 Dr. Goodman started out by talking about who is on a medical team.
Establish your medical team
Goodman explained that the doctor/patient relationship in today’s
world is not just a relationship between the doctor and the patient.
There is an entire team of people who need to be involved in the
care and treatment of a person who is ill.
That team, first of all, does consist of the patient, but also the
patient’s family members and/or caregivers. These people need to be
well informed as to the patient’s illness, the doctor’s treatment
and need to play a role in the treatment and recovery of the
patient.
On the doctor’s side of the relationship, the team also includes the
doctor’s assistants and or nurses, as well as the office staff.
Depending on the severity of the illness and the means of treatment,
the team can expand to include social or case workers, hospital
nurses, and staff as well.
Goodman said each person in the team plays an important role in the
recovery of a patient, but for them to play that role, they must be
well informed, they must be available, and they must be people who
are trusted by the patient. Goodman explained that the illness and
recovery will take place in a "better environment” if the people on
the team truly care about the well-being of the patient.
Talking specifically about the doctor and his or her team, Goodman
said it is important that the doctor spend adequate time with the
patient. He said that when the doctor meets with the patient, he or
she should not rush the process. The doctor should be willing to sit
and listen, asks questions, answer questions, and show no signs of
being in a hurry to move on to the next appointment.
He said the doctor’s assistant or nurse should be well informed, but
they should not pretend they are the doctor. The nurse shouldn’t
diagnose or offer advice without the direction of the doctor.
On the patient team, the key ingredient to getting off to a good
start in the diagnoses and recovery process, is to be an excellent
communicator. This is why sometimes it takes a team to get the job
done right. The patient and his or her team should be able to
recount to the doctor everything that is going on with the patient,
and events that have occurred leading up to the doctor’s visit.
Goodman warned that the discussion should be frank and honest, but
not over-exaggerated. The doctors job is to listen, taking
everything at face value, to examine the patient, form an opinion or
diagnoses, explain the diagnosis, and establish a plan for
treatment. If he or she doesn’t have all the facts, or is told a
particular pain is worse than it actually is, this can lead to a
failed diagnosis.
In addition, leaving out important information can do the same,
causing a failed diagnosis, and ultimately forcing the physician to
start over in creating a plan for treatment.
By way of example Goodman brought up one particular instance where
lack of information can cause a great deal of harm, “You have high
blood pressure. Your doctor has prescribed a medication for your
condition and given you directions on how to take that medication.
However, for whatever reason, you have not followed those
directions. Your blood pressure remains high.”
“When you visit your doctor, you don’t tell him that you’re not
taking your medication. He decides that in order to help you, he
needs to prescribe a second medication to take with the first.”
Goodman explained that at this point in time, the patient may say to
themselves, “This is pretty serious, and I better do what I’m told.”
So he or she begins taking both medicines as directed.
“What happens?” Goodman said, “You take the medication, your blood
pressure drops, and you drop!”
Goodman said the doctor will understand if you’re not taking the
medication and will try to help you work out that part of the
problem, but he or she can only do so if you are truthful.
He also noted that while it may be a chore, when going to the doctor
take with you every medication you are taking, not just a list of
them, but the actual bottles with the prescription information on
them and the medication in them.
Goodman was asked if that included dietary supplements and vitamins,
and he said “Yes.” He noted that many of these supplements are not
good for a person. This applies to many of the products that are
considered heart health and arthritis health supplements. The doctor
should tell you if you need such products, and otherwise, you should
not take them.
Creating a Medical History
The patient team should also plan ahead for illness events by
creating a health history. Goodman said, “Write it down. Don’t rely
on memory when you are sick.”
Goodman pointed out that when creating a medical history there is
“an App for that.” Many smartphones have a “My Health” App where
information can be placed and updated as needed. There are also
notebooks on many smartphones, where you can store your information
without an App. Also, a piece of paper or small notebook will work
well.
First, list personal information: Name, date of birth, address,
phone number, insurance information, emergency contacts and those
with whom the doctor is permitted to discuss your condition.
List
allergies and hypersensitivities. If someone takes penicillin and
breaks out in hives or has swelling, that is an allergy.
On the other hand, if a medication such as codeine causes nausea,
that is a hypersensitivity. Doctors will avoid medications that
cause allergic reactions. But hypersensitivity may be something the
patient has to tolerate because the need for the medication is
greater than the need to avoid the side effect.
