Thursday, January 31, 2008
These eEmpowered healthcare consumers are simply behaving rationally. Patients are, after all, the biggest stakeholders in their own health. They know the traditional office setting is not user-friendly: It's hard to get a doctor on the phone for advice, difficult to get a timely appointment, and coming in for the appointment obligates up to a half-day away from home or work. So naturally, they look for alternatives. And why shouldn't they? The doctor's office should be reserved for people who really require the special skills offered by physicians."
Such improvement in health habits may be accomplished by incorporating more emphasis on personal health habits in medical school curricula, in residency training, in practice environments, and in continuing medical education. Furthermore, this personal-clinical link should also be explored in other health professionals. For now, physicians at all stages of training and practice should be particularly encouraged to have healthy behaviors, since this helps our patients and even the whole population to make healthier decisions in their own lives."
Tuesday, January 29, 2008
Monday, January 28, 2008
Friday, January 25, 2008
19 Percent of Office-Based Physicians Refuse to See Pharmaceutical, Biotech and Medical Device Sales Reps
I see reps only once - when they have a new product they want to tell me about.
The great thing about the internet is that every once in a while, you come across a gem. This is one of those websites ! I think every medical student, resident and doctor should go through this carefully. It will help them to improve their EQ ( what used to be called the bedside manner, in the good old days !) All of us need polishing in this department - and helpful reminders can never hurt !
They should translate these videos into many other languages - this is a marvellous teaching resource !
Here's what a patient just sent us by email...
My husband and I had been married for three years before we decided we were ready to have a baby. We were still in our late 20s and thought we had all the time in the world to start a family. But when 6 months and then a year went by and I was still not pregnant, we grew worried and consulted my
In the meantime, we started researching options in
We returned back to the
We will be happy to discuss our experiences further. Feel free to contact us at email@example.com"It's feedback like this which makes a doctor's job so worthwhile ! There is lots of stress - but the smile on a happy patient's face and a heartfelt thanks gives pleasure which cannot be matched by anything else. Unfortunately , some doctors are too busy to stop and accept the thanks - or don't take the trouble to savour it !
And if a picture is worth a thousand words, this photo says it all !
Thursday, January 24, 2008
Another source of misdiagnosis: Lab results get lost or forgotten. A study by Dr. Tejal Gandhi at Harvard Medical School found that up to 33 percent of physicians did not always notify patients about abnormal test results. 'No news is not good news,' says Dr. Saul Weingart, vice president for patient safety at Dana Farber Cancer Institute. 'It might be that the report fell down behind someone's desk.'"
'Self-management support is the most important intervention physicians can do to improve patient outcomes,' said FP David Swieskowski, M.D., M.B.A., vice president of Mercy Clinics Inc. in Des Moines, Iowa. 'The New Health Partnerships pilot collaborative provided both the knowledge and the motivation to implement (self-management support) in Mercy Clinics,' he added."
Enter the DUN Factor. DUN is my mnemonic for 'Dynamic, Unpredictable, and Non-linear,' and it reflects how life really 'is.' In brief, life is DUN. The DUN Factor is responsible for the majority of patient safety breaches and accounts for the terrible medical malpractice environment.
Perhaps nowhere in our daily experience is the DUN Factor more evident than in the communication between two (or more) people. Who would argue that conversation between two or more individuals is not dynamic, often unpredictable and non-linear, especially in emotionally charged situations, as is often the case in healthcare."
Wednesday, January 23, 2008
By Stephen E. Beller, Ph.D. and Sabatini J. Monatesti. The Wellness Wiki helps to clarify the complex problems plaguing the U.S. healthcare system and develop sustainable ways to improve the health and well-being of all people. This ever-evolving virtual encyclopedia of the healthcare crisis and potential remedies is updated continually. The various topics include updated links to external blogs and wikis containing relevant discussions."
This is a treasure-trove of updated information ! It takes an exceptionally broad view of the healthcare system; and prescribes clever ways of fixing the many problems which plague it.
Clinicians and other collaborators on a patient's healthcare team can gain access to diagnostic quality and digitally authenticated images and reports in the Health URL with permission of the patient or his or her designated agents. Practice management systems and EHRs interact with the Health URL by coding relevant patient information into CCR format with DICOM and PDF references and implementing Web services and federated identity protocols already deployed in government and corporate networks. A new generation of Internet commerce and collaboration technologies allows healthcare providers to leverage their customers' trust by combining their internal practice management systems with a patient-centered, independent private health record.
