New Medicine, Same Manners, part II

When my late husband and I were first married we lived in an apartment for a short time. The fact that he was a physician seemed to get around the building fairly quickly and led to frequent medical-related questions from other residents. I was used to people asking for his advice, in and out of the office. It seemed to be part of the job and he was always very gracious in responding.
However, the day a neighbor, whom we had never met, presented herself at our door in her bathrobe to get a diagnosis for her rash I felt a line had been crossed. Imagine my surprise when she opened her robe exposing a naked body! Not a pretty picture.
What’s the morale of the story? Be careful not to take advantage of people and their expertise. There is a time and place to seek medical advice from any physician or health care professional. Certainly, family members and good friends in the field can be a great asset in navigating the complexities of health care today and most are eager to help. However, there are some rules to be considered in and out of the office:
• Don’t turn a social event into an ongoing office call. Just because someone is in the heath care field doesn’t mean they are dying to hear about all of your aches and pains
• If you have an office appointment for yourself don’t bring the whole family and expect them to be seen in your time slot
• If you want to add an additional person, call and see if the physician’s schedule can handle it
• Many practices limit the number of complaints that can be addressed at one appointment. If you have multiple issues you may need another appointment or two.
• Bring your medication list with you at every visit
• If medications and/or dosages have changed, be sure to ask if the new medicine is replacing one you have been taking. This helps avoid double dosing.
• Be sure to introduce any friend and/or family member who may go with you to an office visit. Let the doctor know their relationship to you.

A little courtesy and understanding on the patients’ side is important and will be greatly appreciated by the physician and staff. I know…I was once an office nurse.
Please feel free to share your thoughts and experiences regarding this.

New Medicine, Same Manners

New Medicine, Same Manners

The contemporary practice of medicine has taken a major shift for physicians and patients alike. The reasons for this shift are multifaceted: managed care, expenses, insurance, technology, and the list goes on and on.
Certainly, physicians and hospitals find challenges and feel a lack of control as they adjust to the rapid changes in the medical field. Similarly, patients must make adjustments as well, in order to feel they have a sense of control over their health care.
Historically, progress has two sides: we usually have great benefits, but also often lose something that is unique to the old way of doing things. Medicine is no different. The solo practice where the patient has a close one-on-one relationship with the “ole family doctor” is becoming rare.
However, this does not mean a patient has to sacrifice a meaningful relationship and excellent medical care with his or her physician who is a member of a large group. It does mean that the patient may have to shift his thinking or adjust her approach.
Patients who take more responsibility for their health and learn to effectively work with the medical system and their physician’s practice can reduce the miscommunication that is a common complaint today.
Some tips to navigate a modern medical system are:
• Be proactive before you get sick, if possible.
• Learn the routine of your physician’s office.
• Try to see the same physician at every appointment to establish a relationship.
• Learn the names of the medical staff.
• Learn when to place a call to the office. Avoid Monday mornings, before lunch and minutes before the office closes.
• Plan ahead for prescription refills. Don’t wait until the last minute or weekends.
• Learn how to navigate the telephone system by asking for the extension number of the nurse and how to get a “live” person.
• Understand the office’s protocol for emergencies.
• Find out what hospital your physician works in. Many medical groups split the hospitals for efficiency. Your physician may not make rounds or have privileges in your preferred hospital.
• Know the people who are providing your care. If the staff or physician does not let you know who they are, introduce yourself and ask their name and title or position.
• Turn off your cell phone! Taking calls during your appointment is rude and disruptive.
• Understand your physician’s protocol for receiving test results. Some offices only call patients with negative test results. If you are in doubt about the expectations or if you are anxious about test results, call the office.
• Keep a home file for each family member that contains all pertinent health information like: lab results, x-ray results health history and immunization history. This can help avoid errors and having to duplicate immunizations. Providing proof of immunizations is essential for school, work, military enlistment and more.
• List medications on a card and keep it in your wallet in case of an emergency hospital visit.
• Adult children of older parents can be more effective advocates if they keep copies of parent’s records.
• Call ahead and see if your physician is running behind if timely appointments are a concern. Ask again when you arrive and check periodically if your wait is getting lengthy.
• Be familiar with the privacy guidelines and be sure to document the family members who are privy to your medical information.
• Consider taking a family member or trusted friend to your appointments. If you are elderly or have serious medical issues, another person can act as an advocate and help prevent errors in information transmission.
• When making an appointment, note if you need to arrive 15 minutes ahead of your appointment time to fill out paperwork.
• Understand that courtesy is very important and infectious on all sides. Make sure you are considerate.
• If you encounter rudeness from a staff member or physician respond kindly. It will often diffuse the behavior. We all have a bad day, but if it is one individual, and the behavior is persistent, let the physician know. They can’t fix a problem if they don’t know about it.
• Change practices if the personalities and attitudes of a particular office are something you can’t live with. Be sure to let the office know why you left.
• Document serious glitches. For instance , if you call multiple times and no one returns your calls, let management know. Your time is valuable and waiting for long periods of time without a response can hold up progress.

Be a partner with your health care providers…it’s good medicine. Here’s to your health!

Respectful Care of the Elder Patient

In the past month I have had the opportunity to accompany my parents to physician appointments and be part of their health updates. Even though, I was invited into the room by them, I was in no way in charge. My parents are very capable of making their own decisions, but appreciate having one of their daughters present as moral support. And in the event that we will have to be part of their decision making process we will be apprised of their health status.

At one appointment, as the physician entered the room he greeted my parents first and directed all of his remarks to them. I was so appreciative of that courtesy. The fact that my parents are getting older does not mean they should be slighted in any way and be treated in a patronizing manner.

That was not the case when I was helping with another family member out of state a few weeks ago. I drove and accompanied my family member to see her husband in a Rehab facility during my week long stay and helped with the process of transitioning both of them to an assisted living facility. During this time I found people directing the conversations to me and essentially ignoring my family members. At one point my in-law scolded the nurse and said, "you look at me...I am the one who will be living here, not her." I thought that the nurse deserved that rebuke and hopefully she will change her approach when dealing with older patients and their families.

Treating patients of all ages with respect is important, but it is especially important when dealing with older people. At a time when many of the changes in their lives are beyond their control, genuine respect can help make them feel valued and a part of the decision making. Even if there are memory issues with older people, that is not a good enough reason to ignore them or treat them in a condescending way.

Here are some tips for all health care workers in dealing with older patients:

• Refrain from calling them "honey"or "dear" or other patronizing terms... it's insulting.
• Address patients formally...Mr., Mrs., Ms. until you have been invited to call them by their first name.
• Make direct eye contact with the patient when speaking to them.
• Be careful not to speak too loudly that everyone within a mile can hear you.
• Maintain personal privacy, as much as possible, when doing procedures or assisting with personal care.

Remember, this older person had a life before their illness and was a contributing member of society in their job, as a spouse, parent and grandparent...that should always be honored.