Wednesday, February 13, 2013

Coping with Time-Crunched Physicians



What Patients Can Do to Get the Most Out of Their Office Visit


It’s not your imagination – you’re getting less time with your doctor.
Primary care physicians are in short supply in the United States, which means increased pressures and heavier workloads for those in practice, says Dr. Paul Griner, (www.drpaulgriner.com), author of “The Power of Patient Stories: Learning Moments in Medicine.”

“Many physicians say their favorite part of being a doctor is the relationships they form with patients, but those are harder to cultivate now because physicians are so squeezed for time,” Griner says.

More than 80 percent of physicians said patient relationships were the “most satisfying” part of their job, according to a survey of more than 13,000 doctors last year by The Physicians Foundation.
But nearly 40 percent said they were seeing 11 to 20 patients a day, and nearly 27 percent had a daily load of 21 to 30.  On top of that, they spent an average 22 percent of their day on paperwork that had nothing to do with patient care.
“A good doctor-patient relationship is essential to achieving the best possible care, but the reality is, most doctors have less and less time to spend with each patient,” Griner says. “So it’s important for patients to take some responsibility for that relationship, too.”
By preparing for your visit, you can ensure you make the best use of your time together, he says.
He offers the following suggestions:
• Prepare your thoughts ahead of time so that you can be as precise and accurate as possible. What are the symptoms? When did they begin? What were you doing at the time? How are the symptoms affected by activity or rest? What makes them worse? Have you been able to do anything to relieve the symptoms? How have they affected your daily activities? Don’t withhold any information that might be relevant to your symptoms.
 Be on time or early. Up to 15 percent of patients are late for their doctor’s appointment, which adds to the time crunch. Arrive early so you’re ready when the physician, or the physician’s team, is ready. While the doctor is the senior person on the team, he or she also relies on advanced practice nurses and physician’s assistants, who have received extensive training in their areas of responsibility. Give them time to obtain your medical history or perform preliminary tests. Their functions are an important aspect of the overall quality of the visit, so it’s important to allow for that time. View the wait as valuable personal time for reading and relaxation.
• Research your health concerns ahead of time and use the information to help focus your questions. Use reliable sources for research, including www.mayoclinic.com or www.uptodate.com; information from the well-established and respected organizations such as the National Cancer Society; and written materials such as the Harvard Health Letter.
 Avoid unnecessary office visits. Some things can be done by e-mail, Skype (or other video hookups), or new technology such as iPhone recording and transmission of your EKG.
Other things you can do to make the best use of the visit include:
 Bring your medications, or a list of them, with you.
 Bring copies of the results of tests or procedures from other physicians.
 Wear clothes that make it easy for you to be examined.
 Let your doctor know when you are using any complementary or alternative medicine.
 Bring a spouse or other relative with you when the problem is complicated. Two pairs of ears are better than one for remembering what the doctor said.
About Paul Griner, M.D.

Hematologist/internist Paul Griner has had a 59-year career in medicine. He is a professor of medicine emeritus at the University of Rochester School of Medicine and Dentistry and was a consultant at the Massachusetts General Hospital, senior lecturer at Harvard Medical School, and consultant to the Institute for Healthcare Improvement (IHI) in Cambridge, Mass. He has written or co-written 130 journal articles, book chapters, and books on clinical medicine, medical education, and health policy. He is a member of the Institute of Medicine of the National Academy of Sciences and was president of a number of national medical organizations, including the American College of Physicians.

Friday, February 1, 2013

Family tragedy and an Update.


Richard M. Lefaive




On January 18 2013, I received the news that my cousin Richard Lefaive had passed away while at work that evening. He had fell and cut his arm and had gone to the nurses station and was told there that he needed stitches and the nurse bandaged his arm and was sending him to the hospital by cab.

Rick was headed to his locker to retrieve his coat when while walking down the hall he just "passed out" and collapsed to the floor. Efforts were started at his workplace to revive him while they waited for the ambulance. Upon arrival at the hospital further efforts were made to revive him but they were to no avail. Rick was gone, he had passed away at the young age of 55.

The news of Rick's passing was devastating to everyone who heard it, after all Rick was the go to guy for any handyman projects. From car repairs to doing a basement rec room he did it all, was always willing to help anyone who asked, and always pleasant to be around.

He knew how to have a good time too. I recall our "youthful" days and all the incidents we got into, the good, the bad and everything in between. Those were the days, let me tell you we had a blast.

Rick was just a couple years older than me so he was the cousin closest to me in age and his brother Ron who we lost several years ago to cancer was just a few years older than us and we always hung out together. I am missing them both, Rick is now with his brother Ron and their Dad, Donald Lefaive. May they all rest in eternal peace.


Moving on to other news, my last chemotherapy treatment did not go as expected. Due to low blood counts (weak immune system) and developing a high fever the evening of day one, my second day of chemotherapy was cancelled. The thought was that as I came in on day one with borderline counts, that after having chemotherapy on day one, my counts would have lowered even more already. 

That would have meant that should I have gone through with day two, I would have most likely became neutropenic. Which would have meant that within a day or two of receiving that second treatment I'd have ended up being admitted to the hospital being neutropenic and confined to a room hooked up to antibiotics for 4-7 days, until my white blood cell count and neutrophils came back up into a safe range.


Yesterday (Wed. Jan 30) I had several appointments at the Cancer Center. My first stop there was at the lab where I had a blood draw, then it was over to see my Social Worker Nancy Hannon for one of my regular appointments. After that I seen my Dietitian, Donna Danelon and had my weight taken. I was up about 3 lbs which made her happy as I had been on a losing trend the past several months.



Me, Dr.Schneider & Brenda at the
Relay for Life event in 2010
My next and last appointment of the day was with Dr. Schneider my Radiation Oncologist for my six month checkup. Dr. Schneider on this visit decided to check my throat with the camera just to have a look and make sure all was still well. Well, the result was not bad news, but not good either! There appears to be a small spot in the area of were I had the biopsy taken which turned out to be the Squamous Cell Carcinoma.

Ever since the biopsy and the radiation treatments that followed I have never worried or even really thought about that returning or causing any further issues as we caught that in a pre stage one situation. Well, now I worry, even though Dr. Schneider believe it is just a spot of inflammation, he wants me back in a month to recheck it.


So a bit of a worry for me, never a dull moment! I will get past this as I always do and for now I will go with what the good Doc said and hope it is just a spot of inflammation. For those of you who read this and are dealing with or have dealt with cancer and relapses, you know how any little thing plays on your mind. So as much as I try to believe that it's just inflammation, my mind will take me other places! Time to fill the candy dish with Ativan again! lol. (I use Ativan for anxiety when needed). 


Take care for now and be good to one another, and take life for what it is, enjoy each and every day you have to it's fullest.