Patient & Doctor Value Visit

Visits to your doctor or any healthcare provider can be frustrating and time consuming for all involved.  These are some things you can do to make it an easier and more productive.

One of the first things you want to do is make a written or typed medical history to take with you, especially if this is your first visit to a new doctor. Make a copy for you and your doctor. You both will be able to refer to it as needed. This will save valuable time, and give you and your doctor more time to talk instead of flipping through your medical record. It can be difficult trying to "remember" what test or procedure you had 10 years ago or even last year.

It is a good to make appointments when you are well and stable.  Keep a list of things you want to talk to your doctor about. Update the list before each visit. This way you will be able to keep track of what has been discussed, and what needs to be discussed. Try to talk about the most important things first especially those that need immediate attention. Each time you go for your visit, you can refer to your list and take up where you left off. Be sure to express your immediate concerns first. We all know how short a doctor visit can be.

Request copies of your medical records from all your doctors. "The medical record is the cornerstone of keeping track of everything pertaining to your health." This gives you a complete assessment of all your medical problems. You will be able to check the accuracy of your records, and bring any errors or absent information to your doctor's attention. Let your doctor know about anything you do not understand, or if there is something you are unable to read due to poor handwriting. It is surprising to see how many doctors are often unable to read their own writing.

Schedule your appointment for first available times in the morning or afternoon.*  This will likely ensure that you will be seen on time with a shorter wait time and longer visit.  It will help you and your doctor focus on your total health care versus acute, intermittent health concerns that can easily take up your whole time. Unless an emergency arises, the wait should be less than 15 minutes.  If there is an emergency you should be notified and given the option of waiting or rescheduling, or going elsewhere for treatment. 

The easiest thing you can do is be on time.  Best health!

*How to Make Your Doctor Appointment http://bit.ly/akMrpX

by J.L, Richardson, M.D., family medicine expert and author of Patient Handbook to Medical Care: Your Personal Health Guide, honorable mention of Writer's Digest International Self-Published Book Award** and Indie Excellence Award finalist.

(**Written by a reliable source, this book is the perfect quick reference for all of those squeamish people who hate going to the doctor. I am one of those people. I hate wondering why a certain test was performed, exactly what a common diagnosis may mean, what the proper specialist for my malady might be called, and negotiating the maze of health insurance forms and other paperwork that seems to accompany my ailment; thereby adding insult to injury. To avoid the mystery, misery, and tedium of the wellness process, I often remain sick in order to forego or delay much needed medical appointments. The author writes for people like me; she writes in a calming, professional tone and explains, in as simple and non-threatening a manner as possible, what I can expect along every step of the healing process. By learning to keep a medical diary, knowing what to expect of my medical staff as well as how to decode their complicated language, and then by understanding the basics of the complex American healthcare system, I can take charge of my own healthcare. This little book provides me with all the tools necessary to do just that. ~Writer's Digest)

Doctor's Office Should Enhance Good Health

When you visit your doctor's office you should feel healthy.  The waiting room in the doctor's office is the entry point for most initial patient encounters.  Amidst the unhealthy anxiety often encountered on doctor visits the waiting room should exude good health for each patient that enters.  

Pay attention to the surroundings to see how they make you feel.  You  may have noticed that your blood pressure was twenty or more points higher than before you left home.  Your doctor visit can be more healthy and focused if the waiting room is healthy.  The following are signs of a healthy doctor's office waiting room:

• No television screen. If there is a television screen, it should be on healthy topics that educate instead of unhealthy loud programs that can increase anxiety, blood pressure, and more
• Comfortable seating
• Kind, courteous staff
• Current reading materials
• Limited if any cell phone use

If your doctor's office has aromatherapy and offers free ten minute chair massages, this can create a healthier healing haven.  Make suggestions to your doctor on other things that can enhance patient wait times without discomfort and stress.  Best health!

How to Make Your Doctor Visit Easier

http://bit.ly/1lfIfJw

Your Medical History & Preventiuon Guidelines

Preventive health guidelines were developed to improve one’s health using things that prevent disease and detect it early.  They are based on credible research in which the criteria have been studied extensively.  The United States Preventive Services Task Force (USPSTF) is a leading resource for preventive health guidelines along with doctor specialty organizations like the American Academy Of Family Physicians and American Academy of Pediatrics.  There are so many that it can become confusing as to what you should do.  Like one size fails to fit all so do the guidelines. How will you know what you need and when you need it?

Use your medical history as your guide in deciphering through different health organization guidelines.   Though they may address the same thing, there will be similarities and differences.  If you have a history of cancer, you may want to get a mammogram or colonoscopy more often. If there is a family history, you may want to get tests sooner than the guidelines suggest.  Abnormal physical exam findings warrant testing regardless of guidelines.