Aggregate Information from providers and the patient to one Health URL.
Support the Physician HIPAA compliant, FDA registered, diagnostic imaging, digital signatures, single sign-on.
Clarify Privacy Access authorization is a combination of host policy and patient consent.
True Portability enables a Host URL to be moved from one host to another without disturbing access from any practice. "
That's why I don't want to hear anymore about universal health care or HMOs or the evils of insurance companies until each and every hospital in this country can look me in the eye and tell me that they their staff is full of truly compassionate people who treat their visitors like patients, not products. Hire and train the right people, and then and only then come talk to me about everything else you need.
Our politicians are right; we do have a health care crisis in this country. But it's not going to be fixed by them, it's not going to be fixed by some government agency, and it's certainly not going to be fixed by throwing more money around. No, if you really want to fix our healthcare system then look no further than the word 'healthcare' itself because the secret is right there.
The secret is 'care.' "
Yes - putting care into healthcare is simple - but not easy !
By swiping a membership card, credit card or driver's license at the kiosk, patients can be automatically checked-in, presented with their appointments, given the opportunity to sign consent forms and even prompted for their co-pay. Once the patient is checked in, the kiosks can display patient education, collect medical history information and provide way-finding directions. Registration or front desk personnel can then view and manage patient checked-in lists, monitor patient flow through the organization and much more."
Here are some products and services designed to help prepare you for the unexpected. Regardless which one you use, be sure to update medical information regularly. Outdated information may be more dangerous than none at all."
This is a hilarious spoof on Big Pharma websites which use DTC ( direct to consumer advertising ) to sell their drugs. After looking at this site, you'll never get fooled by Big Pharma marketing whizkids again ! I didn't know whether to laugh - or to cry !
If you look at these photos, you'll stop eating processed foods bought at the supermarket ( and improve your health in the bargain) !
Tuesday, January 22, 2008
Introducing nine new made-up diseases for drug companies to exploit with mind-altering drugs (satire)
Disease mongering Restless Legs Syndrome: A case study of how the media helps make people sick (PLoS Medicine)
Discussions about disease mongering usually focus on the role of pharmaceutical companies—how they promote disease and their products through “disease awareness” campaigns and direct-to-consumer drug advertising, and by funding disease advocacy groups. But diseases also get promoted in another way: through the news media. News reports are a major source of health information for people . Unless journalists approach stories about new diseases skeptically and look out for disease mongering by the pharmaceutical industry, pharmaceutical consultants, and advocacy groups, journalists too, may end up selling sickness."
Read the entire book free online !
The great direct-to-consumer prescription drug advertising con: how patients and doctors alike are easily influenced to demand dangerous drugs
You may be wondering why doctors base their prescriptions on the requests of their patients, who usually have no medical training whatsoever. That's a good question with a simple answer. The pharmaceutical-advertising machine seduces doctors, too.
According to Burton Goldberg's book, Alternative Medicine, paid pharmaceutical advertisements are the main source of the Journal of the American Medical Association's revenues. The American Psychological Association is equally under the pharmaceutical companies' spell, as 15 to 20 percent of the American Psychological Association's (APA) income comes from pharmaceutical advertisements in its journals."
In my opinion, a candidate should get up and say, 'Politics has absolutely no business in reproductive rights.' A politician should say, 'This is not even something I'm willing to discuss. It is a woman's right. It's not my decision.' Unfortunately, that's not the way it's happening."
Unfortunately, politicians and bureaucrats want to meddle in our lives and take away our reproductive rights - one by one. Most of us are blissfully unaware that this is happening , and we are powerless to prevent this.
And while such doctors have always been part of medicine, medical organizations say they fear that they are increasingly common - doctors, under pressure to see more patients, are spending less and less time with each one and are replacing long discussions with laboratory tests and scans - and that most problem doctors apparently have no idea of their patients' opinions of them.
Patients usually do not confront doctors. Instead, most rant to friends or family members about their experiences or simply change doctors. But in most areas of the country, there is an abundance of patients. If a few patients leave a medical practice, plenty more can take their place, so doctors may never even know what their patients think."
What determines popularity? The effectiveness of the drug company's marketing and advertising efforts. In essence, doctors are often bribed or lied to so that they will prescribe certain medications.' Bribery is a danger in any business sector. In medicine, bribes can prove downright deadly; nevertheless, they are shockingly common.
