The High Cost of Not Listening to Patients.

This article reminds me of my days as a medical librarian.
If I did not carefully listen to a patron (customer) or ask the right questions, I gave the person the wrong information!

Minutes spent in listening and asking focused questions often saved an hour (or more!) of fruitless searching.

So, when I talk with a health care practitioner, I am mindful to give as much relevant information as possible to so the proper diagnosis and treatment can be given!

It is also necessary that we all do whatever we can so that health care practitioners are given the time they need to listen to patients.
Ultimately this will result in lower health care costs overall.

 

From the 18 January 2013 post at The Health Care Blog

Before we can understand the high cost of not listening, we need to examine in detail the diagnostic process. I am limiting my discussion to patients with chronic or recurring symptoms lasting several months. I am not discussing acute illnesses. They fall into completely different category.

At the front line of medical care, at the first contact between a patient and a doctor, the patient describes physical symptom. Whatever the real underlying cause, a physical symptom is the required ticket to see a physician. The physician, on first contact, has no idea what the underlying nature of the patient’s chronic complaint really is.  At the risk of oversimplifying, there are five broad categories of the causes for complaints.

These are:

1. There is a definable medical disease in one or more organs.

2. There is no definable medical disease but the patient is in contact with an unknown toxic substance causing the symptom (inhaled, ingested, or from skin contact).

3. The patient is in a stressful or toxic relationship at home or work producing physical symptoms or even a definable medical disease. (“What the mind cannot process is relegated to the body.” Dr. William Mundy, psychiatrist, personal communication. )

4. The patient or a companion is inflicting harm. Here, there are several categories:…

 

…

5. There is no definable medical disease but the patient has assumed a chronic illness role in life with multiple symptoms (i.e. hypochondriasis).

Psychosomatic Illness

6. There is a sixth category; patients with psychosomatic disorders. Time and space does not permit a full discussion of this important and very common set of disorders. I suspect they represent more than fifty percent of patients seeking primary medical care. The book“The Divided Mind” explains and defines these disorders and the successful treatment applied to thousands of patients at NYU by Dr. Sorno and his colleagues. At present the medical profession denies the existence of this category. The epidemic emergence of pain clinics comes from lack of knowledge about psychosomatic disorders and their proper treatment.

Of course, the patient can have any of these, and also be suffering from a definable medical disease.

But my experience in primary care over the past 55 years — combined with studies in the medical literature —suggest that between 30 and 40 percent of first contact  primary care visits are stress related or are psychological in nature (#3 and #6  in above list).

It should be obvious that the only way to sort out these causes of symptoms requires very careful listening to the narrative of the patient’s life. Some of these causes can be determined only by listening…..

 

Read the entire article here

[Reblog With Abortion Infographs] Planned Parenthood Drops the Pro-Choice/Pro-Life Labels

I’ve added this to the blog because of the infographs which highlight “the racial/ethnic disparities in accessing abortion care, income disparities, how women pay for abortions..”
Always thought that abortion decisions were largely based on economic factors. These infographics, which seem to be factual, confirm this. If the print is tiny (and I do apologize) please go to the source..Planned Parenthood Drops the Pro-Choice/Pro-Life Labels.

Comments are welcome that address the statistics and facts presented in these infographs.
Other civil and respectful comments are welcome as well.

Reblog

And here is their video explaining why.

Thoughts?

I generally agree that using labels in an incredible complex and nuanced decision like terminating a pregnancy is for the most part unhelpful. However, I never much liked “pro-life” for those opposed to abortion rights anyway, and preferred to use the term “anti-choice,” for the reasons that many have articulated – that a woman’s life must be considered above that of a fetus, that choosing to terminate a pregnancy based on one’s personal circumstances is in fact being pro-life and thinking of a potential child’s future, that a fetus is not yet an actual life, that a woman has a right to decide what goes on in her own body. As with all things, the weight and emotions of descriptors sometimes get too heavy, and I do hope that this will encourage more in-depth conversation around abortion rights.