Be sure to review guidelines from different organizations. This gives you a broader view of what you need.  Look at the pros and cons as they fit you.  Focus on those that concern you and your condition.  Discuss them all with your doctors and healthcare providers to plan your guidelines. Your medical history is your guide to the guidelines right for you.  Best health!

Preventive Guidelines: Do Lower Medical Numbers Make Chronic Disease More Likely?

Hypertension has new numbers that are lower for normal.  To be considered normotensive your blood pressure numbers should be lower than 120/80 versus the former normal blood pressure below 140/90.  This is the new recommendation from the cardiology experts.  This may be shown to cause less morbidity and mortality, but it may cause more people to be considered hypertensive.  If your reading on three doctor visits is over 120/80, you will be considered a patient with hypertension.

This is just one of the many medical measurements or blood tests where the WNL (within normal limits) has been lowered.  Cholesterol was at one time considered normal at 300.  The normal now is under 180.  New tests can have the same effect.  The BUN and creatinine were once the basic kidney function tests.  Now the GFR is added to these.  Your BUN and creatinine can be normal while your GFR suggests kidney disease based on your sex and your ethnicity. 

Do lower medical measurements and numbers really mean that more patients will have some chronic disease sooner? Or does it mean lower numbers mean better health with less morbidity and mortality?    Good health care will help keep you and your numbers healthier.  Keeping a lifestyle of healthy food, exercise, good sleep, and minimal stress are important health care routines for better health.  These can be integrated with complementary medicine and medication treatments if necessary. 
You should know the measurements and numbers of all your health tests.  This helps you attain better understanding and control of the unhealthy abnormal.  Lower numbers can mean less chronic disease if you know what you have and how to keep it from becoming chronic disease.  Best health!
  

10th ANNIVERSARY PATIENT HANDBOOK TO MEDICAL CARE THANK YOU

This year marks the tenth anniversary since publication of Patient Handbook to Medical Care: Your Personal Health Guide.  Thank you all for reading my book and nine year old blog.  This book was written to help each and every one of you for we all are patients at some time in our lives.  The primary intent and purpose for writing Patient Handbook to Medical Care: Your Personal Health Guide was to help patients learn the basics involved in seeing your doctor and healthcare providers.  It was far too much to tell in a short office visit so I decided to write it down and self-publish!
Since 2006 publication, Patient Handbook to Medical Care: Your Personal Health Guide has become available in many libraries and bookstores (on and off line). There is a Kindle e-book with plans for the audible version.  The blog has been viewed by so many!  Book giveaways, sales, and blog reads are an indication of the patient interest in health facts and information. Health literacy improves your health care in all ways. It helps you make the right choices for you and your family.

Again much thanks to you all! Best health!

Personalized Precision Medicine

As we look forward to medical breakthroughs of the future, precision medicine becomes more of a reality in your medical care. Precision medicine uses treatment and intervention based on a person’s genetic and non-genetic (e.g. lifestyle, environment).  Unlike the present but ever changing protocols for wellness and disease management that are used on everyone, precision medicine is individualized just for you.  It will be your own prescription for staying well and treating your ailments. 

The basis of precision medicine is genomics.  Sequencing of your genome is done.  This molecular process identifies normal and abnormal genes.  Genomic mutations are studied and tested for different characteristics.  The results of this testing allows for prevention, diagnosis, and treatment based on your molecule makeup within your genes that have been influenced by family history, lifestyle, and environment.  DNA analysis of your genes in addition to a thorough history and physical will help your doctor determine what you have and what health risks may be present.  This information will then be used for further diagnosis and treatment.  Prevention of conditions that you are prone to develop may be less likely to develop if at all.

Precision medicine has become prevalent in drug treatment as well as disease diagnosis.  Clinical pharmacogenetics makes use of patient’s genetic data as a guide for drug therapy.  This information can then help your doctor pick the right medication for you. Pharmacogenetic information for blood thinners like coumadin and clopidogrel can be helpful in choosing which will work best for you with least complications.  Neonatal (newborn) diabetes and mature onset diabetes of the young (MODY) are rare causes of diabetes.  The cause of these types of diabetes is from an inherited mutation of one gene (monogenic).  Genetic testing can make the correct diagnosis that would otherwise be missed or misdiagnosed.  Some cancers have specific gene mutations that can be detected and treated successfully based on this information.  Drugs are made to target these and eradicate the cancer.

