Someone recently asked me a very interesting and controversial question. What would I truly wish my patients would know about their medical care? It made me think. There are so many details I wish patients knew that I cannot possibly include all of them here.
But here's a sample of what goes through my mind as a practicing primary care physician: all this fascination with the numerous medical TV shows and news in the past decade, why can’t we doctors just simply give a straight answer? Why are people obsessed with non-evidence-based gimmicks created to simply deflate their wallet? Dr. Oz, why do you do this to your integrity? Honestly, it’s depressing to see other physicians lose themselves in this world full of temptation and deception. We need to be honest with our patients—whether it’s in social media, TV, or in the office. How else can we live with ourselves and sleep at night?
One word: integrity.
So what would I want my patients to personally know as a primary care physician striving for premium patient advocacy and education? Here’s my top five list
1. Know What Medications You Are Taking
You have one body, one mind, one life. Please learn as much as you possibly can about it (and not from the Internet!). I always find it a tad comical when a patient comes to see me to complain about a certain medication they are taking, without knowing the name or dose.
“It’s a little white pill, Doc. You must know which one it is.” The truth is doctors don’t know. Because there is an endless list of “little white pills”on the market. Generic drugs are also often manufactured by multiple pharmaceutical companies, so they can come in almost any size, shape, or color. There is no way that doctors can keep up with that type of rapidly changing information.
“Don’t you have it in the computer, Dr. Majd?” I do hear this one I hear quite often. Here’s what you need to know about me and many other doctors—we will ask you what medications you are taking at every single visit. Yes, we have a list of your filled prescriptions in the electronic medical records (EMR) system, but just because they are listed there doesn’t mean that the patient is actually taking and ingesting them. And even if they are, it doesn’t mean they are taking it exactly as prescribed. I cannot tell you how many inconsistencies of patient medications I find on a daily basis—more than I care to think about.
Imagine you end up in the Emergency Room for something unexpected (as ER visits often are). And it’s a facility that does not share medical records with your private doctor’s office (as they commonly don’t). They ask you what medications you are taking. Oh-oh … what to do? You are there for severe abdominal pain, are puking your guts out … and they need it now. It cannot wait. Their decision-making often depends on your prior diagnoses and medication lists.
So, yes…please take charge of your own health and understand:
1. What medications you are taking
2. The dosage of each medication
3. How many times a day you are taking each one
4. And just as importantly, for what indication you are taking each drug for
If you feel more comfortable carrying a medication list with you on a piece of paper, you may do so … even though it’s not quite the same as truly understanding it all inside and out. What I find, unfortunately, is that patients who whip these pieces of paper out of their wallets have inconsistencies on their lists, and are not keeping it updated. If you do decide to keep a list in your wallet, please update it every single time a change is made to that list (including over-the-counter drugs you take or change on your own, and medications that specialists manage or tweak).
If remembering these long and complex-sounding drug names is too much of a challenge (which is quite understandable), another option is to bring your bottles to every single office visit. But please make certain that you have grabbed all the bottles you take (including OTCs).
I have a patient that brings me her bottles every time. And about every other visit, I find either a double bottle of a drug that she’s taking both of inadvertently, or she leaves one or few bottles at home but “swears” she’s taking it. I’m never sure what she’s actually consuming on a daily visit. She even neared dialysis because of her medication bottle inconsistencies. I worry about her every time I see her.
2. The Common Cold, Flu, and Acute Bronchitis Are Viruses
The winter season brings a seemingly endless list of patients with viral syndromes to the doctor’s office. Viruses thrive in the cold environment, and therefore, tend to run rampant during these months. They are much, much more common than bacterial illnesses. And are not treatable with antibiotics. Yes, antibiotics do not do a thing for those sometimes just-as-nasty viruses.
And antibiotics are not harmless. They have very serious consequences and risks, especially when used unnecessarily. Please listen to my previous podcast on this very important topic that I honestly believe every single person should be aware of. Because unfortunately, I too often see a patient who requests antibiotics to treat their “sore throat” or “runny nose.” Not that these symptoms are for the light-hearted … certainly not. They are downright invasive, and sometimes debilitating, for a short period of time. But it doesn’t mean they are bacterial.
How can you tell if you have a virus (versus a bacteria)? I’ve discussed that one, too. In order to save yourself and your family members an unnecessary visit to the doctor for something that is, yes, highly disrupting and ill-producing, but that self-resolves within 7-10 days without producing any red flags (such as shortness of breath, difficulty breathing, inability to break a fever with various OTC meds, etc.), make sure to understand when it’s viral and when it’s possibly something more serious.