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 Include a social history that outlines if you
are a smoker and if so how much and for how long, do you consume
alcohol, your marital status, work status, diet and exercise habits,
activities, hobbies, and even membership in organizations. This
information gives the doctor a picture of your whole self.
Also, note if you have a living will, give the name and contact
information for your power of attorney, if you have one; and also
your medical surrogate if you have one.
Goodman was asked to explain medical surrogate. This is a newer
terminology for medical power of attorney. Goodman said it is a
better term because it lessens confusion regarding POA’s. A power of
attorney may have control over several aspects of your life
including your financial needs when you are incapacitated. A medical
surrogate has only the right to make medical decisions on your
behalf when you are incapacitated. Goodman also noted that the
doctor has the right to veto the decision of a medical surrogate if
he or she feels the decision is not in the best interest of the
patient.
Include medications in your history. Write down the medications,
including over-the-counter products you are currently taking. Also,
write down if you are taking prescriptions according to direction.
This is so important that doctors know whether or not you are taking
your medicines as directed. Also include the name and contact
information of your pharmacy.
Include your immunization record. For kids or adults, this too is
very important. Write down what immunizations you have had, and the
date.
And finally, record doctor visits, hospital stays, diagnosis, and
treatments. This can and should be a summary. If the doctor needs
detailed information, that can be obtained through his or her
discussion with you, members of your “team” or from the doctor or
hospital that provided the service.
Be a patient patient and have a patient doctor
Goodman said that there were going to be times when a doctor cannot
immediately make a diagnosis. He said there are times when a patient
should be concerned if a decision appears to be a “snap decision.”
Goodman said, “No matter how complicated it may be, a good doctor
needs to and can get things sorted out. But it may take two or three
visits.”
Goodman said a doctor should also do multiple examinations during
the process and should avoid ordering an excessive number of tests.
He shared one very interesting bit of information regarding CAT
scans. He said doctors should be prudent in ordering this test not
only for the cost of the test but also for the exposure to radiation
for the patient. He noted that one CAT scan discharges as much
radiation as 600 chest X-rays. He also noted 10 percent of cancers
are the result of radiation. He said for those caring for youngsters
this should be of particular concern.
Finally, the doctor should be patient with you. If you have
questions ask, and ask with the expectation that the doctor will
give you a thorough explanation of your condition and will be able
to justify fully the need for any special tests he or she is
ordering.
The doctor should also be able to admit when he or she needs help
with your case. Second opinions and referrals are sometimes a
necessity. Goodman warned guests to be wary of a doctor who appears
reluctant to get those second opinions.
Be well informed
Goodman said that in today’s internet society, Doctors are more
respectful of the well-informed patient than ever before. He said
doctors are aware that there are medical websites that offer
important information, and a good doctor will not be intimidated by
that. He said if a patient or patient team member has done research
and has theories or ideas, those can and should be discussed with
the physician. The doctor will be able to expand on what the patient
already has learned, or explain why in this particular instance the
research done by the patient may not pertain to his or her illness.
Goodman did suggest that when doing online research to be sure that
the source is a reputable medical professional or firm. He named off
the Mayo Clinic, Cleveland University, and Barnes Hospital in St.
Louis as having information that is reliable and honest.
On the flip side, Goodman said that sometimes too much information
can be detrimental. He advised his audience not to get caught up in
what they read to such a point that it causes them stress and
anxiety.
The role of the doctor is to find the problem and assist the
patient, and patient team, in reaching a treatment plan that will
bring about the recovery from the illness. While internet
information is good and worthwhile, it is not a personal
examination. Goodman said, “So yes, be well informed, but also know
that the doctor is acting in your best interest and is going to find
your problem and fix it if at all possible.”
Debbie Deopere of the Area Agency on Aging acknowledged some of the
folks in the room. Dr. and Mrs. Paul Boatman of Safe Haven Hospice,
Marcia Cook, also of Safe Haven; Lindsey Starcevic, the new
Community Relations Coordinator for Castle Manor; Don and Debbie
Hoover, who serve on the Area Agency’s Board of Directors and the
Advisory Board; as well as Cory Roe, who is with Advanced Health
Care, and assisted Dr. Goodman in his presentation.
The Lunch and Learn is part of a quarterly program that the Area
Agency will be hosting in Lincoln. The next Lunch and Learn will be
held on October 26th. “Healthy Habits for a Healthier You” will
feature Sara McGrady of the Alzheimer Association of Greater
Illinois.
Guests for the Making the most of your doctor’s visit enjoyed a cold
luncheon provided by Advance Healthcare.
[Nila Smith] |
