Hear my interview with Dr. Steve Feldman by clicking on the link below.
Dr. Feldman cares about the quality of your health; he is the founder of www.DrScore.com, an online doctor rating website that doctors nationwide use to get feedback from patients and has authored over 400 peer reviewed medical articles. Much of Dr. Feldman’s work has been compiled for lay people in his book, Compartments: How the Brightest, Best Trained, and Most Caring People Can Make Judgments That are Completely and Utterly Wrong.
Dr. Feldman is Professor of Dermatology, Pathology and Public Health Sciences at the Wake Forest University School of Medicine in Winston-Salem, North Carolina. He directs the Center for Dermatology Research, a health services research center working to improve the care of patients with skin disease. Dr. Feldman’s chief clinical interest is psoriasis. He received a Presidential Citation from the American Academy of Dermatology in 2005 for his psoriasis education efforts and received one of the AAD’s highest awards, the Clarence S. Livingood Lecturership, at the 2006 AAD Meeting. Dr. Feldman also was awarded the Astellas Award (and its $30,000 prize) by the American Academy of Dermatology in 2008 for scientific research that improved public health in the field of dermatology.
Getting Better Health Care – What does it take to be a better patient?
To learn more go to www.savvypatienttoolkit.com
Monday, May 31, 2010
Saturday, May 29, 2010
New Symptoms: Obtaining a Diagnosis – Part I
"Mr. James, I understand you are having problems with your stomach. Tell me what has been going on," Dr. Brown says as he walks in the door.
"Well, I have this pain in my stomach. I'm not sure how to describe it. It started about 2 weeks ago - or was it three or four weeks ago. It comes and goes. I don't know what else I can say," Mr. James replies.
A little exaggerated, but not much - very little for the doctor to go on. He asks questions that may or may not be the right ones and may order numerous tests to make the diagnosis.
What can Mr. James do to increase his chance for a timely, accurate diagnosis?
Document symptoms as they occur. It's simple to do. Why don’t we do it? Laziness? Not necessary - I can remember? Won't help much?
Laziness – probably not, it is more about habit and not having a management system for our medical care.
Memory – if lucky, we’ll remember 50% of the details.
Helpfulness –accurate, complete information is key for an accurate diagnosis, fewer tests and appropriate treatment plan.
Still no diagnosis - take the following steps:
• Obtain copies of all test results & doctor notes.
• Research your chronic conditions and medications. You may find connections to them your doctor hadn’t considered or better words to communicate your symptoms.
Listen to your instincts, it may be time to:
• Get a second opinion
• Ask for a referral to a specialist
• Change providers if you feel he’s has reached the limits of his abilities, says you are anxious or that your problems are all in your head.
To learn more go to www.savvypatienttoolkit.com
"Well, I have this pain in my stomach. I'm not sure how to describe it. It started about 2 weeks ago - or was it three or four weeks ago. It comes and goes. I don't know what else I can say," Mr. James replies.
A little exaggerated, but not much - very little for the doctor to go on. He asks questions that may or may not be the right ones and may order numerous tests to make the diagnosis.
What can Mr. James do to increase his chance for a timely, accurate diagnosis?
Document symptoms as they occur. It's simple to do. Why don’t we do it? Laziness? Not necessary - I can remember? Won't help much?
Laziness – probably not, it is more about habit and not having a management system for our medical care.
Memory – if lucky, we’ll remember 50% of the details.
Helpfulness –accurate, complete information is key for an accurate diagnosis, fewer tests and appropriate treatment plan.
Still no diagnosis - take the following steps:
• Obtain copies of all test results & doctor notes.
• Research your chronic conditions and medications. You may find connections to them your doctor hadn’t considered or better words to communicate your symptoms.
Listen to your instincts, it may be time to:
• Get a second opinion
• Ask for a referral to a specialist
• Change providers if you feel he’s has reached the limits of his abilities, says you are anxious or that your problems are all in your head.
To learn more go to www.savvypatienttoolkit.com
Friday, May 14, 2010
Prevent Hospital Medication Errors
"Mr. Corbett, your doctor wants you to take two new antibiotics," the nurse said as she arrived with one pill in hand. Time passed and no more pills arrived. When the nurse came to do a blood pressure check, I asked, "When will he get the second antibiotic?"
"I'll check," she said and left. The same dialog repeated twice. Finally, she returned and told us, "He had the first new antibiotic at 8:00 am, he will get the original one at noon, and the second new one at 8:00 this evening." She started to leave the room.
"Wait a minute; it was my understanding, when the doctor spoke to us this morning, that he was stopping the antibiotic they gave him in the emergency room and replacing it with two different ones."
"I'll check the chart again, but those are the orders we have." She returned and verified no stop order for the initial antibiotic prescribed.
At that point we asked her to hold his noon dose and double-check with the doctor to verify which antibiotics he was to take and when.
On returning, she said, "You were right. He is to have only the two new antibiotics."
The next morning, we discussed this mix-up with the doctor. "You were right to persist, and it is good that you did," he said. "The combination of the three could have caused shut down his remaining kidney function."
Lessons Learned:
Check and double check before taking medication if you have any doubts.
Don't take for granted that orders in the chart are correct.
Persist respectfully, when there is a difference of understanding or in the face of resistance.
Keep notes of your conversation with your doctor to aid you in resolving differences.
To learn more go to www.savvypatienttoolkit.com
"I'll check," she said and left. The same dialog repeated twice. Finally, she returned and told us, "He had the first new antibiotic at 8:00 am, he will get the original one at noon, and the second new one at 8:00 this evening." She started to leave the room.
"Wait a minute; it was my understanding, when the doctor spoke to us this morning, that he was stopping the antibiotic they gave him in the emergency room and replacing it with two different ones."
"I'll check the chart again, but those are the orders we have." She returned and verified no stop order for the initial antibiotic prescribed.
At that point we asked her to hold his noon dose and double-check with the doctor to verify which antibiotics he was to take and when.
On returning, she said, "You were right. He is to have only the two new antibiotics."
The next morning, we discussed this mix-up with the doctor. "You were right to persist, and it is good that you did," he said. "The combination of the three could have caused shut down his remaining kidney function."
Lessons Learned:
Check and double check before taking medication if you have any doubts.
Don't take for granted that orders in the chart are correct.
Persist respectfully, when there is a difference of understanding or in the face of resistance.
Keep notes of your conversation with your doctor to aid you in resolving differences.
To learn more go to www.savvypatienttoolkit.com
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