Wednesday, August 26, 2009

On Being A Good Patient

In the midst of all the health care reform discussion/arguments/debates/screaming matches, one issue that is brought up periodically is the potential shortage of doctors, primary care ones especially. Here's the problem, there are fewer doctors becoming PCPs after medical school and more and more are specializing. Then the ones that are PCPs, start leaving and doing something else. Why? Because they apparently get so fed up with their patients, if this commentary is true.

I read this with interest and then started thinking (but promise my thinking was done AFTER coffee consumption). First of all, I consider myself to be a relatively good patient. I mean I usually go to my doctor appointments and try to do what they suggest (but has anyone ever flossed enough for their dentist? No I don't think that is possible.) But if they say get exercise, I try. If they say come back for a follow up, I do. If I need a test/procedure/biopsy, I try to understand why and its implications and go. But apparently I am not normal. You can read the article I cited for some examples but here are some more that I have seen.

- A friend of a friend was told they needed heart surgery after a heart attack to relieve blocked arteries. He didn't and died a week later. Perhaps the surgery could have saved him. Why didn't he do what the doctor suggested? If they give you a significant suggestion like 'you need heart surgery or you will die', that isn't something you can wait on or just ignore. Perhaps at the very least you need a second opinion to tell you the same thing and then with two doctors giving the same advice, follow it.

- Numerous times on message boards and elsewhere, I get advice 'you should be getting this scan/test quarterly/yearly. You should ask your doctor why and insist you get it. I make sure I get it regularly.' This is done with the best of intentions because it made them or someone they know feel better but it may not be the right treatment for me. Well, first can I say if my doctor says no I don't need it, I'm not going to have it. Perhaps your cancer/ailment is different than mine. Also, the doctor went to medical school and knows his stuff. While I do consider doctor's suggestions just that - suggestions - I also don't demand stuff that I don't need.

- Also hear about people saying 'the doctor prescribed this but I decided not to get it filled'. Okay that's one thing when you get strep and an antibiotic prescription with a refill and are told only to refill it if you are still showing symptoms. But if you see a doctor and need thyroid medication/blood thinners/pain meds to treat your symptoms and decide not to take them, don't go back to the doctor and blame them for not healing you. Its a two way street and you both need to be going in the same direction.

Finally, don't get me started on people who cancel follow appointments or just skip appointments and wonder why they are still sick. Never mind the people who show up late and demand to be fit in, and make the doctor and staff run through hoops around them.

I think doctors become doctors because they want to heal people. But you have to let them do their job too.

So yesterday I went to the doctor (and showed up on time) for a follow up on my ankle. Its better. The chip on the fibula is not significant. Its just there and will eventually smooth out and be fine. Its the strained ligaments from the sprain that take a long time to heal. Now I get to be out of my air cast for an additional 30 minutes a day and completely out of it when I go back to see her in a few weeks. Then I will have a few PT visits to get exercises to strengthen it. I also get to go to the gym and ride a stationary bike - which I did as soon as I got home. I will start going three times a week for now. Then I will probably ask to see a physical trainer to learn what more I can do with weights to get back in shape - its hard to lift if you are on a 20 lb weight restriction. But that's not for a few more weeks.

Last night we celebrated my father's 81st birthday and had a nice dinner that went way too late. So now I am running late and want to leave for work in 30 minutes and haven't showered or had breakfast. Hmmm... Is this possible?

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