How would you like a bonus of $100,000 per year on top of your already outrageously high salary? Wow, that sounds like a dream, doesn't it? Well, for many doctors, obtaining a bonus of that amount is a reality. These days, the majority of doctors have dived right into the 'deep waters of entrepreneurship, where there is always the danger of conflict of interest between patient care and making a buck,' as Martin. L. Gross phrases it ".
According to a 2006 study of online health searches by the Pew Research Center, eight of 10 Internet users, up to 113 million Americans, have gone online looking for health information on behalf of themselves or a loved one. For those with a chronic problem, like Susan, that number rises. People with chronic medical problems are more avid users of the Web and state that their online searches affect treatment decisions, their interactions with doctors, and their ability to cope with their condition. That's not something that any doctor can dismiss."
Sunday, January 20, 2008
Ouch - sometimes the truth can hurt !
I am sure we'll all continue advising breast self-exams and mammography, even though they do not help ( and can actually harm) because
1. It makes sense . After all, if you pick it up early, isn't it common-sense that treatment will help ? Unfortunately, we refuse to let ugly facts slay a beautiful hypothesis !
2. We've been brainwashed into believing it helps . Repeating something ad nauseam will do this very effectively !
3. It's become a billion dollar industry !
4. We want to believe that we can prevent and treat cancer - it's a helpful delusion to have.
5. We don't want to accept the fact that everything we've done for the last 30 years has been wrong and unhelpful !
You may feel more comfortable talking things over with your doctor if you do some of the following things:
* Write down a list of questions to take with you when you go to see your doctor
* Have a family member or friend come with you to the appointment
* Make notes of what your doctor says during your visit"
Not all medical research is good. Some studies are more reliable than others. So we've put together some guides to help you weigh up the evidence and work with your doctor to choose the treatment that is best for you."
Now family physicians have one more problem to worry about - competition from these clinics.
The extensiveness of medical testing is stunning. Speaking of the early 1980s-- and since then greater numbers have assuredly been achieved--Dr. Edward R. Pinckney noted: 'When all direct and related costs for medical testing are added together--including office visits and hospital charges--the annual bill for medical testing, in 1983, came to about 160 billion dollars, or about half of the entire cost of all medical care' ('The Accuracy of Medical Testing,' in Dissent in Medicine: Nine Doctors Speak Out.)
Doctors often excuse their obvious over-exuberance in ordering tests by saying that much 'defensive' testing is necessary to protect them from lawyers. This is no doubt true. But the 'better safe than sorry' philosophy has been very successfully promoted in an effort to make testing a synonym of prevention in the popular mind. This is, without doubt, one of the Church of Medicine's most lucrative beliefs."
However, over-testing can cause a lot of harm - including the Ulysses syndrome and over-treatment !
Examining why we believe myths and using evidence to dispel false beliefs can move us closer to evidence based practice.
Physicians would do well to understand the evidence supporting their medical decision making. They should at least recognise when their practice is based on tradition, anecdote, or art. While belief in the described myths is unlikely to cause harm, recommending medical treatment for which there is little evidence certainly can. Speaking from a position of authority, as physicians do, requires constant evaluation of the validity of our knowledge."
Physicians are human too - and both they and their patients need to be reminded of this fact !
We might also request another test, and risk inducing 'Ulysses syndrome.' Ulysses fought in the Trojan war but afterwards took 10 years, with many dangerous and often pointless adventures, before he got back to where he had started. Patients with Ulysses syndrome find themselves caught in a web of further investigations, referrals, and sometimes treatment before finally being recognised as healthy, which they were in the first place. Ulysses syndrome is a side effect of unnecessary and inappropriate investigations or wrong interpretation of results. It was first described 30 years ago,1 and the number of tests available is now much greater. With greater choice comes greater responsibility and the need for greater discernment. Otherwise we may condemn our patients to a similar ordeal."
I just wish more doctors ( and their patients) became aware of what they are potentially subjecting their patients to when they order tests. Tests are meant to reassure - but they often end up as a "wild-goose chase" - and cause more distress and anguish ! Masterly inactivity is sometimes the best course of action.
It can be very comforting to believe that if we want relief from our miseries, all we need to do is turn to our doctor and let him fix all our problems with a pill !
This is because transporting these workers to a training conference is hugely difficult in countries where roads are inadequate, or don't exist, or fuel is scarce -- and sending paper-based materials to workers is either expensive, or more likely impossible given a poorly-functioning postal mail system.
But imagine a system that lets managers at a national level, who probably do have access to the internet on a desktop computer, coordinate and transmit SMS-based continuing education messages to the computers - sorry, to the cell phones - of those health professionals. What a difference would that make to the level of up-to-date knowledge available to a clinic worker? And how would that impact the quality of care?"
