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Friday, June 19, 2009

41 Secrets Your Doctor Would Never Share... most of it are true :)

http://www.rd.com/living-healthy/41-secrets-for-your-next-doctor-visit/article75920.html

Interesting reading from Readers Digest, US, website. Here I hightlight the bits that interest me most =)

We're Impatient

I am utterly tired of being your mother. Every time I see you, I have to say the obligatory "You need to lose some weight." But you swear you "don't eat anything" or "the weight just doesn't come off," and the subject is dropped. Then you come in here complaining about your knees hurting, your back is killing you, your feet ache, and you can't breathe when you walk up half a flight of stairs. So I'm supposed to hold your hand and talk you into backing away from that box of Twinkies. Boy, do I get tired of repeating the stuff most patients just don't listen to. --Cardiologist, Brooklyn, New York
~I hafta agree with this somehow. Everyone has been a patient & we all know we are not alwiz compliant to any advice.

• I was told in school to put a patient in a gown when he isn't listening or cooperating. It casts him in a position of subservience. --Chiropractor, Atlanta
~This somehow doesnt apply to most Aussie patients, they do wat they want despite wat we advise them & they kno it.

• Thank you for bringing in a sample of your (stool, urine, etc.) from home. I'll put it in my personal collection of things that really gross me out. --Douglas Farrago, MD, editor, Placebo Journal
~This probably applies to the nurses/ path people than us docs, except probably LMO a.k.a. GP & of course the pathologists.

• One of the things that bug me is people who leave their cell phones on. I'm running on a very tight schedule, and I want to spend as much time with patients as I possibly can. Use that time to get the information and the process you need. Please don't answer the cell. --James Dillard, MD, pain specialist, New York City
~I hafta agree on this sometimes because I make the effort to reject/ ignore foncalls when I'm seeing patients, unless if the call is life-threateningly crucial.

I wish patients would take more responsibility for their own health and stop relying on me to bail them out of their own problems. --ER physician, Colorado Springs, Colorado
~ I soooo totally agree with this. Enuf with us being taxed extra by gov, now we are taxed again for cleaning up ur own mess.

• So let me get this straight: You want a referral to three specialists, an MRI, the medication you saw on TV, and an extra hour for this visit. Gotcha. Do you want fries with that?
--Douglas Farrago, MD
~ Hehehehe... this is where informed choices are made, & we hope that u digest most part of it before we proceed to all of these.

• I used to have my secretary page me after I had spent five minutes in the room with a difficult or overly chatty patient. Then I'd run out, saying, "Oh, I have an emergency."
--Oncologist, Santa Cruz, California
~I sometimes do this with a nurse whom I can rely on.

Many patients assume that female physicians are nurses or therapists. I can't tell you how often I've introduced myself as Dr. M. and then been called a nurse, therapist, or aide and asked to fetch coffee or perform other similar tasks. I have great respect for our nurses and other ancillary personnel and the work they do, but this doesn't seem to happen to my male colleagues. --Physical medicine and rehabilitation doctor, Royal Oak, Michigan
~ I get "The Lady" or "Nurse", which most of the times annoys me & I do feel insulted. Thanks.

The most unsettling thing for a physician is when the patient doesn't trust you or believe you. --Obstetrician-gynecologist, New York City
~Unless if the doc is seriously ... unreliable. Yet, it is impossible for each doc to know every single knowledge in medicine world.

It really bugs me when people come to the ER for fairly trivial things that could be dealt with at home/ GP. --ER physician, Colorado Springs, Colorado
~Emergency Department is for EMERGENCY cases. Enuf said.

• Your doctor generally knows more than a website. I have patients with whom I spend enormous amounts of time, explaining things and coming up with a treatment strategy. Then I get e-mails a few days later, saying they were looking at this website that says something completely different and wacky, and they want to do that. To which I want to say (but I don't), "So why don't you get the website to take over your care?"
--James Dillard, MD
~Well, nowadays most medical journals are online anyways, but only accessible by medical professionals. The ones that patients go to sometimes are not alwiz reliable, understandably patients today are more educated than patients before. But nuthing beats real contact with a real doc because there r millions of presentations to any medical conditions & webbies dont tell u this.

• I know that Reader's Digest recommends bringing in a complete list of all your symptoms, but every time you do, it only reinforces my desire to quit this profession.
--Douglas Farrago, MD
~Desire to quit the profession... also because of lotsa other stuff.

Pills, Pills, Pills

• Sometimes it's easier for a doctor to write a prescription for a medicine than to explain why the patient doesn't need it. --Cardiologist, Bangor, Maine
~GP do this sometimes. Junior docs at the hospital dont, well, mebbie at least here in Au.

• Those so-called free medication samples of the newest and most expensive drugs may not be the best or safest. --Internist, Philadelphia
~Agree.

• Taking psychiatric drugs affects your insurability. If you take Prozac, it may be harder and more expensive for you to get life insurance, health insurance, or long-term-care insurance. --Daniel Amen, MD, psychiatrist, Newport Beach, California
~Agree. But if u need it, u need it.