Thousands of disease genes and genetic tests have been discovered since the Human Genome Project of 2003.  As costs go down and precision medicine improves, personalized medicine will get more precise.  Prevention instead of treatment will be more likely.  Genetic tests and treatments for the individual will be precisely what the doctor orders for you.  Best health!

Living with Arthritis - Keep Moving!

Arthritis is an inevitable part of the aging.  It affects 1 in 3 people worldwide. Age-related arthritis usually starts at about 40 with increasing incidence as one gets older.  The more joints it affects the more likely it may become disabling and painful.  The joints most commonly affected are the hands and feet followed by weight bearing joints like the hip and knee.  The spine is also affected causing low back pain, one of the top five reasons for doctor visits.

Arthritis, also called degenerative joint disease (DJD), is just that – degeneration of bone surfaces from years of wear and tear and or occupational overuse.  Over time joint spaces throughout the body become narrow and less mobile leading to a progressive decline in affected joints.  The narrowing of the joint spaces involves an inflammatory process.  Severe degeneration causes bone surfaces to rub against one another in places where cartilage and synovium used to be. All of this can lead to disabling pain and limited movement. 

 Symptoms of arthritis include stiffness, pain, and joint swelling.  This can lead to decreased, limited movement affecting your activities of daily living.  If arthritis worsens, it can lead to mobility issues and may require surgery.  Chronic, debilitating pain may also make all activities more difficult and less enjoyable.

Is this avoidable?  No.  Is it treatable? Yes.  Some studies postulate that cartilage damage induced by inflammatory arthritis that chondroitin sulfate may at least delay progression.  Antiflammatory medications like aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) help with inflammation and pain.  Further pain contol may be achieved with narcotics which are potentially addictive.  Dietary adjustments include increase calcium and Vitamin D.

The most beneficial treatment is movement. When it’s hard to move, efforts to move must be made to keep from moving even less.  Ironically so, when you feel like you are having a hard time moving, it’s time to keep moving!  Ask your doctor for an orthopedic doctor consult and a physical therapy evaluation for treatment.  You will be able to implement your own home exercise program. 

Best health!

Family Health: Allergy vs. Adverse Reaction

Do you know the difference between an allergy and adverse reaction?  When taking medication of any type, prescription or non-prescription, reactions from a single or multiple drugs may occur.  An allergic reaction usually involves allergy symptoms which may include difficulty breathing, hives, and itching.  Adverse reactions may include this and much more essentially indicating your body is unable to tolerate the medicine.

It is important that your health care team is aware of any reactions to medication you have taken.  When asked about allergies be sure to include adverse reactions as well.  It is also important to note any drug-drug and drug-food interactions you may have experienced.  Medication in the same drug class are often offered as alternatives. These can also be adversely tolerated.

Be aware of your medication history and include it in your medical history.  Share this with all of your healthcare providers.  This will assure that you will be unlikely to be prescribed anything that may cause an allergic or adverse reaction.  Best health!

Keep a Happy Heart, Be Heart Smart

A healthy heart is a cheerful heart.  Keep your heart smart and happy with this quick, easy to understand information.

Check your heart list:
___Heart and vascular exam by health care provider
___Blood pressure, pulse, weight, height
___EKG

For further evaluation, especially if symptoms are present, and/ or if there is a strong family history of heart and vascular disease see a cardiologist.

Tests may include:
___Doppler echocardiogram (checks heart valves, size, etc.)
___Stress test - nuclear, doppler or exercise (heart function)
___Heart MRI scan (artery disease)
___Interventional studies like cardiac catherization, angiogram (checks artery blockage, valve function)

Heart health habits:

1. Maintain a healthy weight.
2. Eat healthy small portions.
3. Exercise regularly - every little bit counts! Just do it regularly.
4. Keep blood pressure under control.
5. Keep stress level low.
6. Get adequate sleep.
7. Take an aspirin a day if in a high risk group. Check with your health care provider.
8. Love, laugh, and let go!

Have a happy, healthy heart! Best health and love!

J.L. Richardson, MD, family medicine, is the author of the award winning Patient Handbook to Medical Care: Your Personal Health Guide.

Family Health: How to Keep Your Health History

Your medical history is the cornerstone of your medical record.

Use it to keep up with your health. Update your medical history often especially as new treatment plans and healthcare issues arise.  Copy and complete the following assessment to keep up with your family's health and medical history. 

