Therapeutic Tests
There are many times physicians examine patients and really do not find any specific explanation for their symptoms.
Some patients find this hard to accept and will occasionally continually complain about their symptoms even though there is no clinical reason to explain it.
At times, simply ordering a test (any test) and then informing the patient of the results suddenly leads to marked improvement in symptoms.
Allaying a patients fears and easing their mind can at times be accomplished by the following things:
• Sometimes, just giving a diagnosis rather than trying to explain symptoms may help. Telling a patient they have myalgia rather than just stating their muscles may be sore for a week or more after an injury may help.
• Many patients would rather be told when to return for follow-up rather than telling them to come back if things don’t get better.
• Some patients will hear you say the symptoms may last 7-10 days and when they aren’t completely gone; they become upset, fearful or feel you were wrong. Don’t be too specific as it can sometimes be detrimental to patients getting better.
• Words can sometimes be misunderstood. For some patients, there's a difference between "better" and "improved" and even though symptoms may be heading in the right direction, the expectation of some patients is to have no symptoms at all. Being clearer in telling patients what to expect is helpful
• Trying to find out from patients and families how compliant they are with the specific instructions and limitations on their illness is also helpful as many patients try doing too much too soon and then don’t get better as quickly as we might expect.
• Many patients, particularly the elderly, are fiercely independent and to accept help is to admit defeat. They may have symptoms longer because they are not following the directions of rest and limited activities.
• Changing our minds about a treatment without a good explanation for the patient can cause trepidation among patients. If we tell a patient they don’t need an X-ray or lab test but then get one a few weeks later because they are hounding us can cause problems with some patients. We need to explain to patients why we are making the change.
• Sometimes just ordering the test is therapeutic and it validates what they have already been told even when it does not change anything else.
• Many patients believe we cannot know what is going on by just an exam. We have created a generation that believes this fallacy but we have to acknowledge it.
Part of this problem is patients have, for too long, not had to pay for services and therefore expect more than is often needed. I don’t see a significant change until patients actually have to be more financially responsible for the services they receive.
Some of these pointers may help patients improve faster from illnesses and may help physicians with the “art of medicine”
Some patients find this hard to accept and will occasionally continually complain about their symptoms even though there is no clinical reason to explain it.
At times, simply ordering a test (any test) and then informing the patient of the results suddenly leads to marked improvement in symptoms.
Allaying a patients fears and easing their mind can at times be accomplished by the following things:
• Sometimes, just giving a diagnosis rather than trying to explain symptoms may help. Telling a patient they have myalgia rather than just stating their muscles may be sore for a week or more after an injury may help.
• Many patients would rather be told when to return for follow-up rather than telling them to come back if things don’t get better.
• Some patients will hear you say the symptoms may last 7-10 days and when they aren’t completely gone; they become upset, fearful or feel you were wrong. Don’t be too specific as it can sometimes be detrimental to patients getting better.
• Words can sometimes be misunderstood. For some patients, there's a difference between "better" and "improved" and even though symptoms may be heading in the right direction, the expectation of some patients is to have no symptoms at all. Being clearer in telling patients what to expect is helpful
• Trying to find out from patients and families how compliant they are with the specific instructions and limitations on their illness is also helpful as many patients try doing too much too soon and then don’t get better as quickly as we might expect.
• Many patients, particularly the elderly, are fiercely independent and to accept help is to admit defeat. They may have symptoms longer because they are not following the directions of rest and limited activities.
• Changing our minds about a treatment without a good explanation for the patient can cause trepidation among patients. If we tell a patient they don’t need an X-ray or lab test but then get one a few weeks later because they are hounding us can cause problems with some patients. We need to explain to patients why we are making the change.
• Sometimes just ordering the test is therapeutic and it validates what they have already been told even when it does not change anything else.
• Many patients believe we cannot know what is going on by just an exam. We have created a generation that believes this fallacy but we have to acknowledge it.
Part of this problem is patients have, for too long, not had to pay for services and therefore expect more than is often needed. I don’t see a significant change until patients actually have to be more financially responsible for the services they receive.
Some of these pointers may help patients improve faster from illnesses and may help physicians with the “art of medicine”
Labels: healthcare, perceptions
posted by Anonymous at 5:53 AM
4 Comments:
I continue to be puzzled by your belief that patients don't pay for your services. I pay over $400 per month (deducted directly from my net pay) for my family's medical insurance, and then usually about $1,000 annually in deductibles. I doubt I'm alone.
I pay health insurance as well, but I really do not have to pay for what an office visit really costs.
The point here is that patients have been taken out of the mix for the most part over the past many years.
HB is correct, things won't change until patients have to pay for what they recieve at the time they recieve it.
The tax code would change dramatically if individuals would get their gross salary and would then have to write a check to Uncle Sam on a monthy or quarterly basis
Patients have not been taken out of the mix. They don't pay at the time of service -- they pay before.
The reason many people are skeptical of their doctors' diagnosis is that they've often heard various opinions from different doctors and have been on various treatment plans with little or no success sometimes for years.
If the doctors were paid only for what worked, maybe things would change also.
doctors are not miracle workers nor God. The body is very complicated and most people expect way too much from their physicians.
Medical care has dramatically improved over the past 100 years and huge improvements have been made.
Patients abuse their bodies in all sorts of ways and then expect a quick fix.
Rarely does anyone pay more than a co-pay prior to a visit and this does not cover the cost of the service.
Try just paying that at your next auto mechanic visit, lawyer visit, accountant visit, grocery visit, dental visit, vet visit, etc, etc
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