Ninety-four percent of doctors take gifts from drug companies, even though research has shown that these gifts bias our clinical decision making. --Internist, Rochester, Minnesota
~ To be honest, as hospital docs, we sooooo love goodies, but we dont really care about what the drug companies tell us about their drugs. We treat patients how we were taught at uni/ in our training. We just like the pens, cups, notepads, etc. simply because they show to the outside world that we are doctors. =)

Bills, Bills, Bills

I really do know why you're bringing your husband and three kids, all of whom are also sick, with you today. No, they are not getting free care. --Douglas Farrago, MD
~Plus, once I step out of the practice/ I'm on my off days, I dont wear my 'Doctor' title anymore... at least here in Aussie lah. I dont want to be accountable for any mishaps around me. The court processes are just unbearable.

Free Advice

• Avoid Friday afternoon surgery. The day after surgery is when most problems happen. If the next day is Saturday (or public holidays), you're flying by yourself without a safety net, because the units are understaffed and ERs are overwhelmed because doctors' offices are closed. --Heart surgeon, New York City
~I sooo totally agree with this. Especially here in Melbourne.

• In many hospitals, the length of the white coat is related to the length of training. Medical students wear the shortest coats. --Pediatrician, Baltimore
~This doesnt apply to Au hospital/ clinics.

• Often the biggest names, the department chairmen, are not the best clinicians, because they spend most of their time being administrators. They no longer primarily focus on taking care of patients. --Heart surgeon, New York City
~Agree.

The Darker Side

It saddens me that my lifelong enjoyment and enthusiasm for medicine has all but died. I have watched reimbursement shrink, while overhead has more than doubled. I've been forced to take on more patients. I work 12- to 14-hour days and come in on weekends. It's still the most amazing job in the world, but I am exhausted all the time. --Vance Harris, MD, family physician, Redding, California
~We dont own our lives anymore.. the courts, the nurses, the public, everything... exhausting mentally & physically, somehow the enthusiasm can just fade away...

• In many ways, doctors are held to an unrealistic standard. We are never, ever allowed to make a mistake. I don't know anybody who can live that way. --James Dillard, MD
~ Sob sob.

Not a day goes by when I don't think about the potential for being sued. It makes me give patients a lot of unnecessary tests that are potentially harmful, just so I don't miss an injury or problem that comes back to haunt me in the form of a lawsuit. --ER physician, Colorado Springs, Colorado
~There's no more cost effective/ efficient/ all that crap. The law is our biggest 'Big Brother'. Plus, health care system is never a cost effective/efficient/ environment friendly anyways.

• It's pretty common for doctors to talk about their patients and make judgments, particularly about their appearance. --Family physician, Washington, D.C.
~Among doctors, & mebbie to others if the patients are interesting enuf, but confidentiality is still guaranteed ;) But, hey, we somehow can tell what diseases a patient might have once they come to our attendance.

• Plan for a time when the bulk of your medical care will come from less committed doctors willing to work for much lower wages. Plan for a very impersonal and rushed visit during which the true nature of your problems will probably never be addressed and issues just under the surface will never be uncovered.
--Vance Harris, MD
~Somehow true.

At least a third of what doctors decide is fairly arbitrary. --Heart surgeon, New York City
~True. We only have discovered probably 1/5 of the whole wide world's health care conditions & their managements. Its impossible to know everything.

Doctors are only interested in whether they are inconvenienced -- most don't care if you have to wait for them. --Family physician, Washington, D.C.
~Sadly this is true. Well, at least to the hospital doctors. Again, its all because of the law, the pay vs expenses, training, nurses, etc. Unless if the patient is going to die there & then if we dont attend to their needs.

The Sensitive Side

• When a parent asks me what the cause of her child's fever could be, I just say it's probably a virus. If I told the truth and ran through the long list of all the other possible causes, including cancer, you'd never stop crying. It's just too overwhelming. --Pediatrician, Hartsdale, New York
~True.

• Most of us haven't been to see our own physicians in five years. --Physical medicine specialist, Royal Oak, Michigan
~True. Unless if we need some 'medications' or other things.

When a doctor tells you to lose 15 to 20 pounds, what he really means is you need to lose 50.
--Tamara Merritt, DO, family physician, Brewster, Washington
~Well... But, somehow I personally dont really care, I only care about the waist, bum, thigh, arm measurements...

• Though we don't cry in front of you, we sometimes do cry about your situation at home. --Pediatrician, Chicago
~And somehow most of us dissociate ourselves from the social part of the patient's conditions. At the end of the day, a doctor is just another job, who has to attend to clients...

Anatomy of a Doctor's Bill
Just how much of the $100 your doctor charges for taking 30 minutes to investigate your stomach pain goes into his pocket? After paying the bills, he gets less than half. The breakdown, according to Robert Lowes, senior editor at Medical Economics:

$3.50 for malpractice insurance

$3.50 for equipment, repairs, and maintenance

$6 for supplies, including gowns, tongue depressors, and copy paper

$7 for rent and utilities

$11 for office expenses, such as telephones, accounting fees, advertising, medical journals, licenses, and taxes

$28 for secretary, office manager, and medical assistant salaries and benefits

$41 Amount that goes into the doctor's paycheck

Over the course of a year, that adds up to $155,000, the annual salary of the average family physician. That number rose just 3.3% between 2002 and 2006, while expenses increased nearly 25% over the same period.
~All these figures are in the States. Somehow it can be much worse in Victoria, Au. How sad.

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