Show The Herald Journal Logan Utah Thursday August IS 1985 Living Medical experts say the quality of health care you get often depends on it By Barbara Stinson Lee correspondent y When stresses begin to drag you down more than usual when you know you haven't been feeling well for a few days but just can’t put your finger on the cause you know it's time to call the doctor In this day of rising health costs however many people find themselves without that once figure the family physician Instead they seek out help only when they’re sick beyond what their own home remedies will handle or when an accident makes the services of a physician absolutely imperative Too often choosing a physician and providing him or her with adequate information is left for a time of emergency or crisis a time when a person is least able to differentiate and decide what is important and what is not According to the American Society of Internal Medicine choosing a physician is an important decision one that shouldn't be postponed until you become ill or injured Seeing a doctor for the first time when you are ill puts the physician at a disadvantage He or she knows nothing about your medical history nor have you had the chance to assess your doctor's competence or develop a day-to-da- ever-prese- nt rapport "The most common source of referrals (to local physicians) is word of mouth " said Dr Douglas R Hyldahl a family doctor and a spokesman for the Cache Medical Society “If you are new in town and needs a personal physician the local medical society will provide an unbiased list of physicians from which an individual can make a choice The key word here is choice" According to Hyldahl most individuals choose a physician from the range of internists (specialists in internal medicine) family practitioners obstetricalgynecological specialists and pediatricians available in their area “Most people need some kind of primary physician” he said “Most chose a physician by first figuring their needs Then they ask a trusted friend for the name of their personal physician It's important to know why others go to specific physicians Are they competent and caring? Why do other people like them?" Some people In an effort to get treatment for different medical problems they often chose one physician for one problem and another for something different This can result is a disjointed medical approach with one physician not knowing what the other is treating or prescribing This become a special concern when medications are involved g can result in what is known as polypharmacy an excess of drugs prescribed" Hyldahl said "Sometimes it is intentional Often it is innocent but not very “doctor-shop- ” “Doctor-shoppin- smart" Most first visits to a physician are for episodic problems — colds viruses and accidents This first visit if it is not an emergency should be prepared for carefully Care shot-Ibe taken to give a new physician all information pertinent to your entire medical picture The American Society of Internal Medicine of things you shoi:M be suggests a check-lis- t all-o- ut prepared to discuss with your physician (see below) It includes your current medical problems (if any) — when they started when you noticed them and how you’ve treated them so far You should be ready to discuss openly and specifically any symptoms such as dissiness nausea coughing diarrhea bleeding or pain You should be prepared to supply a personal medical history including major illnesses surgeries medical conditions and vaccinations Even if past medical problems don’t seem to be affecting you now your physician needs to know about them You also need to provide a family medical history which may include a familial tendency to diabetes heart disease cancer stroke arthritis or alcoholism to If you have experienced allergic reactions medications either prescription or medications your physician should be notified You should let him or her know if you have experienced any allergies or reactions to antibiotics such as penicillin Both prescription and drugs should be discussed with your physician Even drugs can interfere with prescription drugs or cause some episodic problems They can also exacerbate one problem while apparently relieving over-the-count- over-the-coun- another It would also be helpful to share some of your health habits with your physician as well as the particulars about your Individual lifestyle Diet exercise sleep and smoking and drinking habits all affect your health Sources of stress or anxiety at home or at work are also important pieces of information for your physician who must often try to look at the whole person that is you in a limited amount of time With this information on hand a physician can more easily look at your entire health picture and will be better able to supply you with the treatment and the answers you need You on the other hand deserve something from your physician "Patients deserve sincere concern for their problems" Hyldahl said "They should expect a physician to be willing to honestly explain specific problems and procedures They should be able to ask ‘why do I have what I have?’ They should be able to ask if the treatment has a potential for pain when they can expect change and what if any are the preventive measures they can take to avoid the problem in the future" For some people going to the doctor can be a traumatic experience They wait months sometimes years in their effort to avoid what they feel is an unpleasant experience at best Many of their medical problems go untreated and ignored until they either simply disappear or become major medical situations Checklist for the doctor's office To help you collect the information you need to prepare for your visit with a new physician here’s a checklist of things the American Society of Internal Medicine suggests you discuss You may wish to clip and save this list for your next visit to the doctor Current problem treated it so far - When it started when you noticed it how you've two-wa- nt busy or knowlegeable to be questioned They feel intimidated or embarrassed and many times assume the doctor will simply ask everything he or she needs to know and won’t offer any additional information This says Roehrig is a mistake The reason? Some 70 percent of accurate diagnoses depends on communication between doctor and patient according to the American Society of Internal Medicine Not everyone “clams up" in the doctor's office Women tend to be more verbal and ask more questions As a result they receive more doctor time and more detailed explanations according to a recent study of doctor-patieencounters published in the Journal of the American Medical Association That same study shows patients almost always want as much information as possible about their diagnosis and treatment But doctors the study said underestimate their patients desire for information in 65 percent of the encoifhters studied and overestimate the amount of time they actually spent giving information Patients should be aware however that scheduling in a doctor’s office can sometimes be unpredictable Sometimes the physician seems rushed because her or she is rushed “There are those patients who need to be worked into the schedule" Hyldahl said “And we do have emergencies which may upset the office schedules” The ideal Hyldahl said is a primary personal physician who can care for you and your family problems and who can refer you to a specialist when needed thus providing a person with an inlet to the medical system "There is nothing more important than developing a trusting confident relationship with a physician with whom you can share your inner feelings how you feel intide ” Hyldahl said “Patients should feel confident that they will be treated with respect If there isn't trust quality care will suffer” nt - Personal medical history Make a few notes for yourself on major illnesses surgery medical conditions and vaccinations Even if you're feeling fine now this information is important if your doctor needs to follow up on previous problems or determine measures to maintain your health - Family medical history You may have to do a little research on this one But information on illnesses such as diabetes heart disease cancer stroke arthritis or alcoholism in your family (parents aunts uncles brothers and sisters) is important - Medications and allergies Let your doctor know about all the medications you are taking including drugs and tell him or her about any allergies and reactions to drugs that you experience over-the-count- Health habits and lifestyle — Give your doctor a complete picture of how you eat sleep and exercise and indicate such habits as drinking and smoking and others that may affect your health - Doctors now know that stress is a major factor in some Sources of stress diseases Pinpoint areas of tension at the office or home that are causing you anxiety - “A lot of people avoid doctors because they fear disease" Hyldahl explained "They figure that there is nothing wrong with them so why should they go (to a doctor)? “Others avoid doctors because they want complete control of their lives It's hard for them to turn over any control and physicians must have some control in order to be effective Others are dealing with unhappy childhood memories of pain associated with doctors There are also those who fear the financial burden of medical treatment They are afraid of the bills They prioritise their lives and money for health problems is hard to justify especially if the problem is not easily defined" Still others have been influenced by unfortunate experiences with physicians which can often be seen as simply incidents of poor communications between doctors and their patients or their families "Sometimes physicians come across as being rushed or abrupt when seeing patients tend to control the questioning too much or speak in medical terms that mystify people y comWhen that happens effective munication stops" says C Burns Roehrig MD president of the American Society of Intenal Medicine in a news release on doctor-patierelationships Often Roehrig says patients view their physicians as authority figures who are too Once you have established this base of knowledge about your Symptoms medical history be prepared to aiscuss any new or continuing problems symptoms and concerns in specific terms - |