I have a range of long-term and acute medical conditions, and as a result I have extensive experience of outpatient appointments, admissions and discharges over the last 40 years. My long-standing interest in human biology and medical matters makes me a very motivated patient, but I’m aware that there is an increase in patients getting involved with their care more generally. However, effective communications with some groups, especially older patients, can be extremely challenging for the medical profession.
I read with great interest the Academy of Medical Royal Colleges Guidelines for Writing Outpatient Clinic Letters to Patients. I was immediately impressed that they encourage doctors to write outpatient letters directly to the patient, with a copy of same letter being sent to patient’s GP. The guidelines clearly explain why doctors should write letters directly to patients, and spell out the benefits of this approach to both patients and practitioners. I feel strongly that the principles underpinning outpatient letters apply almost equally to all forms of communication both written and verbal.
In spite of my many conditions which keep me on my toes, my visits to my GP and various consultants take up only 10 or 15 minutes every few months or so. For the rest of the year my carer and I are responsible for my health and wellbeing. I need to make as much use as possible of these precious 10 and 15-minute consultations and their respective follow-up letters if I am to fulfil my responsibilities. I want to understand what is happening to me when I’m unwell and be fully informed about the choices in front of me. I need to be able to take my medications in the right way, monitor my progress and understand what I can do to take care of myself in the best way. With all due respect to the practitioners on whose expertise I rely so heavily, I feel responsible for myself and view myself as my primary caregiver because I spend so much time actively engaged. I welcome the ‘Letters to Patients’ initiative because I feel that by aiming medical information clearly in the patient’s direction it underlines the key part that patients are able to play in their own healthcare. Motivated patients like myself will welcome this and hopefully, patients who lack confidence or understanding will be encouraged to become more actively engaged when they receive letters they can understand more easily. There will always be patients who still find involvement difficult. This presents a challenge to build on the vital role of carers in many such situations, writing the carer’s position more formally into the communications network (representing patients directly when they are not well enough to act for themselves).
When I am speaking to my consultant, if I am feeling well at the time, my mind is buzzing with what I want to ask, listening to answers, posing more questions, and deciding which questions to leave out because there isn’t enough time. However, if I am feeling unwell at the time that I am speaking to my consultant, or the implications of the subject matter are particularly distressing, my mind can be a fog and my memories of the discussion are confused. In this situation, the outpatient letter is so important, especially if it arrives soon after the appointment and it is written clearly and concisely.