Doctors Overlook Chemical Illnesses, Study Finds

While I know folks who are prone to conditions triggered by chemical intolerances….am blessed that environmental chemicals don’t seem to affect me for whatever reason..

Am posting this especially for folks with chronic conditions of any kind. Please ask your health care provider if screening, testing,prevention of,  and treating for chemical intolerances is right for you.

 

From the 10 July 2012 article at Science News Daily

Chemical intolerance contributes to the illnesses of 1 in 5 patients but the condition seldom figures in their diagnosis, according to clinical research directed by a UT Medicine San Antonio physician.

Clinical tools are available to identify chemical intolerance but health care practitioners may not be using them, lead author David Katerndahl, M.D., M.A., said. The study is in the July 9 issue of Annals of Family Medicine.UT Medicine is the clinical practice of the School of Medicine at The University of Texas Health Science Center San Antonio.

Avoidance of triggers

The study’s authors said physicians need to know how chemical intolerance affects certain people and understand that conventional therapies can be ineffective. Some patients would improve by avoiding certain chemicals, foods and even medical prescriptions, the authors said.

Patients with chemical intolerance go to the doctor more than others, are prone to having multi-system symptoms and are more apt to have to quit their job due to physical impairment, the authors said….

…Chemically intolerant individuals often have symptoms that affect multiple organ systems simultaneously, especially the nervous system. Symptoms commonly include fatigue, changes in mood, difficulty thinking and digestive problems.

Related articles

• Environmental Toxins to Blame for Declining Fertility Rates? (prweb.com)

Related Stories

---

Morgellons: Unexplained Skin Condition Is Non-Infectious, Not Linked to Environmental Cause: CDC Report (Jan. 25, 2012) — The U.S. Centers for Disease Control and Prevention has completed a comprehensive study of an unexplained skin condition commonly referred to as …  > read more

Why Do Smells Make Some People Sick? (Jan. 20, 2012) — Do you get a headache from the perfume of the lady next to you at the table? Do cleaning solutions at work make your nose itch? If you have symptoms prompted by everyday smells, it does not …  > read more

Fructose Intolerance Common in Children With Functional Abdominal Pain; Low-Fructose Diet Is an Effective Treatment, Study Finds (Oct. 18, 2010) — Fructose intolerance, or fructose malabsorption, is common in children with recurrent or functional abdominal pain, but the condition can be effectively managed with a low-fructose diet, according to …  > read more

Gluten Intolerance in Finland Has Doubled, Experts Say (Mar. 5, 2010) — The occurrence of gluten intolerance in the Finnish population has doubled in the past twenty years. According to researchers, gluten intolerance may often be symptom-free, and people may be unaware …  > read more

Virus Infections May Be Contributing Factor in Onset of Gluten Intolerance (Mar. 5, 2010) — Recent research findings indicate a possible connection between virus infections, the immune system and the onset of gluten intolerance, also known as celiac …  > read more

Stop Lying to Your Doctor

From the 7 March 2012 article By James Salwitz at the Health Care Blog

…

Doctors frighten all of us. No matter how warm and congenial they are, there is always the threat of what they may say. A few words from a physician can change your entire life. An oncologist may be the scariest of all. For this reason it can be very hard for any of us to tell our doctor the complete absolute truth.

It is easier to diminish or deny pain, then describe in detail and submit to tests. Emphasizing the balance in a diet has less risk than noting it is only 600 calories. Increasing fatigue can be blamed on stress, not progressive weakness. Everyone seems to have quit smoking, despite yellow stained nails. “Social” drinking sounds better than a daily six-pack. We carefully parcel out the information we tell our doctor. It is gut level denial and it does us no good.

Physicians understand the desire of patients to limit and control the conversation. They learn to recognize incomplete and evasive answers. They try to ask questions which produce accurate information. A compassionate doctor knows that his response to a patient’s words is as important as the question asked.

Even though it can be hard, it is in our best interests to supply good information to our caregivers. Doctors cannot make correct diagnoses or order proper treatment using erroneous data. Unneeded X-rays are frequently ordered to fill gaps in information, which the patient could have supplied.  Understanding it can be tough to disclose personal medical facts, here are several ideas that might make communication easier and more complete:

 

1) Write down a list of complaints before the visit. We tend to be more truthful with ourselves in the quiet of our home, than nervous under bright office lights.

2) Bring an “honest” friend or relative to the visit and encourage their help. Try not to snarl when they contradict what you say or fill in the blanks.

3) Take a deep breath, take your time and make a specific effort to answer completely. Do not be afraid to “take too long.”

4) Try to be objective, scientific, almost like you are answering not about yourself, but about a person in the next room.

5) When the doctor is questioning about how you feel, answer in symptoms, not in diagnoses. For example do not say “I think I have a kidney stone like I read on the Internet,” say, “I have back pain which comes in waves.”

