Patient Advocate and Author Leslie Michelson

The patient advocate discusses his latest book, The Patient’s Playbook.

Leslie Michelson is the Founder, Chairman and CEO of Private Health Management, a unique, patient-focused company that has helped thousands of people to obtain exceptional medical care. His most recent book, The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love, distills his three decades of experience as a medical-case-management expert into actionable steps and practical tools that will empower readers everywhere to achieve the best possible health outcomes at every stage of life. He frequently speaks to audiences around the world, providing life-saving information and a revolutionary approach to medical decision-making.

He is on the Advisory Board of the UCLA Fielding School of Public Health and the board of the ALS Therapy Development Institute. He received his B.A. from Johns Hopkins University and a J.D. from Yale Law School.

Follow @lesliemichelson & @PatientsPlaybk on Twitter.

Like Patients Playbook on Facebook.

TRANSCRIPT

Tavis Smiley: Good evening from Los Angeles. I’m Tavis Smiley.

Tonight, as part of our Road to Health series, a conversation with patient advocate and author, Leslie Michelson, whose book offers tips for how to get the best possible medical care and make the system work better for you.

Then singer, BeBe Winans, joins us to discuss a new musical about his life’s journey. It’s called “Born For This”.

We’re glad you’ve joined us. Patient advocate Leslie Michelson and singer BeBe Winans in just a moment.

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Tavis: And by the Robert Wood Johnson Foundation working with diverse partners to build a national culture of health so that everyone in America can live productive and healthy lives.

The California Endowment. Health happens in neighborhoods. Learn more.

Announcer: And by contributions to your PBS station from viewers like you. Thank you.

Tavis: Pleased to welcome Leslie Michelson to this program. He’s an expert in medical case management and an advocate for patient education and empowerment. His text is called “The Patient’s Playbook”. It’s been described as a primer on how to make the right moves and be an active participant in your healthcare. Leslie, good to have you on this program.

Leslie Michelson: Thank you, Tavis. My privilege.

Tavis: By being an active participant, you mean what exactly?

Michelson: Well, you know, Americans are great consumers throughout the entire economy. The one place where they don’t express their consumerism is when it comes to their healthcare. What I’ve learned is that everybody can get better healthcare just by learning how to become a better healthcare consumer.

Tavis: Are we afraid? Are we intimidated? What’s the reason why, in that one arena, we tend to shy away?

Michelson: It’s both of those things, and when it comes to your health, people get nervous. They get intimidated. They get scared so that consumer DNA that people are so good at using when it comes to buying cars, planning vacations, picking a school for your kids, gets suppressed.

So I wrote “The Patient’s Playbook” to teach everybody how to harness the consumer DNA that they have to get the very best medical care.

Tavis: What is it specifically about healthcare that causes us to be frozen by our fears?

Michelson: Well, you know, when you’re forced to confront your own mortality, when you sit in that doctor’s office in a flimsy gown and the doctor says some of those very dangerous words, “You have cancer. We need to do surgery”, you get paralyzed and you want to believe that everything that doctor’s doing is exactly right.

But doctors will perform better when people overcome those fears, when they follow the teachings and the guidance and use the tools and the techniques in “The Patient’s Playbook” and they learn how to partner with their doctors.

Tavis: Let me run through in the time that I have on this program these six steps that might help us get more out of our experience with our physicians. Number one, diagnosis is specific and confirmed.

Michelson: So these are my six steps to getting to the no-mistake zone, which is the process I’ve developed over the decades . I put the book across all the medicine to get people better outcomes and it starts with the diagnosis. 10% of all deaths in the United States of America are the result of diagnostic errors.

So the very, very first thing everybody needs to do is make sure that their diagnosis is specific and independently confirmed. Make sure that it truly is breast cancer before they start treating you. Make sure that it is a herniated disc in your back or whatever it is. Because if there’s ambiguity in the diagnosis, virtually every single subsequent step is going to be random or wrong.

Tavis: 10% out of the aggregate isn’t a high number, but it’s 10% too high. Why is it still sitting at 10%?

Michelson: Because the healthcare system doesn’t check all the time and patients don’t ensure and make certain that they get second opinions on things like diagnoses. Look, doctors are terrific. They’re some of the most hardest working, most caring people I’ve ever met. But like you, like me, they all make mistakes.

And it’s up to the consumer, the individual patient who, frankly, pays the consequence if it’s wrong to get a second opinion, to have that x-ray seen by another orthopedist, to have those slides from the tumor tissue read again to make sure that they’re exactly right.

Tavis: Step number two, convinced about when and why.

Michelson: So determining when to treat a medical condition is really important. There are medical emergencies where hours and minutes matter and you need to be persuaded that that’s the case for you. But in so many other circumstances, you have the time to do some homework, to think about options, to see if there are other experts who might have different perspectives on it that might be better for you.

And you need to ask your doctors, “Do I need to get his thing treated right now, or do I have a couple of days or a couple of weeks”, which you generally do, to make sure that you’re getting it down right.

Tavis: Number three, explored and understand the most promising treatment options.

Michelson: So we live in the golden age of biomedical research. Never in the history of the world have there been so many developments that are so positive happening so quickly, and patients can find that information online.

The problem is, it’s a bit tricky and what I encourage everyone to do is either to read “The Patient’s Playbook”, to go on our website, the nomistakezone.com. There’s all sorts of guidance about fabulous websites. And the good news, Tavis, is they’re all free.

