Pharmacynote – the latest pharmacy, pharmacist news

Unfortunately, few doctors now practicing have been trained in geriatrics. But good physicians will have intuitively learned to adapt their approach to the special needs of patients who are older or disabled by chronic disease. Before age even enters the equation, your doctor must have the twin essentials for providing good care – technical competence and a good bedside manner.

A good bedside manner is not irrelevant to quality treatment. We are more likely to visit a doctor who is warm and accepting; we are more likely to make an appointment and to follow through on any procedure the doctor suggests. Having a doctor with a congenial personality is even more important as we grow older, because our physicians are almost destined to become much more central in our lives. These 1983 statistics are a grim testament: in that year, Americans aged twenty-five to forty-four saw a doctor an average of 4.8 times; the figure for people over seventy-five was 8.4 times.

Dealing with chronic illnesses involves ongoing collaboration. It behooves you to have a collaborator who seems caring, whom you can talk to honestly, who values what you say, who believes that something can be done for you, whom you can feel free to “bother” with any reasonable question or concern.

On the other hand, a pleasing personality can be seductive. We tend to develop an intense attachment to our doctors-, a combination of respect and adoration very like the bond young children develop with their parents. We are especially likely to develop these “transference” feelings if we have a longstanding relationship with our doctors, are seeing them regularly, and have a potentially fatal disease. But love can blind, and blind loyalty can be dangerous. It can cause us to put up with poor care beyond the time we should. We don’t get a second opinion because we are afraid it will hurt the doctor. We have been with him for thirty years, and he has always treated us so well. We may be afraid if we change doctors we will not get the same attention. “Won’t I lose my special relationship with Dr. Smith if he learns I consulted someone else?”

My husband is assertive in his business, but he is jelly when it comes to saving his own life. He has cancer of the throat. The prognosis is not good. I know oncologists differ in their skill and their ability to cure. He insists on staying with the first doctor we consulted, a man I know is second-rate. I think another doctor might be his life raft, or at least buy him more time. He is clinging like a baby to this sinking ship.

If you suspect you are getting inadequate care, harden your heart. Put aside loyalty, love, and inertia and get a consultation. What you learn may make you more secure, or you may discover your suspicions are right – that you must steel yourself and find a new doctor.

*139/159/5*

GENERAL HEALTH

The success rate of this program shows that to wage war against disabilities it is important to have high-quality medical care. Here are some ways to help ensure you get that care.

School yourself in the modern point of view. You and your physician are collaborators. The doctor is obliged to treat you as an intelligent person, to explain things to you carefully in understandable terms. You have the obligation to want to know and should take the following steps to be a responsive partner in your care.

Call your doctor when you experience any unusual new symptom or physical change. It is not necessary to pick up the phone at every headache or cold, but when anything unusual happens physically, give your doctor a call. If thoughts like these give you pause – “It’s old age”; “I don’t want to bother the doctor”; “He can’t do anything for me” – tell yourself, ‘ ‘Until I get my medical degree, I’ll let Dr. Jones be the judge.”

Visit or call armed with a written list of questions. Many people get flustered when they talk to a doctor and forget half of what they wanted to say. So be organized. Write down every question before you see your physician. Make your list as comprehensive as possible. Understand that difficulties such as getting to the store are also legitimate problems for the doctor to help you with.

Ask for exact information about what tests, treatments, and diagnoses mean. Do not accept “doctorese.” Insist on explanations you can understand. When the doctor prescribes drugs, know what to expect and what the possible side effects are. When your physician suggests surgery, know the risks and the nonsurgical alternatives.

Question your doctor thoroughly if anything is unclear. Squelch the thought, “She’s too busy” or “I’m being difficult.” Take all the time you need. If you still have doubts or questions after you leave the office, get more information. Don’t hesitate to call back armed with a new list.

If necessary, read about your problem on your own. Go to a library and check out some medical books. You may not have gone to medical school, but any intelligent person can become a lay expert in an area of special concern.

Report side effects of medications or treatments promptly. If a prescribed drug makes you feel bad, rather than suffering in silence or not following through, call back. Your doctor may be able to suggest an alternative treatment that works without having the side effect.

When surgery is recommended, get other opinions. Medicare will pay for any surgical second opinion and also pays the full cost of a third if the first two doctors disagree. To get a second opinion, rather than asking for a name from the specialist who recommended the operation, call your family doctor for a referral. Or try this approach: call a top-rated teaching hospital and ask for an appointment with the chairman of the department that handles your disease (the chief of cardiology, oncology, etc.). If you cannot see that person, ask for a referral to another senior faculty member. For your own peace of mind, try to get any second opinion about surgery from the very best source. Since some of these suggestions may be difficult to implement on your own, consider asking a relative or close friend to help. Could your brash son-in-law be prevailed on to set up an appointment with that ultra-competent, hard-to-reach specialist? On your monthly visits to the doctor, could your daughter or Mrs. Smith from around the corner accompany you? Because things move so quickly during those often-rushed office visits, having a companion (that is, an ally) to step in and slow things down may increase the chance that your concerns will be heard. Meet beforehand to formulate your list of concerns and questions. And check with one another before you leave the office: “Was anything Dr. Jones said unclear?” “Do I have other things to ask?”

*138/159/5*

GENERAL HEALTH