6) Trust that the doctor is not going to gasp, faint or throw up, by what you say. While the doctor is there at that moment to take care of just you, he/she has heard it all before. The doctor will not be bored or offended.

7) Do not be bashful and do not be embarrassed. This is the place to complain, whine and focus on you. Maybe there are other people who are “worse off,” but when you are with the doctor you are the only patient.

If you still find you are hiding facts from your doctor, ask yourself whether you trust him/her.  If trust is an issue, then either discuss with your doctor or change physicians. If the doctor is distracted for a moment, pause until he/she focuses on you. If he/she never seems to focus, it is time to get a new doctor….

Image via Wikipedia

What Doctors Are Telling Us Even When They’re Not Talking

Image via Wikipedia

Am thinking…how does one be compassionate to a doctor who lacks good communication skills?
And how does one draw out needed information from the same doctor when one is in a confused state of mind?
Maybe a communication and or/ life skills class in high school should be required that includes body language?

From the 9 February 2012 New York Times article

…For nearly two decades, teaching good communication skills has beenmandatory for medical schools because of research showing that good patient-doctor communication can lead to improved patient satisfaction and better health care outcomes. To this end, medical educators have developed a host of communication courses and workshops that combine lectures, self-assessments, video recordings and “standardized patients,” or actors in the role of patients.

More recently, many schools have broadened their courses to include “cultural competency,” or the ability to communicate with those from different racial, ethnic and social backgrounds. Studies have shown that while a patient’s race and ethnicity can be linked to sharply different treatment courses and quality, better communication between doctors and patients of different backgrounds can reduce the disparities.

Despite these tremendous efforts, there is one area of communication to which few schools have devoted significant time or resources: body language and facial expressions.

 In this recent study, for example, a group of medical sociologists analyzed the interactions between 30 primary care doctors and more than 200 patients over age 65 and found that white physicians tended to treat older patients similarly, regardless of race. Black physicians, on the other hand, often gave white patients contradictory signals, mixing positive nonverbal behaviors, like prolonged smiling or eye contact, with negative ones, like creating physical barriers by crossing the arms or legs….

Related articles

• What Doctors Are Telling Us Even When They’re Not Talking (well.blogs.nytimes.com)
• Doctors may paint overly rosy prognosis (cbc.ca)
• Study Finds Doctors Not Always Honest With Patients (dfw.cbslocal.com)
• Study finds doctors aren’t always honest with patients (mercurynews.com)
• 1 in 10 Doctors Admit Lying in the Past Year (livescience.com)
• Many doctors in survey admit they have lied to their patients (seattletimes.nwsource.com)
• Study finds MDs not always honest with patients (seattletimes.nwsource.com)
• Skills in medicine (slideshare.net)
• Doctors’ Honesty Put to the Test (webmd.com)
• Some physicians do not agree with, uphold standards on communication with patients (Eureka News Alert)

  A significant minority of physicians responding to a national survey disagreed with or admitted not upholding accepted standards of professionalism for open and honest communication with patients. In the February issue of Health Affairs, investigators from the Mongan Institute for Health Policy at Massachusetts General Hospital (MGH) report that, among other findings, one fifth of respondents indicated they had not fully disclosed a medical error out of concern for malpractice lawsuits and about one tenth admitted telling a patient something that was not true during the preceding year….

  …

  Five questions on the survey specifically addressed attitudes related to communication – including whether physicians should fully inform patients of the risks and benefits of their treatments, disclose all significant medical errors to patients and always keep patient information confidential – and four addressed what respondents had actually done in the preceding year. The survey was sent to 3,500 U.S. physicians – 500 each in internal medicine, family practice, pediatrics, cardiology, general surgery, psychiatry and anesthesia – and almost 1,900 surveys were completed and returned.

  The overhelming majority of respondents agreed that physicians should completely inform patients about risks and benefits, never disclose confidential information and never tell a patient something untrue. While 66 percent agreed that all significant medical errors should be disclosed to affected patients, one third did not completely agree. Also, about one third did not agree that financial relationships with drug and device companies should always be disclosed. When asked about their own behavior in the preceding year, almost 20 percent admitted not fully disclosing a medical error for fear of being sued,[my emphasis] 28 percent admitted revealing a patient’s health information to an unauthorized person, and 11 percent responded that they had told a patient or the parent of a child something that was not true.

ACR in Choosing Wisely campaign to promote wise use of resources among physicians and patients

 

From the 14 December press release via Eureka Alerts

As part of its ongoing efforts to ensure safe, effective and appropriate medical imaging, the American College of Radiology has joined the ABIM Foundation and eight other medical specialty societies in Choosing Wisely. The new campaign promotes wise choices by physicians and patients to improve health outcomes, avoid unnecessary interventions and make efficient use of healthcare dollars.

