Primary care physicians often have to see patients with a litany of issues — often within a span of a 15-minute office visit.
This places the doctor in the middle of a tension: Spend more time with the patient to address all of the concerns, but risk the wrath of patients scheduled afterwards, who are then forced to wait. And in some cases, it’s simply impossible to adequately address every patient question during a given visit.
It’s a situation that internist Danielle Ofri wrote recently about in the New York Times. In her essay, she describes a patient, who she initially classified as the “worried well” type:
… a thin, 50-year-old educated woman with a long litany of nonspecific, unrelated complaints and tight worry lines carved into her face. She unfolded a sheet of paper on that Thursday morning in my office with a brisk snap, and my heart sank as I saw 30 lines of hand-printed concerns.
Ms. W. told me that she had recently started smoking again, after her elderly mother became ill, and she was up to a pack a day now. She had headaches, eye pain, pounding in her ears, shortness of breath and dizziness. Her throat felt dry when she swallowed, and she had needling sensations in her chest and tightness in her gut. She couldn’t fall asleep at night. And she really, really wanted a cigarette, she told me, nervously eying the door.
This is the kind of patient who makes me feel as though I’m drowning.
Dr. Ofri did as many doctors do: She listened appropriately, went over the patient’s history and physical, reviewed prior tests, and concluded that many of her symptoms were due to anxiety. Except, in this case, they weren’t. The patient eventually had a pulmonary embolus, and hospitalized. Read more »
*This blog post was originally published at KevinMD.com*
A neighbor of mine was diagnosed with breast cancer about the same time my wife was being treated for lung cancer. I saw my neighbor the other day for the first time in several years. I asked her how she was doing. She said great. In turn I asked her how her PET/CT exam looked. PET/CT scans are often done to make sure that one’s cancer hasn’t spread. My wife gets one every year.
My neighbor told me her doctor never told her she needed one, that mammograms would suffice. She went on to say a friend had also recently asked her if she had a PET/CT as well. “Maybe I should ask my doctor,” she told me. That was the same response she gave me the last time I raised the subject two years earlier: “I should ask my doctor.”
So Why Don’t People Ask More Questions?
My neighbor is not alone when it comes to asking their doctor questions. In an earlier post, I cited research which found that patients ask their doctor an average of two important questions during the office visit. According to researchers, there are five reasons why people don’t ask their doctor questions. Read more »
*This blog post was originally published at Mind The Gap*
Kevin Pho, MD, primary care physician in Nashua, N.H., blogs at KevinMD.com, member of USA TODAY’S board of contributors and a guest to the Health in 30® Radio Show, writes about the importance of doctors engaging in social media to communicate with patients.
He writes in an op-ed in USA TODAY “Doctors ignore Internet at their own peril” on January 27, 2010:
“Raise your hand if you’ve ever left a physician’s office without fully understanding what the doctor just told you. According to The New England Journal of Medicine, half of patients admit to not understanding what their doctor told them during an office visit.
As a primary care physician, being unable to clearly communicate with patients is frustrating. The typical, 15-minute office visit often is not sufficient for a thorough discussion. A better way to connect with patients is needed.”
Read more »
*This blog post was originally published at Health in 30*