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    What physicians what their patients to know: 13 more things

    by Joanne Jarrett MD February 5, 2018

    After reading “13 things every doctor wants their patients to know,” here are 13 more things good doctors wish their patients knew.

    1. We need the complete truth. I feel for patients who hesitate to reveal something embarrassing. But we hear so much. Very little shocks us. Also, we realize we haven’t walked a mile in your shoes. Or an inch. We take in the facts and get down to the work of helping you. But we need the straight truth. This means telling us what drugs you’ve taken, legal and illegal, to avoid drug interactions. Or telling us exactly when you last ate before surgery to minimize pneumonia risk. It means answering honestly about sexual encounters. We ask questions for specific reasons and need your careful, honest, thorough answers to appropriately direct your care. In college, I had abdominal surgery. For days, awkward med students and interns came to my hospital room asking if I’d passed gas. Well, sheesh. Of course, I hadn’t passed gas. Must you rob me of my last shred of dignity? My evasion created concern that my bowels weren’t functioning. It didn’t change my outcome, but trust me. A dishonest or partial answer can have a terrible ripple effect. The truth, while clunky and awkward at times, is imperative.

    2. We get frustrated when we can’t find the answers. I hated having to say “I don’t know.” As an ambitious problem solver, it’s frustrating to fail to fix your problems and explain their cause. Medicine is an ever-developing, inexact science. We’d love to climb in and look around. In a way, imaging comes close, but there are some things that will remain mysterious. It feels like failure, and we hate nothing more than letting you down.

    3. Antibiotics hurt if they can’t help. Antibiotics should be reserved for susceptible bacterial illnesses. Taking them inappropriately, like for a viral illness, risks complications and advances humankind closer to an eventual reality in which antibiotics no longer work.

    4. Sometimes, “watch and wait” is the best first reaction. Reacting to every symptom with imaging, labs, or medication can cause dangerous and avoidable complications. If you trust your doctor, trust that sometimes time is the best clarifier.

    5. We make mistakes. It is impossible to reconcile our imperfection as humans with the gravity of being responsible for the health of our patients. This conundrum is exhausting, weighty, and ever-present. We do make mistakes. Be wary of anyone who won’t admit that. We are extremely vigilant. But we can’t always be perfect. This is the hardest thing about doctoring.

    6. We are safe confidantes. I had a patient that eventually saw me for long-standing depression. I was taken aback. We had built a rapport. She said she hadn’t told me sooner because she hadn’t wanted to ruin my impression of her. I wish she would have trusted earlier that I was a safe confidante. Confide in us. We can help. We hate the stigma attached to mental illness, which is more common than you realize. We think no less of patients who struggle with it. Mental health is interwoven with physical and spiritual health, and the best care comes when a full picture is provided and considered.

    7. Words can hurt us. We know we see you during the most trying times of your life and are there to walk you through it, but our jobs are only one facet of who we are. We are tender, vulnerable people just like you. Some patients are downright verbally abusive to doctors, nurses, and other medical professionals. We have thick skin. We grew it during training. But when a person is abused, the natural reaction is retreat. We remain professional and suppress our reaction. But a doctor or nurse in retreat mode isn’t in a position to administer the best care. Behavior can effect care quality. Ideally, it shouldn’t, but healthcare is administered by humans.

    8. We know lifestyle change is hard. And boring. We struggle with it too. Chances are there is a box of donuts in the break room as we speak. It’s hard to take the straight and narrow. We try and fail often. But sometimes a specific diet, exercise, alcohol abstinence, or better sleep really are the best treatments. We know it’s not tidy and quick, but we must recommend what’s best.

    9. We are not conspiring with insurance or drug companies. They drive us crazy. We want the best for your care. When insurance companies say no or drugs are prohibitively expensive, it frustrates us. We are your advocates. You are our priority. Period.

    10 We come in all ages, genders, and races. Some doctors are women. Some are minorities. Some are older. Some are young. None of these factors can inform you as to the quality of care a particular doctor can provide. Being fresh out of training has its upside. Experience does too. A conscientious doctor of any shape, size, color, or age can deliver excellent care.

    11. We can be terrible patients. When I was in labor with my oldest, I planned to be quiet, stoic, focused, and compliant. Well, my behavior was lunacy. I was shocked. The pain was savage, and I felt so out of control. When I got an epidural after several hours of hard labor, I was so relieved that I practically proposed marriage to my anesthesiologist. When my obstetrician turned off the epidural so I could push, I panicked. I said, “it hurts” at least nine hundred sixteen times. In case he hadn’t heard me. My sweet doctor finally said, “it’s ok if it hurts.” Well, I begged to differ. I dreaded showing my face at my postpartum appointment, but he didn’t bat an eye.

    12. Some of us use hospitalists. This is a bit dry but bears explaining. Most of you have a primary care physician. If you need to stay in the hospital overnight, you may be cared for by your doc, the doc on call for him, or a hospitalist (doctors that do only hospital care.) They don’t know you and can’t do your after hospital care, but they deal with hospital-worthy illness every day and are well versed in appropriate care and the inner workings of their hospital.

    13. We don’t sneak in the back and Google your symptoms. We only sneak in the back to eat donuts. No, really. Remember our wisdom, experience, and understanding of your history makes our care for you unique. But sometimes google is right. I said it. Just be careful. The internet can lead you to unnecessary panic or dismissal of something that shouldn’t be ignored. And be wary of discussion boards. Incorrect advice can sound very convincing. There is no substitute for medical training, experience, and complex analysis.

    We want the very best for you. Just know that. It’s the bottom line.

    Read the article here

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    What physicians what their patients to know: 13 more things was last modified: February 9th, 2018 by Joanne Jarrett MD

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