The ACR will develop a list of five things to reduce unnecessary imaging exams ordered by physicians and improve quality of care. The list names imaging exams whose necessity should be discussed before being ordered. The list also equips providers with steps to help ensure safe, appropriate use of scans.

“Medical imaging exams are a perfect fit for Choosing Wisely. Scans lower healthcare costs by replacing more invasive surgeries and allowing for shorter hospital stays. Although imaging use is down significantly since 2008 and Medicare spending on imaging is the same as in 2004, opportunities remain to ensure appropriate ordering of scans. As greater access to imaging is directly tied to increased life expectancy, ACR will identify areas where care can be improved without restricting patient access,” said John A. Patti, MD, FACR, chair of the ACR Board of Chancellors……

…….

The ACR list, and those of other Choosing Wisely partners, will be released in April 2012. To learn more, visit ChoosingWisely.org.

The ChoosingWisely Web page includes the following under Resources

• Five Things Physicians and Patients Should Question
• Choosing Wisely Video Mini-Series
  

This series of six video vignettes featuring physicians and patients emerged from research the ABIM Foundation conducted to better understand public and professional attitudes about stewardship of finite resources. Watch the videos.

 

Related articles

• ACR in Choosing Wisely campaign to promote wise use of resources among physicians and patients (medicalxpress.com)

Should Patients Get Direct Access to Their Laboratory Test Results? An Answer With Many Questions

From the November 28 article in the Journal of the American Medical Association 

In the outpatient setting, between 8% and 26% of abnormal test results, including those suspicious for malignancy, are not followed up in a timely manner.^1​,2Despite the use of electronic health records (EHRs) to facilitate communication of test results, follow-up remains a significant safety challenge. In an effort to mitigate delays, some systems have adopted a time-delayed direct notification of test results to patients (ie, releasing them after 3 to 7 days to allow physicians to review them).^3​,4

On September 14, 2011, the Department of Health and Human Services jointly with the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and the Office for Civil Rights^5​ proposed a rule allowing patients to access test results directly from the laboratory by request (paper or electronic). …

Read the entire commentary

Related articles

• When patients see their medical record (kevinMD.com, January 2012)
  “The study found that doctors worried that open visit notes would result in greater confusion and worry among patients and they anticipated more patient questions between visits.  But the patients overwhelmingly wanted to see the notes and were not worried about being confused.   They thought seeing their own record would provide information that would help them be healthier.  They could see the treatment plans and the test results directly.”

  Risks and benefits of direct access to lab results (jflahiff.wordpress.com)

• Should Patients Get Direct Access to Their Laboratory Test Results? An Answer With Many Questions (jflahiff.wordpress.com)
• Risks and benefits of direct access to lab results (kevinmd.com)

A complete guide to planning a social media presence for healthcare

by HOWARD LUKS, MD , the complete Dec 2011 article is at KevinMD.com

The world of healthcare is inherently siloed,  tethered,  fragmented and prone to poor communication and collaboration.  Today, healthcare workers solve their problems via traditional methods that are often costly, inefficient, nor timely.  Increasingly, more savvy healthcare workers are looking outside the system to digital media and communities for answers, but are challenged with uncertainty over concepts of usefulness, practicality, bandwidth issues, “ROI” and privacy concerns.

Establishing a digital presence is rapidly becoming a necessity for healthcare professionals, medical practices, and institutions.  Many have recognized this fact, yet many more have not.

At its heart, digital media is about people, it is about relationships, and it is about communication.  A social media presence is about educating, engaging and growing your audience, improving outcomes, compliance and potentially the bottom line of your practice….

The medium long article includes summaries of overall use of social media, how to plan for and engage in social media and online reputation tips.

Ethics Forum Speaker KevinMD: Social Media Gives Doctors a Voice

http://blog.massmed.org/index.php/2011/11/ethics-forum-speaker-kevinmd-social-media-gives-doctors-a-voice/

Posted on November 9th, 2011 by Erica Noonan

We recently caught up with Dr. Kevin Pho, MD, a Boston University-trained internist now practicing in Nashua, NH.  His website, KevinMD.com, is one of the Internet’s top sites for physician commentary and news.

Dr. Pho is a featured speaker at the Massachusetts Medical Society’s Ethics Forum,“Social Media and Medicine: the Impact on Your Patients, Your Practice, and You,” onFriday, Dec. 2, 2011, from 3:30 p.m. – 5:30 p.m.

MMS:  Why should physicians get involved with social media?

Dr. Pho: We know that social media is important to patients. A Pew study says that 8 out of 10 of Internet users are online looking for medical information, but only 25 percent of them check the source of what they find. There is lots of bad information out there. I’ll be making the case for doctors to be online, guiding patients to good information.

