// April 29th, 2009 // No Comments » // Health
I don’t work in cancer research, but basically everyone else in my lab does. PhD Comics did an excellent job of explaining cancer research this week. This was too good not to share. Click through to their post for a full sized image.
// April 22nd, 2009 // No Comments » // Health, Surgery, Twitter
Twitter is a microblogging service that lets people share short updates about what they are up to. There are a lot of doctors, nurses and other medical people on twitter, and they share difficult, funny, horrible and uplifting situations that they go through in their work. Here are some of my favourites from the last few weeks. (Follow me, DrCris, on twitter).
GiggleMedAnd another ER chart… “She has not had her minstrel for the past 5 days” (…yeah, those bastard singing bards run away all the time)GiggleMedSaw this on a chart: “s/p interplanetary device”
KidneyNotesCollecting made-up medical words ending in -ized this week: coumadinized, rectalized, syncopized…
drlori71Be sure to wash your hands after reading my tweets - I have a cold (or as us doctor folks call it a viral upper respiratory infection)
DrKimMDOverheard: “Only take one toy sweetie; that’s all our insurance plan covers.” This from a mother of my patient, at the toy box.
pyknosisSick to my stomach about a patient suffering in ways I can’t help.DrKimMDVital signs: From an ER note about a 2 1/2 yo: “Upon discharge the patient was smiling; had eaten a popsicle; and was able to give “5″.”DrKimMDGood way to start the week: from my 5 yo patient, “I was waiting all naptime to see you!” (It’s not me; it’s the treasure box….)
GPforhireJust lanced a nice juicy paronychia on someones big toe. Lots of pus. Quite satisfying.GPforhireLOL, Doctor says my job is to treat and not to judge. Bollocks, we judge and bitch and moan, but treat nonetheless. Or maybe its just me?GiggleMedI’ve decided…. The worst possible name for a drug would be “NKDA”GiggleMedSaw this in the nursing notes: “She has a drug addition problem” (If I take 2 percocets, 3 dilaudid, & an ambien, it’s all really 1 dose)
KimmehkinsThe most adorable old man with his pants up to his nipples just called me pretty, totally made my day12:18 AM Apr 1st from web
// February 19th, 2009 // No Comments » // Health
This article is part of a patient education series that I previously published elsewhere. Explanation is here. If you have already read this article, please accept my apologies.
A good primary care doctor, or general practitioner is the key to “playing” the health care system. They can be your passport to skipping queues, finding the best specialist, getting timely appointments, getting the best after hours care, and attention to the things you worry about.
I have written more about the need for a good GP previously. Now I would like to give explain one way to find the right doctor.
It is in our control to find a better doctor. There are very few people that are limited to only one family doctor in their town. Most of us have the luxury of 3 or 5 or 15. However, we get stuck going to a doctor we aren’t happy with. This is silly – patients are the consumers.
You wouldn’t go to a bad restaurant every week, so don’t continue going to a bad or even average doctor.
Recognizing that you are the consumer is vital – you are not limited to one provider, and you have no obligation to continue to use a service that you are not happy with.
I always knew these principles in theory, but it took having a family to realise their importance. I had been seeing a doctor for many years, one that I was “putting up with”. I had not been happy with the referrals she made and was not thrilled with her manner, but it was good enough. But when my daughter was born, I realised I needed someone better. My daughter was too precious to entrust to half-rate, “good enough” medical care. So I started looking around all the doctors in my area, and after a few visits, found someone I was really happy with, who continues to care for my family today.
I feel really happy with that decision – it is one of the most important things I ever did to care for my family.
Are you happy? Do you feel you can trust them, and talk to them about embarrassing problems. Can you get an appointment when you need one? Do you have good conversations. Do you like them as a person, and respect their knowledge? Do they know you and your family and what is important to you? Would you trust them to make decisions about what medication to give you, or what treatment to offer, if they couldn’t discuss it with you?
If you answer YES to all of these questions, congratulations, you have the doctor that is right for you. If you answered NO to some questions, then it may be fixable. Trusting your doctor to make your decisions is the basic test of whether they are right for you. Normally good doctors consult with their patients, but as they can’t possibly explain all the variables, then they will have to abbreviate and select and recommend based on what they know of you. Maybe you need to have a conversation about your priorities, so that thy understand you better.
Is the gender of your doctor important to you? Do you have to be able to get an appointment at the last minute, or is after hours service more important? Is it more important to have a free service, or are you willing to pay out of pocket to go to the right doctor? Should the practice be close to home or work? Do you need a doctor who is right for all your family, or are you willing to go somewhere else to find someone that suits you personally?
It doesn’t really matter who you try, but feel free to try as many doctors as you like. You have an opportunity every time you get sick. You can try recommendations from friends or family, or you can just work you way around the different practices. It is ok to try someone out. You are not obligated to continue seeing the same person. Remember, you are the consumer, and they are providing the service. You will probably have to fill in new forms at every place you go to, but that doesn’t oblige you to keep going.
The best way to form a relationship with someone is to share your trust. Doctors need to know all the background to your health to help you make decisions in the future. Let them know about all the little things about your health, and your relationship will develop so that you can trust them when you need to.
Most importantly, never give up. Your needs change over time, as mine did when I had kids. If you retire, you will probably be less demanding about after hours appointments. If you develop a chronic illness, you may prefer a different style of practitioner.
In today’s “ehealth” environment, we are not stuck with the same doctor for life, so claim your right to upgrade. Find the right doctor, and start to take more control of your healthcare.
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// February 4th, 2009 // 5 Comments » // Health, Rants
Our first world health system is bizarre, and I can’t reconcile the contradictions. Basically, we have lots of sick people that need help, and help is becoming more and more expensive. And we are cleverer and able to do more stuff. However, there is always someone out there that is willing to do things another doctor would walk away from.
In Australia, a lot of healthcare is subsidised, and free. I couldn’t make those trade-offs, but I find them perplexing. Given the lack of funding for elective surgery, and hospital beds for the sick, I have trouble figuring out how to reconcile:
I’m not saying that these procedures are unethical, or should be abolished, I just can’t figure out how a government can fund them in preference to other things. I really have no problem with people choosing to have procedures that they are willing to pay for. I have friends who have experienced all of the situations listed above. I don’t have an issue with a mother choosing to try to deliver all babies in a multiple conception. I would find it hard to follow medical advice in that situation.
But I have an issue with people using the health system to do things they can’t afford to pay for. And they may not even “need.”
I guess these decisions are too hard for me. In the drivers seat, I would probably make the “wrong” decisions in the cases listed above. Maybe it is wrong to chime in on a news article from the other side of the world. But I just would like to say that we don’t always need to do stuff, just because we can.
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