A Spoonful of Sugar Helps the Medicine Go Down



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Ever feel like you aren’t getting what you need from your doctors? 5 tips to optimize your healthcare:


If you are anything like me (a busy girl!) you wait until you are either on your deathbed ill or have five or more problems lined up before you take the time to make a doctor’s appointment. Once you have that established, you go, wait for at least 15 minutes if not an hour, then spend a whole five minutes with your doctor. Then you leave, remembering that you didn’t get to four out of your five complaints. So you call back, and to discuss those “other issues” you will need another appointment. Then, the frustration ensues, is anybody listening? Is anything getting fixed? So you switch to another doctor, then realize it’s not them, it’s you, the patient, and your insurance that will only pay for five minutes a pop. What to do? What to do:
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As a Physical Therapist I frequently get the brunt of frustrated patients who feel that in the five minutes they spent with their doctor, they didn’t get anywhere and the feeling begins that no one is listening or caring. When I tried to research actual average appointment times I could only find a number from 1999; it was 6.7 minutes on average, and I can promise you that time is not increasing, it’s decreasing. Don’t believe me? Newsweek published “The Doctor Will See You-If You’re Quick” in 2012 and discussed a possible reason why appointment time is vanishing: doctors are making less money each year courtesy of “managed healthcare.” I’m not just picking on primary care doctors though; we are all getting less time to spend with you, the patient. My reimbursement rates are going down also and I’m struggling in the 20-30 minutes I now get per patient (where I take insurance) to fully evaluate everything I need to know to help, believe me! Lately though I’ve been figuring out, given the same amount of time per patient, why I get a better handle on the big picture with some patients more than others, and I figured I would share those things to you, from a healthcare provider to you, the patient. So here we go, besides writing your congressmen and Obama to change these policies, these are 5 steps you can take to optimize your healthcare:

5) DO USE FLASHCARDS
If you know your doc is especially speedy when you go see them, write down beforehand all the things you want to discuss, not paragraphs with long stories, just bullet points or things you want addressed. Put the most important things in the first couple of cards you have just in case you don’t get to all of them. It is much harder for a doctor to walk out the door on you if you are mid-sentence with a direct, no fluff, question on a flashcard.

chillpill4) DON’T UNDERMINE OR EMBELLISH THE PROBLEM
Making the injury or illness seem more trivial or more brutal than it really is just makes it harder for me to figure out what’s going on and actually help you. I’ve found that with some patients, they are trying to seem tough or impress me, and in this way they make their injury seem less painful and debilitating than it really is. If I don’t manage to get to the bottom of it, I might end up pushing you harder than you need to be. On the other end of the spectrum, some patients feel that I won’t take them seriously unless they convince me they are in 10/10 pain and can’t move a muscle without excruciating pain. Let me be honest here- I have only had two patients who were actually in this much pain, and in both cases they went to the hospital. Tell me what actually hurts, surely not every bone in your body is killing you. I need to be able to hone in on the specific problem, and I do this by figuring out which things are ok, and which things increase pain.

 

3) FIND SOMEONE WHO WILL ADDRESS YOU AS AN ENTIRE PERSON
99% of time the 5 different things that are wrong with you are connected, if you have five different docs, you may never get to the root of the problem causing all your symptoms. A lot of meds out there just treat your symptoms, not the illness. You need at least one doc that can manage to think of all your symptoms and you as a single being, because that’s what you are. A great example is this: I had a patient who came to me with shoulder pain caused by a fall at work because she insidiously became dizzy and lost her balance. During her therapy sessions I could never get her to exercise and she complained constantly of fatigue and that her limbs were feeling heavy. I started asking if she had recently had any bloodwork done, or allergy testing. Turns out her blood sugar was constantly in a peak or valley, both were unsafe numbers. Once this was under control, she was much better at partaking in physical therapy.

 

somefunnymed22) REMEMBER THAT YOU ARE SMART
I find that most of the time, if I listen long enough or ask the right questions, the patient will pretty much tell me what’s wrong with them. Don’t underestimate your ability to help in your own treatment, speak up with important information. For example: maybe you only get pain at night when you are lying in bed, or the visa-versa, only when you get out of bed in the morning. Believe it or not, there are diagnoses that are specific that way. Also remember that your goals are more important than mine. If I think you should be able to run 10 miles but you only want to be able to walk a mile without pain (or again the visa-versa) let’s discuss it!

 

1) BE A GOOD HISTORIAN
The number one thing I’ve realized helps me to ascertain the big picture and therefore, produce better outcomes, is if you can answer all of my questions. I really do need to know if you sprained your ankle in the 9th grade, and had a to wear a boot for 6 weeks, or that you take blood pressure medication, or that you’ve had 6 cortisone shots in the knee that’s hurting you, or that you’ve had five C-sections. Why do I care? Even if something happened awhile ago, you are in the same body are you not? You never know which piece of your history will close the gaps for me and help me get a clear picture. You would be amazed how many people out there have no idea what meds they are on, what surgeries they have had, etc. If you can’t remember, then keep a log. This stuff is critical! I can only do as well as you can. I need the facts. We’re a team!

Contributed by Dr. Katie Addis

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