even when you are upset and scared Advocacy Speak up and ask questions about your care and treatment plan.

But all that training can be undone the moment the students hit their clinical years.

And the engine for all of that, indeed the place where the dialogue between doctors and nurses takes place, is the computer. The consequence of losing both faith and skill in examining the body is that we miss simple things, and we order more tests and subject people to the dangers of radiation unnecessarily.

Just a few weeks ago, I heard of a patient who arrived in an E. After being stabilized and put on a breathing machine, she was taken for a CT scan of the chest, to rule out blood clots to the lung; but when the radiologist looked at the results, she turned out to have tumors in both breasts, along with the secondary spread of cancer all over the body. View all New York Times newsletters.


In retrospect, though, her cancer should have been discovered long before the radiologist found it; before the emergency, the patient had been seen several times and at different places, for symptoms that were probably related to the cancer. I got to see the CT scan: the tumor masses in each breast were likely visible to the naked eye — and certainly to the hand. Yet they had never been noted. Too frequently, I hear of and in a study we are conducting, I am collecting stories like that from all across the country. They represent a type of error that stems from not making use of basic bedside skills, not asking the patient to fully disrobe.

It is a more subtle kind of error than operating on the wrong limb; indeed, this sort of mistake is not always recognized, and yet the consequences can be grave. IN my experience, being skilled at examining the body has a salutary effect beyond finding important clues that lead to an early diagnosis. It is a ritual that remains important to the patient. Recently my ward team admitted an elderly woman who had been transferred from her nursing home in the night because of a change in her mental status.

A CT of the head and all other tests were determined to be normal; the problem had been dehydration, and she was better, ready to go back.

Patient Rights & Responsibilities

After introducing myself to the patient and to her daughter, I did a thorough but quick neurologic exam. I put the patient through her paces: mental status, cranial nerves, motor and sensory function, used my reflex hammer and pointed out interesting things along the way to my interns and students.

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WMA Declaration of Lisbon on the Rights of the Patient

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