Friday, January 18, 2008
A representative from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) raised the issue of changing the communication practices of healthcare providers, noting that good communication practices need to be introduced in provider education and training. An audience member from the American Medical Association (AMA) echoed these concerns and announced that the AMA would be launching an initiative linking health communication and patient safety. Dr. Schillinger pointed out that nursing, medical, and pharmacy students are very receptive to learning these skills, but noted that skills training needs to continue into the residency phase/clinical context. The positive effects of communication skills training can be displaced by the demands of residency. He commented that medical student associations can often drive curricular change, making them excellent points of intervention.
Dr. Pignone noted that system changes such as team-based care, information technology infrastructure, and reimbursement practices can also improve patient-provider communication."
Empirical evidence suggests that there are four stages of activation that patients go through in the process of becoming fully competent managers of their health:
1. The patient does not yet believe that they have an active and important role in their health;
2. The patient lacks the confidence and knowledge to take action;
3. The patient begins to take action; and
4. The patient maintains behaviors over time"
Thursday, January 17, 2008
Wednesday, January 16, 2008
When we laugh our bodies release a cocktail of hormones & chemicals that have startling positive effects on our system. Stress is reduced, blood pressure drops, depression is lifted, your immune system is boosted & more. Western science is just starting to discover the great effects of laughter.
Why Laughter Yoga? Eleven years ago Dr Madan Kataria, an Indian doctor and student of Yoga was writing a paper for a medical journal titled 'Laughter is the best medicine'.
Convinced of the medical benefits of laughter and Yogic breathing exercises, Doctor Kataria was searching for a way to bring these benefits to modern man. You can't prescribe 20 minutes of laughter a day, and for best effect a range of different types of laughter should be combined.
In a flash of inspiration Laughter Yoga was born. Thanks to Doctor Kataria, countless people all over the world today enjoy the benefits of a daily dose of laughter."
I prefer watching Laurel and Hardy; or reading comic strips such as Sherman or Zits :)
Tuesday, January 15, 2008
The online clinic, called Connecting People for Health Co-operative, will charge users $9.95 Canadian, or about $9.77, per month. Users will be able to enter their health data and update their profiles with test results and other information received from their family physicians."
The philosopher Martin Buber taught that we all live with a two-fold attitude, which he called the ‘I-It’ attitude and the ‘I-Thou’ attitude. ‘If I face a human being as my Thou’ he argued, ‘he is not a thing among things, and does not consist of things’. In the same corridor as the ECG technician, there is a secretary who is outstandingly helpful, although presumably she shares many of the same work conditions as the technician. I know her name, her direct line and her email address. She always remembers my name, what I do, who I am seeing and why. When I contact her, she seems to operate from the premise that my request is going to be reasonable and that she will try her utmost to make sure it is met. I believe she treats everyone else in the same way. Without the active will, and the moral choice, of people like her, I suspect that all the well-meant interventions of politicians, managers and educators to improve the way patients are treated will subside into mere noise. Or to put it in Buber's words: ‘All true living is meeting.’
Nurses and paramedical workers play such a key role in humanising the medical care patients receive. How can we teach them to be more empathetic ?
The answer, of course, is that the rules were familiar, and familiarity breeds conformism. As Robertson found, protests against convention can invite ridicule, particularly from the medical profession. We also need to remind ourselves of innumerable other examples of social practices that were considered humane for considerable periods of time, but that now fill us with horror—including slavery, workhouses, and large mental asylums in remote rural locations.
Which brings us, somewhat uncomfortably, to the question of whether there are any current practices that doctors now accept with complacency, but ought to regard as similarly grotesque. My own nomination for such a practice would be the ward round."
One of the sacred cows of medicine we should consider sacrificing ?
It did not feel like that at the time. It felt, of course, like normality. Better than normality, positively hunky-dory. But that precisely is the problem. Apathy is a retrospective diagnosis. Had there been a serious epidemic of gastroenteritis ending in hospitalizations and a catastrophic end to people's summer break, I am sure that we would have reframed the experience very differently. What seemed at first like an idyllic holiday would have been recollected as a nightmare, and our inaction would have become a cause of deep guilt and shame. Next time, I have promised myself, I will make a fuss."
This explains why doctors turn a blind eye when they see another doctor doing something wrong. This is also the reason why most patients never complain about incompetent doctors. How will things ever improve ? If you are not part of the solution, you are part of the problem !