Additionally, Guttmacher*** recently release a series of infogrpahics covering the racial/ethnic disparities in accessing abortion care, income disparities, how women pay for abortions, and a cross-sectional look at abortion in the United States. Check them out:

How do Women Pay for Abortions?

Racial and Ethnic Disparities

Abortion Concentrated Among the Poor

Barriers to Abortion Access

***From the about page of the Guttmacher Institute: Advancing Sexual and Reproductive Worldwide through Research, Policy Analysis, and Education

Four decades after its creation, the Guttmacher Institute continues to advance sexual and reproductive health and rights through an interrelated program of research, policy analysis and public education designed to generate new ideas, encourage enlightened public debate and promote sound policy and program development. The Institute’s overarching goal is to ensure the highest standard of sexual and reproductive health for all people worldwide.

The Institute produces a wide range of resources on topics pertaining to sexual and reproductive health, including Perspectives on Sexual and Reproductive Health,International Perspectives on Sexual and Reproductive Health and the Guttmacher Policy Review. In 2009, Guttmacher was designated an official Collaborating Center for Reproductive Health by the World Health Organization and its regional office, the Pan American Health Organization.

 

Related Resource

Abortion Research Package -includes results from a new public opinion survey, a slideshow on how opinion differs among various demographic groups, a discussion of the legal issues and a summary of religious groups’ positions.

Early Estimates of Seasonal Influenza Vaccine Effectiveness — United States, January 2013

Vaccination; 041028-N-9864S-021 Yokosuka, Japan (Oct. 28, 2004) – Hospital Corpsman 3rd Class Tiffany Long of San Diego, Calif., administers the influenza vaccination to a crew member aboard USS Kitty Hawk (CV 63). Currently in port, Kitty Hawk demonstrates power projection and sea control as the U.S. Navy’s only forward-deployed aircraft carrier, operating from Yokosuka, Japan. U.S. Navy photo by Photographer’s Mate Airman Joseph R Schmitt (RELEASED) (Photo credit: Wikipedi

On January 11, 2013, this report was posted as an MMWR Early Release on the MMWR website (http://www.cdc.gov/mmwr)

In the United States, annual vaccination against seasonal influenza is recommended for all persons aged ≥6 months (1). Each season since 2004–05, CDC has estimated the effectiveness of seasonal influenza vaccine to prevent influenza-associated, medically attended acute respiratory infection (ARI).

This season, early data from 1,155 children and adults with ARI enrolled during December 3, 2012–January 2, 2013 were used to estimate the overall effectiveness of seasonal influenza vaccine for preventing laboratory-confirmed influenza virus infection associated with medically attended ARI.

After adjustment for study site, but not for other factors, the estimated vaccine effectiveness (VE) was 62% (95% confidence intervals [CIs] = 51%–71%). This interim estimate indicates moderate effectiveness, and is similar to a summary VE estimate from a meta-analysis of randomized controlled clinical trial data (2); final estimates likely will differ slightly.

As of January 11, 2013, 24 states and New York City were reporting high levels of influenza-like illness, 16 states were reporting moderate levels, five states were reporting low levels, and one state was reporting minimal levels (3). CDC and the Advisory Committee on Immunization Practices routinely recommend that annual influenza vaccination efforts continue as long as influenza viruses are circulating (1). Persons aged ≥6 months who have not yet been vaccinated this season should be vaccinated.

However, these early VE estimates underscore that some vaccinated persons will become infected with influenza; therefore, antiviral medications should be used as recommended for treatment in patients, regardless of vaccination status. In addition, these results highlight the importance of continued efforts to develop more effective vaccines……

Related articles

• Flu season worsens, 29 children die (msnbc.msn.com)
• CDC: Manufacturers making more flu vaccine (upi.com)
• Will The Flu Shot Protect Me From This Year’s Flu? (alternativendhealth.wordpress.com)
• 2012-13 Seasonal Influenza – an update! (bio230fall2010.wordpress.com)
• FDA approves new flu vaccine (kmov.com)
• Flu vaccine halves risk of infection this year, Canadian study shows (vancouversun.com)