I have many ailments which are followed by doctors. Currently two previous cancers, back problems, depression/anxiety issues, and my stupid sprained ankle. I also have issues which aren't being really treated but still interfere with my life - tennis elbow and a partially torn ACL. As a result I have these doctors: primary care, medical oncologist, radiation oncologist, breast surgeon, ankle surgeon, endocrinologist, psychologist, psychiatrist, and a back pain doctor. I did have a knee surgeon who I could go back to if I really want more surgery - but I have had enough thankyouverymuch. I can also go back to the elbow doctor if my tennis elbow continues to be painful. All these doctors are in the same hospital and access my same electronic medical records.
But I feel my care is very vertical. I am switching to a new primary care doctor in hopes that it will get pulled together. My psychiatrist put me on an antidepressant. My back pain doctor put me on a pain med that works in the same way as the antidepressant so I didn't need it any more. Then my back pain doctor put me on a different pain med but that left me without an antidepressant until I called my psychiatrist and got back into see her. Each doctor tries their best in their area of care to take care of me. But they don't always take into account the rest of me.
Apparently I am not alone. 25% of Americans suffer from two or more chronic conditions. Chronic conditions are ones which require continuing medical care. Cancer is now treated as a chronic condition. By this definition, back issues are also a chronic condition. (I don't have any of the other medical conditions they list but they are plenty for me.)
This sums up my medical care issues:
Because of the way medicine is typically practiced these days, people with multiple chronic diseases commonly receive disjointed, often conflicting care. That can lead to preventable hospitalizations and a host of avoidable complications, adverse reactions to treatment, and duplication of expensive, sometimes hazardous tests.
And this is another reality for me:
Dr. A may prescribe something for a heart problem that reacts badly with what Dr. B prescribed for the same patient’s asthma or what Dr. C prescribed for arthritis or osteoporosis.
So as a patient I need to keep on top of what is prescribed by my doctors. More doctors does not equal better care.
Saturday, February 26, 2011
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