November is National Diabetes Awarenss Month. Primary care providers take care of many patients with diabetes during their careers, but how often does one of those patients tell providers exactly what he wants and how he'd like to be treated? Here, in a piece from our archives, read 17-year-old Trevor Torres' refreshing perspective.
By Trevor Torres
My name is Trevor Torres, though I’m also known as the Diabetes Evangelist. At 17 years old, I’ve launched a speaking career through which I share my unique perspective with the health care community -- that of an empowered teenage patient. Before I began public speaking, I recorded a video for the Institute for Healthcare Improvement (IHI) Open School. It exploded in popularity and led to the start of my speaking career. In that video – as someone who has spent a lot of time with doctors – I talk about what I expect from health care providers. I thought the health care professionals and trainees who read this blog might like to hear my perspective, especially because they will undoubtedly take care of lots of diabetics and teenagers during their career in primary care.
There's two main things I expect from my heath care providers. One: Don't condescend. When I was first diagnosed with diabetes, the doctors said, "You can give yourself insulin in one of two ways: You can do it based on your blood sugar, so if you have higher blood sugar, give yourself more insulin. Or you can do it based on what you're going to eat, so if you're going to eat x amount, give yourself x amount of insulin." Now maybe I’m one of the smarter patients, but I was like, "Why don't I just come up with an algorithm that incorporates both variables?" That's probably a little atypical, but the bottom line is if your patient already has something like that figured out, you don't need to simplify the explanation down to what you perceive your patient's level of understanding to be. You can explain something, and then if your patient doesn't understand it, they can ask for clarification. That may be just me, but I really hate it when I feel like I'm being talked down to. And that also might be my age: I know we kids are a little uptight about that! Another thing that I hate is the word "poke," as in, "I'm going to poke you." No, you're not going to poke me, you're going to stab me, okay? A poke is when you prod someone with your finger. A stab is when you insert a sharp metal object with the intent either to inject a foreign substance into the body or to draw blood by breaking the skin! In health care, you stab; you don’t poke. Another thing that's important is to understand how your patient learns. I don't have all the answers about learning, but I know that I personally like to know why something's being done. If doctors say, "You need to eat this way," "You need to do this," "You need this treatment," they better tell me why I have to do it. That way I know I actually should do it. Because people tell you to do things all the time, especially if you’re a kid, and if I did all those things…well, ain't nobody got time for that! But if my doctor says, "You need to take this medication because this is what it's going to do in your body and this is what's going to happen if you don't do it," then I know exactly why I should, and I'll be much more likely to do it! If you’re complaining that your patient didn't do x, y, and z, and you didn't tell them why they should have done those things, then of course they didn’t do it. People like me – teenage diabetics – have a lot of experience going to doctors and other health care providers. So we understand a lot more than we often get credit for. So just say what you mean. I don’t need my health care providers to oversimplify. I’ll understand if you tell me how my medicine works or what changes certain foods will cause in my body. And I certainly don’t appreciate a condescending tone, so just say stab, not poke! Trevor Torres wrote this piece as a 17-year-old freshman at University of Michigan. Diagnosed with type 1 diabetes at age 14, he calls himself a “Diabetes Evangelist” and has started a public speaking career through which he brings his unique perspective to the health care world. For more on this topic, check out his recent keynote speech, “The 21st Century Patient's Perspective - What Millennials Expect From Healthcare” at TrevorTorres.net.