3. Reasons Why Doctors Run Late
Like I’ve previously mentioned, I hate it when people run late. Even more so when it’s myself. I also hate excuses. This is why this one kills me. Because the truth is that the primary care predicament in this country is quite a messy one. It’s mayhem. Clinics have a tremendous high overhead, and primary care office visits are not well-reimbursed. Therefore, there needs to be a high volume of patients seen in order to even break even, and office visits are often 15 to 20 minutes maximum.
This is the exact reason why there’s a shortage of primary care doctors in this country, because medical students are not selecting a primary care specialty because they realize they will not only have to live a high-stress, fast-paced work schedule on a daily basis for the next 40 years, but that they cannot pay off their school loans doing so.
My previous article on this topic went viral. Perhaps partly because I have struck a nerve with those in the trenches of primary care, like myself, who can relate. Listen to the podcast (or view the article) to learn what a very realistic and typical chaotic schedule and day for a primary care doctor really is like.
So if your doctor is running late, believe me, they are not out to lunch or on a Starbucks run.
4. Be Honest
We are here to help you take charge of your health.
I recently had a patient come see me for a routine physical. After asking my long list of questions to decipher his overall health, I ran some routine labs that returned with anemia and abnormal liver enzyme results. At his second visit, even though he had denied alcohol use initially, after much further prodding and poking he finally admitted that he’s a heavy drinker. He also uses marijuana on a daily basis. Why does he do these things? He’s self-medicating another underlying mental health issue, like many patients with alcohol and drug abuse.
I remember also seeing a young woman in her early 20s, brought in by her mom for severe abdominal pain. Her mom was very visibly worried about her. I was, too—even though I sensed there was a missing piece of mysterious information at the time.
I kicked the mom out of the exam room like I always do with teens and older patients. She didn’t reveal a thing. So I had no choice but to send this young patient to the ER. Turns out, she was simply severely constipated. So when I saw her back in the office for a follow-up visit, she admitted to having taken her boyfriend’s “vicodin” while on a trip to a local amusement park after some “foot pain” she experienced there. Then later, she finally revealed … it was really to heighten her roller coaster “high.” Narcotics are notoriously known for causing constipation, and sometimes quite severely.
I see these cases more often than I like. But the bottom line is this: please be honest with your doctor. Doctors are not in law enforcement, we are not reporting alcohol and drug intake. Your medical records are protected by HIPPA laws, and no one can have access to them without your consent. We are here to help you take charge of your health. There’s no reason not to be completely honest. How else can we care for you to the best of our ability?
5. Stay Off the Internet
Last but certainly not the least involves a topic that is highly unpopular within the physician community all-over … Google University. Googling your symptoms on the Internet is plain unhealthy. Especially if you are the anxious type. Honestly, I am telling you this not just as a physician but as a doctor who truly cares about her listeners.
Just think about it: If Google could truly replace your doctor, or be as accurate, wouldn’t doctors be out of business? Why would we need to go through a minimum of 11 years of schooling past high-school to get to where we are? How can Google replace this extra and prolonged amount of complex problem-solving knowledge and experience?
No, Acai berries are not the answers to your weight loss dream. Please stop listening to resources on the television and Internet that are simply after your wallet and not in your best interests. I know it’s sometimes not easy to hear the truth. But a physician with integrity will always give it to you straight, no matter how much you don’t want to hear it.
The truth is … TV, Google, and social media simply cannot replace your doctor’s knowledge and experience. It just can’t. Leave it alone. Really … just stop it.
If you don’t trust your doctor, then it’s time to find a new one.
If you do decide to search the Internet for medical information, for goodness sakes, at least select sources and websites that will tell you the truth (like the House Call Doctor who is dedicated to providing her listeners with the most evidence-based and truthful advice available). My prior podcast on this topic is exactly the advice that I give to my own patients seeking medical information on the Internet. If you want to learn how to seek more valid information, please check it out.
OK, that one was truly close to my heart. I’ll let it go now.
And there you have it: the five things that I wish all my patients knew. If they all could only obtain these five pieces of information, we would be so much closer to reaching our goals, which are to keep you as healthy as possible, and to help you take charge of your health.
Share your ideas and learn more quick and dirty tips with us on the House Call Doctor’s Facebook and Twitter pages. You can even find me on Pinterest.
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
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