Thursday, April 07, 2011

Tips On What To Do When You Visit Your Doctor

ONE of the important aspects of positive living with disability is to have regular check-ups with your medical specialist.

Recently Wheel Power spoke to consultant neurologist Dr Lim Shen-Yang at University Malaya Medical Centre in Kuala Lumpur.

Dr Lim who is also senior lecturer and a Parkinson’s disease and movement disorders specialist came up with some especially pertinent points for people suffering from chronic disabilities to pay attention to when they seek the help of doctors in hospitals.

His suggestions are also relevant for everyone who at some point in their lives will also be on the receiving end of medical care in such institutions.

“There are ways to increase the efficiency of a consultation with your doctor, so that he/she can spend the limited amount of time available coming up with good solutions to your problems,” began Dr Lim.

“For example, not a single day goes by when I do not see patients who have no idea of what medicines they take,” he explained.

“They frequently describe their medication such as ‘it’s that small yellow tablet doctor!’

“In more times than not, patients don’t take the trouble to bring them in for verification nor provided the doctor with a written list of these.”

Dr Lim said precious time is wasted in trying to work out what constitutes very basic information needed for a proper medical consultation.

Having a neatly-written or typed list of medicines that is accurate and up-to-date can go a long way in conveying to your doctor that you are interested in your health and in optimising your care.

This, according to him, will help to minimise the chance of being prescribed a medicine that interacts negatively with one a patient is already taking to cause adverse side effects.

The written list should include information on the generic and/or brand name, dose and frequency of intake of the medicines, as well as a list of medicines that previously caused a patient to have a bad reaction.

For patients with multiple medical problems, it also helps to have a brief but up-to-date point-list of the diseases/conditions that he or she suffers from.

“If you have a medical chart that is six inches thick, it probably is not reasonable to expect a doctor seeing you for the first time to comprehensively go through this,” said Dr Lim.

In such situations, he suggests the following:

  • Bring along whatever scans or test results you have to your doctor’s visits. Whenever possible, ask to keep a copy of important medical records (for example, a hospital discharge summary at the time of being discharged from a ward).  
  • If there are a number of symptoms or problems to tell your doctor about, write these down. If it is a long list, try to prioritise them in order of “most troublesome” to those that are less so.
  • You should come away from a consultation with at least a basic understanding of the doctor’s assessment of your clinical situation and his/her rationale for recommending particular treatments. If no explanation is forthcoming, ask for one. If things are not clear, do not be shy to ask for clarification. Often, it helps to have a family member or friend present during the consultation to listen in and jot down the important points or ask relevant questions. Providing a collateral history is useful to doctors. (For example, an accurate diagnosis of epilepsy relies heavily on the description of the events surrounding the seizures, which cannot be provided by the patient himself, as usually he is unconscious at these times!)
  • If your problem is an unusual one, consider seeking a second (or even a third or fourth) opinion. There have been cases of patients – even with specialists – where a wrong diagnosis was made, or treatments given incorrectly. A good doctor will not be offended if his/her patient asks to consult another doctor for a further opinion – as long as the colleague is one with the appropriate expertise. This, however, needs to be balanced against the other extreme of “doctor-shopping”: these are patients who flit from one doctor to the next, and continuity of care inevitably suffers. In this context, it is worth noting that there are many conditions in medicine where there is great variability in individual response to treatments (in terms of beneficial effects, as well as with unwanted effects). Therefore, failure of a trial of one or two medicines to provide benefit should not immediately indicate that the doctor is incompetent. If you trust your doctor, and provided that time is on your side, it is often best to adopt a disciplined approach and persist with the treatment recommendations, rather than “bail out” prematurely.

To sum up the above in one sentence: “Be interested in, and take responsibility for, your own healthcare”.

The End
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