Sunday, January 13, 2008
Annual Physical Exam: Unneeded Expense? - Disease Prevention and Wellness Information to Improve Your Health on MedicineNet.com
Rather, the preventive services and tests ordered at these exams that are actually necessary often can be received -- and often already are -- at other visits and times, says Mehrotra. The study is published in the Sept. 24 issue of the Archives of Internal Medicine."
India Inc losing working days due to staff sickness: Study-India Business-Business-The Times of India
Almost 82 per cent of the respondents (including many of those who do not provide preventive health care facilities at present) agreed that such measures increase firm productivity and profitability.
Employee wellness demonstrates a real contribution to company bottom lines since promoting employee health is a means to controlling health care costs, the study said. As regards the financing of health care, the ICRIER study found that more than half of the respondents supported the idea of vouchers as an effective delivery tool to encourage preventive health care measures."
While I agree that corporates should be investing in the health of their employees and that preventive healthcare offers a great ROI, I am not sure that providing them with health vouchers is the right way to implement this suggestion. All it will lead to is a greater utilisation of "healthcare" services. This usually just means over-testing and over-diagnosing medical problems, and while this may be good for the bottomline of the hospitals which provide this service, the impact on the worker's health is far more doubtful. We'll just end up seeing an epidemic of "testitis" and an increased population of the "worried well" because of an abuse of "executive health checkup" schemes !
Saturday, January 12, 2008
The commission’s job will be to promote the use of national standards in “security, privacy, data content, format, vocabulary and information transfer standards.”
This is a big step forward - and a big opportunity for companies who provide EHRs !
Can you guess whose wise words these are ? You will be surprised !
Thursday, January 10, 2008
* Take responsibility for maximizing healthy habits, such as exercising, not smoking, and eating a healthy diet.
* Work collaboratively with health care providers in developing and carrying out agreed-upon treatment plans.
* Disclose relevant information and clearly communicate wants and needs.
* Use the health plan's internal complaint and appeal processes to address concerns that may arise.
* Avoid knowingly spreading disease.
* Recognize the reality of risks and limits of the science of medical care and the human fallibility of the health care professional.
* Be aware of a health care provider's obligation to be reasonably efficient and equitable in providing care to other patients and the community.
* Become knowledgeable about their health plan coverage and health plan options (when available) including all covered benefits, limitations, and exclusions, rules regarding use of network providers, coverage and referral rules"
Secondly, our entire system focuses on costs; not on outcomes. It is disappointing that of the health reform plans advanced by all of the presidential candidates, every one of them mentions controlling costs as the primary goal of their proposals. Care models in the US that have shown success, most notably the Community Care of North Carolina model that creates a “medical home” for all NC Medicaid recipients, have shown conclusively that focusing on maintaining health and putting quality outcomes first not only can achieve those goals, but they also save dollars!"
I want to share an interview I did a few weeks ago with someone who I believe is setting the bar for a new generation of healthcare professionals and the patients they care for. Someone who isn't afraid to buck the system. Someone who says, 'why not?' instead of 'why?'. Someone who just plain understands how to leverage the power of the Net in healthcare. He's not the only one out there. He may not have perfected the business model. But he is doing exactly what needs to be done to better serve his patients. He is leading by example, and I have nothing but admiration for what he is doing."
This is such a sensible model !
But what does this have to do with Google and cell phones?
The answer is that the LPR can only be realized through significant advances in our technology infrastructure. And Google’s most recent action begins to address several hurdles that stand in the way of the LPR. One is the problem of bandwidth and transporting information – a curve Google is clearly ahead of. Second, people -- especially those with a high burden of chronic disease and those challenged by socioeconomic factors -- often don’t own computers or have trouble using them. But cell phones are everywhere. Third, the development of new applications is a must – to help people manage complex medical knowledge and to store vast amounts of data. And Google has already started down this road."
