Leslie Michelson and The Patient's Playbook

In an interview with Leslie Michelson, author of The Patient's Playbook: How to Save Your Life and the Lives of Those You Love, we learn what it takes to be an effective healthcare consumer and a

Did you interview your primary care doctor? Do you know which hospitals in your area have a trauma unit? Do you have personal copies of all of your medical records? According to Leslie Michelson, author of The Patient's Playbook: How to Save Your Life and the Lives of Those You Love, your answers to all of these should be a resounding yes; that is, if you wish to get the best healthcare treatment.

After reading The Patient's Playbook I knew that I had to share it with others. The advice in it is priceless and as a patient it was advice I wish I'd received years ago. The early chapters alone on finding a good primary care doctor are worth the price of the book. I don't know anyone who has taken the time to actually interview potential doctors before choosing the one that would handle their healthcare long term. But, as Michelson points out we often spend more time and effort buying a new car or hiring a babysitter than we spend finding the doctor who will take care of us for (potentially) the rest of our lives.

Michelson also addresses how to get the best care in an emergency, how to find the best specialists for your needs, and what to do when serious illness strikes, as well as getting copies of your medical records and what to do with them once you get them.

Why did Leslie Michelson become a patient advocate?

Michelson's background in health advocacy goes back to his high school years. His father was diagnosed with heart problems, and they were told he would require open heart surgery, an operation that was still in its infancy at the time. Michelson took the initiative and not only encouraged his father to get a second opinion from a larger hospital but made the appointment for him. It turned out that he didn't need that surgery after all. That one call avoided a risky surgery and his father lived another 40 years without a problem. That experience set the stage for a life-long interest in helping others get the best healthcare.

As a young lawyer, Michelson had the opportunity to work at the Department of Health and Human Services. This gave him a chance to learn more about the healthcare system and see where he could make a difference. He says that he learned everything he could about the healthcare system and saw how much it needed to be changed. Seeing how anxious people were when they were sick drove him to focus his career on creating entrepreneurial companies that would improve the healthcare system.

"During that period everyone I knew that had a healthcare issues would call me. Over the years I helped thousands of people at night and on the weekends, gratis." Michelson says that finally "about seven years ago friends suggested that I build a business to do [patient advocacy] because I've figured out what others don't know. So we did that, it's called Private Health Management. We get retained by people globally to help them get the best healthcare. The issue is that we have to charge a lot of money because it takes a lot of time and effort."

So, why write a book?

That last bit is why Michelson decided to write a book. He said he wants to "really help everyone become a more effective healthcare consumer whether they could afford us or not. " In talking to him I could tell just how important people are to him, and I could understand how he could have given away so many thousands of hours for free. While he's listed as the CEO of Private Health Management, he's still directly involved in client care and ensuring that the patients get the best healthcare possible. "Helping you become a more effective healthcare consumer" should really be his tagline.

How do you start?

Being an informed healthcare consumer is all well and good, but how do you get started? If you are asking this question, you aren't alone. Mr. Michelson said this is the most common question he hears. "The healthcare system seems so intimidating that they don't know how to begin to put in place the process and find the right physician. Once we get them started things are much better." In The Patient's Playbook, Michelson starts at the beginning and walks you through the steps, getting patients and caregivers the map they need to get on the road to the best healthcare possible.

What is the first step?

According to Michelson your first step should be getting copies of your medical records and putting together a complete picture of your health history. This step alone can seem very daunting as many patients have years of medical records to obtain from many different doctors. Michelson says that even if this is the case you can and should still make the effort. He says that you just have to take it little by little.

Michelson says to "just stay on it on a sustained basis. Identify the big most important pieces (the most recent or times when there was meaningful change) and understand that it's going to take weeks if not months." Don't get discouraged and if you have someone else in your life that enjoys the details put them to work to help. This is especially important if you are already seriously ill, because you don't have the time or energy to worry about the details.

How do doctors feel about informed patients?

He said that most doctors actually do prefer having an informed, prepared patient. A patient who walks in having done the research and says "Doctor I know you are busy and can't research every little thing so I wanted to share what I've found with you," will have good success with most doctors.

As far as what to do if a doctor isn't listening? Michelson says "candor and honesty is always the best thing to do. If the doctor doesn't have time for that it's time for you to find a new doctor that will engage with you. There are doctors that will engage, you just have to have the courage to find them. Just always be respectful and always be very clear with the physician as to what your expectations and desires are in terms of your relationship."

How do you form a partnership with your doctor?

He reminds us that the relationship between doctor and patient should be thought of as a partnership. "Ask your doctor for specific suggestions as to how to partner with them. Ask your partner (who happens to have an MD after their name) what's the best way for me to make it efficient and easy for you to be at the top of your game? We need to take down the wall between doctor and patient, it needs to become a collaboration."

For those who are scared to "bother" their doctor with what they worry are small things or silly questions, Michelson reminds us "They aren't small things. Making sure the physician is fully informed as to what your symptoms are, what subtle changes you may have made to your diet, exercise, sleep, medication, and how they relate to changes in symptoms can be the clue to achieving a higher functioning status." However, he does remind us that we "need to be respectful to the constraints under which doctors function. They all want to spend more time with their patients but they have constraints. Make sure you are communicating as efficiently and as respectfully as possible." If your doctor has an online system for communication use it, if not find out how to best communicate and keep the communication concise and to the point.

What to do when dealing with chronic illness?

When it comes to dealing with long-term chronic illness, Michelson points out how important it is to build a team not only with your doctors but also a support team within your friends and family. "Friends relatives, people you may know from your community want to help. One of my favorite sayings is "A sorrow shared is a sorrow halved." If you've been through adversity and have been through it with another human being then you've halved that experience." He encourages those who struggle to ask for help. He says that if you ask you will find it, but he points out that it takes courage to ask for help.

Courage is something that Leslie Michelson emphasized again and again as we talked. It takes courage to get through any healthcare situation, but especially the big ones. He reminds us that "courage isn't easy but the reward for finding it is extraordinary."

Courage is something you should have more of after reading The Patient's Playbook: How to Save Your Life and the Lives of Those You Love, I know that I did. You will likely reassess your doctor patient relationships and question whether you should stay with that doctor that isn't listening. You will begin the process of chasing down your medical records and putting together a succinct medical summary that tells your story. The next time you have a medical emergency you'll know you are choosing the right hospital for your needs, and if and when tragedy strikes you'll be prepared.

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