Another reason is that social media is gives doctors a voice in national debates they didn’t have 5 or 10 years ago.  With these (social media) platforms, we can introduce topics we think are important to a wide audience.

MMS: Many doctors say they just don’t feel comfortable with social media sharing sites like Facebook, LinkedIn and Twitter.

Dr. Pho: Doctors need an online presence and digital footprint. Patients will be looking for them online, and gone are the days where they will be using the phone book. I tell people, you really need to control your own social media presence….

Related item

Using Social Media For Practicing Evidence Based Medicine  Cochrane Social Media Workshop 2011 (slideshare presentation)

Why doctors can’t say no

Often it’s easier to just say yes. But there are ways to say no that are better for both physician and patient

BY RAHUL K. PARIKH at the 28 November 2011 edition of Salon

Doctors routinely meet with patients who make requests for specific medicines, tests and referrals to specialists. In this era of the Internet, consumer-driven healthcare and direct-to-consumer drug marketing, this is no surprise. And while an informed patient is a good thing, what may surprise you is just how hard it is for doctors to say no when a patient makes a specific request for something he or she doesn’t really need.

Right now, Dr. Conrad Murray sits in jail because he couldn’t say no to Michael Jackson when Propofol came up in conversation between them. But even doctors who aren’t tempted by an enormous monthly retainer and access to one of the world’s biggest celebrities are challenged by the word “no.”

American medicine is a business — but a weird one.  In any other sector of our economy, businesses are determined to give their customers what they want, however they want it. But in medicine, the “have it your way” mind-set doesn’t always jive. First, physicians have a duty to avoid doing harm.  The choice of a drug or test based solely on a patient’s request can undermine that.  Second, as everybody knows, we spend a big slice of our GDP on healthcare. Since the person who has control over expensive tests and the prescription pad is your doctor, there’s ever-increasing scrutiny to be responsible stewards of healthcare dollars….

…

The lesson here is that it’s best for the doctor and the patient to get everything out in the open, and for a healthcare system that affords the right amount of access and time — especially in primary care — to make that to happen.

Read the entire Salon article

 

Related articles

• Dr. Conrad Murray Sentenced to Four Years Behind Bars in Death of Michael Jackson (foxnews.com)
• Why doctors need to be better negotiators (kevinmd.com)

5 reasons why physicians will love mobile health

by DAVID LEE SCHER, MD  in the 28 Nov 2011 edition of  KevinMD.com

1. Mobile health technology will increase patient engagement. Most patients do not take the responsibility they should for their own health. They are likely preoccupied with all the stresses of everyday life and might therefore take the ‘I feel good, so I must be’ approach. They possibly mutter these words after wiping their faces, hurriedly walking out of McDonald’s for lunch. Or is it because of mistrust of their physician who they get to see for a big 15 minutes that the electronic record time slot permits? Or that they are caregivers to others and sacrifice their own well-being for that higher purpose?…

Read entire article

Related articles

• 10 IT challenges for physician practices in 2012 (listahit.wordpress.com)
• Dermatologists, Medical Oncologists are the Top Physician Specialist Groups Communicating with Patients Online (prweb.com)

The culture of medicine needs to change

Image via Wikipedia

by SHARON BAHRYCH, PA-C, MPH in the 23 Nov 2011 article at KevinMD.com

’ve been involved in clinical medicine for more than 20 years and during this time I’ve come across numerous situations that created stress, or emotional upheaval within myself, and even times of burnout.  At one point, I came close to permanently leaving my chosen profession.  The culture of medicine is not geared towards allowing health care providers to de-stress, acquire emotional support, or discuss in an encouraging environment various conflictive work scenarios with their colleagues. The end result of this culture of medicine leads providers to either leave their chosen profession, have professional burnout, deal with work conflict and/or become emotionally broken (i.e. having a lack of integrity, honesty, emotional connectedness with others, etc.)

An example of medicine’s culture which needs to be changed and causes conflict is one of its many unwritten rules of professional conduct.  It states that the hospital attending is the only one who is supposed to go in and tell a patient their medical diagnosis and treatment.  Anyone else on the medical team is just supposed to pretend as though they don’t know anything until after the attending has discussed the diagnosis with the patient.  Usually this works out, but it can also lead to a breakdown in patient’s trusting their providers and/or asking team members to lie to patients until the attending has this discussion.  This can lead to dishonesty and a lack of integrity on the part of the providers…..

Related articles

• The culture of medicine needs to change (kevinmd.com)
• Short waits, long consults keep most patients very happy with their physicians (Eureka news alert)
• Intuition saved this patient from a potentially fatal diagnosis (kevinmd.com)
• 6 reasons why doctors won’t call patients (with possible solutions) (jflahiff.wordpress.com)
• Patients have a part to play in their own medical care (kevinmd.com)