So, for example, there’s a great website called expertscape.com. You just put in your diagnosis. It might be breast cancer, colon cancer, fibromyalgia, whatever it might be. Click enter and it’ll immediately give you the physicians who have done the most research on that particular diagnosis.

And if you happen to live in California or New York or Illinois or wherever you are, you can then focus on that state and find the doctors in your community who have the greatest expertise and it’s free of charge.

For every single diagnosis, there are multiple philanthropies focused on that whether it’s breast cancer, lung cancer, prostate cancer, where there are people waiting by their telephones right now who have the expertise to help you. All you need to do is go to their websites, reach out to them. They’ll provide you great information.

Tavis: Number four, met with experienced physicians at appropriate hospitals.

Michelson: So community hospitals are terrific institutions for most things, but if you have a serious problem, if you have esophageal cancer, if you have an aortic dissection, if you need a very serious intervention, it makes sense to go to a major academic medical center in your city, in your community, and identify the physicians with the greatest expertise in exactly what you have. Look, experience matters and practice makes perfect.

So when people focus on doing something a lot, do it in the context of a research environment, they typically get better outcomes. And the best news about that is it doesn’t cost any more. Most of the physicians who are at the major academic medical centers are inpatient in most of the insurance plans. So you as an individual don’t need to pay more to get somebody who’s at the top of their game.

Tavis: Step number five is you can see your treatment plan with clarity.

Michelson: Everyone has great intuitions. We’ve all made good decisions and we’ve made some crummy ones over the years.

Tavis: I know I have, yeah [laugh].

Michelson: Yeah, me too. But think about those decisions you made that have been the very best. When you’ve collected information, you stayed in neutral to all the data in place, and then something magical happens.

You’re intuition engages and you can see the decision and you wake up and you say, “That’s the right decision for me.” What I encourage everybody to do is to do that when it comes to their healthcare.

I’ve done this for thousands of people over the decades and, when people follow the six steps of the no-mistake zone that I lay out in “The Patient’s Playbook”, they get to that day where they call me up and say, “I’ve seen three doctors. I’ve made sure the diagnosis is right. I’ve gone online and you know what? It’s Dr. Smith in Good Samaritan Hospital that I want to do the surgery and I’m crystal clear on it.” You know what? That’s always the right decision.

What I tell people to do — it’s last step in getting to the no-mistake zone — is if you follow that process and your intuition kicks in, proceed with courage and confidence because you’re now in the no-mistake zone and you’ve done everything that you can.

Tavis: And that is step number six. Your gut is telling you that this is the right treatment and the right physician for me.

Michelson: Right, and listen to your gut which we all do in so many other realms of life, but that intuition which I think is incredibly valuable to people tends to get suppressed when it comes to healthcare.

Tavis: How does the medical industry, how do physicians and other professionals respond when patients start to express their own rights, they start to express their own interests? Because I can tell you a number of industries that come to mind pretty immediately, when you start pressing back, they don’t take so kindly to that.

Michelson: One of the reasons I wrote “The Patient’s Playbook” is to teach patients how to partner with their physicians. So at the 95%, 98% level, they’re going to get the proper engagement from their doctors. Look, doctors don’t have the time they need. They don’t have the resources they need. Nurses are challenged to take care of everybody that they need to take care of.

My view is we have this incredible reservoir of intelligence and energy called the 320 million Americans who become patients at some point in their lives. And if those people can follow the teachings and the practices of “The Patient’s Playbook”, they can make it easier for physicians and nurses to be at the top of their game.

Most every time — it doesn’t happen all the time — but most every time when you follow the teachings, the physicians embrace it and recognize that you’re going to be a partner in your care.

Tavis: What’s in this book for people who go to their doctor’s offices and what they are subjected to maybe even unwittingly is a lack of culturally competent care? So I walk into an office and they just don’t get me. They don’t get my culture. How do you press those issues?

Michelson: You should never be with a physician that you don’t feel is respecting you for who you are, that doesn’t accept the values that motivate you, and doesn’t respect and honor your culture. You should never be there. That person is too important in your life.

And what I encourage everybody to do, if you have that sense — one way or another, we’ve all been there — you should say, you know, this person is not treating me the way I deserve to be treated. You should get a better physician.

One of the things we talk about in “The Patient’s Playbook” is how to find a primary care physician where it’s so important to have a strong and enduring relationship with one and somebody who gets who you are where you feel harmonious.

So if the day comes when you’re feeling crummy, when you have anxiety, when you’ve had a no good, terrible day, you’ve hurt your leg playing basketball or you’ve even something and it’s not sitting well with you and you’re really scared, you’ve got somebody that you can trust, who trusts you, who respects you, and you’re going to follow.

That’s a really important relationship. What I teach people to do is to follow the process we lay out in the book to find that person.

Tavis: I used the cheat sheet tonight to give you some sense of what is in this beautiful book with a lot of great advice in it. You’ll want to get it for yourself. It’s called “The Patient’s Playbook: How to Save Your Life and the Lives of Those You Love” by Leslie D. Michelson, chock full of very good information. Good to have you on the program, sir. Thanks for the text.

Michelson: Tavis: thank you so much.

Tavis: My great pleasure. Up next, singer BeBe Winans. Stay with us.

Announcer: For more information on today’s show, visit Tavis Smiley at pbs.org.

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Tavis: And by the Robert Wood Johnson Foundation working with diverse partners to build a national culture of health so that everyone in America can live productive and healthy lives.

The California Endowment. Health happens in neighborhoods. Learn more.

Announcer: And by contributions to your PBS station from viewers like you. Thank you.

Last modified: July 7, 2017 at 2:07 pm