Wednesday, January 09, 2008
*Is able to establish a 100% success rate in contacting patients—also 90% quicker than a person dialing
* Enables healthcare providers to deliver 100% consistent quality of care
* Has shown that many patients prefer IVR – patients were more honest and therefore received more accurate care
* Is “easy to use” – over 90% of patients who used it, liked the IVR"
Maybe a SMS could be sent to all patients after discharge automatically, to confirm that they are fine ?
obvious that this is not the case in healthcare in spite of the vast amount of literature on the proven benefits of ICT for tackling the fundamental problems of healthcare. The identified reasons for this paradox are many fold but they mainly focus on added difficulty to IS development due to the complexity and volatility of medical concepts. Another important reason roots from the inherent subjective or non-deterministic
nature of medicine. Not only is the body of knowledge highly variable but also the practice changes from time to time and place to place. This means a particular instance of a medical situation may not be valid at all times. The consequences of this during HIS development are disastrous. Medical authorities concentrate on establishing a standardized or at least core medical curriculum in medical education and also try to realize a common medical terminology for practicing physicians to alleviate these problems. Considering the dynamic and fast track advance in ICT, we believe it will be more efficient to attack the former problem while hoping the latter one to progress over time. This is the general motivation for this study.
Tuesday, January 08, 2008
Indian companies still lag behind in taking a proactive approach towards helping their employees remain healthy. This is a shame because it's a big opportunity which is being wasted. The most valuable resource for any company is its human capital - why don't they invest more in keeping it in good shape ?
'There is a large gap between what the patient population expects and demands. That's an important trend to note, because people are now asking hospitals and health care providers where their treatment results will be stored,' Martin Pellinat, president and founder of VisionTree Software, based in San Diego, said during an interview."
This is actually a big opportunity for hospitals ! Giving their patients a PHR will help them to empower their patients with information - and also make life easier for their doctors, as they won't need to hunt for medical records ( since patients will keep these carefully )
Monday, January 07, 2008
This is a great idea ! Since the text book is already available in the wiki, many more doctors will be able to edit and contribute to it, to make it better and more reliable and upto-date. Is this the way all text books will be published in the future ?
Sunday, January 06, 2008
This is one of the wisest websites I have seen. It deals with a very touchy topic - miscarriages - and does so in a very well-informed and comforting manner. I think the reason it's so good is because it's been done as a labour of love by a mother who has suffered miscarriages herself - and her empathy comes through clearly on each page. I recommend this site to my patients who have had a miscarriage - and this is a great model of what a great job an "expert patient" can do !
Saturday, January 05, 2008
This is an interesting point of view. Lawyers do a better job at protecting their client's interests than a doctor does !
Accordingly, PHCAs would not practice medicine. Instead, they would practice medical advocacy, doing whatever is necessary to guard the rights and welfare of their clients in all their interactions with a hostile healthcare system.
Their mission statement might read something like this: As PHCAs, we will perform the same service within the healthcare system that attorneys perform within the legal system. We will become our clients' advocates and advisors, assuring that a dedicated and knowledgeable professional is representing them, protecting them, and advancing their rights and welfare within the healthcare system. Our relationships with our clients will be built on trust; we will hold their confidences in private, will assiduously avoid conflicts of interest, and will work directly for them"
Strategy 1 - Be empathetic. Show that you understand the constraints under which your doctor is laboring, and adjust your expectations accordingly. Don't be too demanding, especially regarding the small stuff. Show that you respect your doctor's skills, and that having his skills working for you is worth a few minor inconveniences. After all, you make clear, you know how hard it is to be a good doctor these days, and you're thankful he's there for you despite everything."
Strategy 2 - Align your interests with those of your doctor. Remember: you and your doctor are in this together. He feels your pain, and you feel his. You both want the same things. You both want the patient (you) to get good health care; and you both want the doctor's practice - and professional integrity - to thrive. So while you fully expect to get the care you need from your doctor, you will help him to deliver that care as efficiently and as cheaply as possible.
You will not bother him needlessly, or thoughtlessly. You will make the most efficient use of your time with him. You will learn how his office operates, and cooperate with his office staff in minimizing interruptions and special requests. (For instance, inquire as to the best time to call the office with questions, or to speak with the doctor.) The main idea is: you are interested in making the doctor's job as easy for him as possible, while still having your own vital needs served.
Strategy 3 - Become engaged in your own good health. Nothing makes doctors crazier than patients who completely neglect their own health, then expect their doctors to pull out all the stops for them when they get into medical difficulties. The fact is, your doctor simply cannot afford to vigorously advocate for every problem for every patient. This being the case, which patient is your doctor more likely to fight for when they get sick - the obese smoker who has made no visible effort to take care of himself, or the diabetic who has carefully tried to follow her difficult diet and drug regimens?
Maybe it isn't fair, but it's nonetheless true. If a doctor is considering stepping out of line and jeopardizing his own security to fight for his patient's best outcome, you can be sure he's more likely to reserve that action for a patient who's fighting right at his side for the very same thing."
This is great advice !
Tuesday, January 01, 2008