MEDICAL HISTORY

 

NAME____________________________

DATE OF BIRTH_____________________________

 

INSURANCE COMPANY___________________

INSURANCE ID #________________________

PHONE______________   FAX__________________

ADDRESS__________________________

CITY_____________STATE___________

ZIP________________COUNTRY__________

EMAIL___________________________

 

PAST MEDICAL HISTORY

ALLERGIES______________________________________________________________________________________

_______________________________________________________________________________________________

DRUGREACTIONS________________________________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

DIAGNOSES & MEDICAL CONDITIONS (include year diagnosed)

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

SURGERY/ OPERATIONS (include year done)

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

MEDICATIONS (list prescription, over-the-counter, foods, herbs

also write dosage and how often taken)

_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

PAST MEDICATIONS (list anything you have taken and stopped – note why it was stopped)

______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

FAMILY HISTORY (list medical conditions in family members – list ages, list if deceased and reason)

MOTHER____AGE________

LIVING: YES___NO____

FATHER____AGE_________

LIVING: YES___NO____

______________________________________________________________________________________________

SISTERS_____AGES_________

LIVING: YES___NO____
_______________________________________________________________________________________________

BROTHERS __AGES_________

LIVING: YES___NO___

_______________________________________________________________________________________________

GRANDMOTHER (Mother’s mother) AGE__________LIVING: YES___NO___

_______________________________________________________________________________________________

GRANDMOTHER (Father’s mother)  AGE__________LIVING: YES__ NO___

_______________________________________________________________________________________________

GRANDFATHER (Mother’s father)    AGE__________LIVING: YES___NO___

 

GRANDFATHER (Father’s father)    AGE___________LIVING: YES___NO___
______________________________________________________________________________________________

 

OTHER RELATIVES (list any more sisters, brothers, great grandparents, etc. especially those with medical conditions)_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

OTHER MEDICAL TREATMENTS (list any other treatments like prayer, massage, chiropractor, exercise, physical therapy, etc.)___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

SOCIAL HISTORY

Home:  lives alone___ 

             lives with family___

             lives with friend____

             lives in facility_____facility name, address____________________year moved in____________

Marital: Single___Married____Divorced___Widow/Widower_____

Use of cane___ walker___ wheelchair___prosthetic_____

Other___________________________________________

Alcohol consumption: 

   How many times per day/week/year?________________

   How much per drink?____________________________

Cigarette use: Yes___ No___

   How many per day?________

   At what age did you start?_______

Sexual:  Are you active? Yes___No___

Drug use: Yes___ No___

 

OCCUPATIONS/ JOBS/SCHOOLING

___________________________________________________________________________________________________________________________________

 

MY MEDICAL NOTES

Use extra page to list any other medical history

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

How To Connect With Your Inner Doctor - You

Studies and common sense have shown that doctors who listen to their patients receive the proper care and diagnosis over 90% of the time.  Self care is very important as are routine check ups on yourself. It is time for you to take responsibility for your health. It is time for you to know what your health numbers are. It is time for you to know your medical conditions, risk factors, and family medical history.

Give yourself a medical checkup. Start by writing or typing or recording your medical history - medical conditions, surgery, treatments, family history. Add your medication. Save it. Update it. Add to it. Correct it. Keep it current. Keep a copy in a secure place.

Examine as much of yourself as you can. Look at your skin, hair, nails, eyes, teeth, and every part of your body that is visible to you. Make note of any abnormalities. Make note of any symptoms you have - new, old and ongoing. Go through each body system. Add this information to your medical history.

Add to this your doctors' and health care providers' names, phone number, land address, and email address.

Call your doctor for an appointment for a comprehensive CPE (complete physical exam).  Get it done routinely (yearly, every other year, etc. ). Take your information and notes with you on your appointment. Review everything with your doctor. Take notes.

Sign a medical record release to obtain a copy of your medical record from each doctor you see at the time of the visit.

Be sure to schedule a follow-up appointment within a month or less to go over everything with your doctor. Get copies of your information including blood tests, and any other tests as well as medical notes.

Take charge. Care for your health is good health care. Be the healthiest you can be. Best health!

Details on all of the above are explained simply in Patient Handbook to Medical Care: Your Personal Health Guide http://amzn.to/13m51UU 
 

Family Doctors: Your Primary Health Care Source

The family physician cares for the whole person and the whole family. Training in this specialty teaches one to care for all aspects of the patient no matter what age, sex, or illness. The Family Physician’s Creed is:

I am a Family Physician, one of many across this country. This is what I believe: You, the patient, are my first professional responsibility, whether man, woman or child, ill or well, seeking care, healing or knowledge. You and your family deserve high quality, affordable health care including treatment, prevention and health promotion. I support access to health care for all. The specialty of family practice trains me to care for the whole person, physically and emotionally, throughout life, working with your medical history and family dynamics, coordinating your care with other physicians when necessary. This is my promise to you.

Because of their versatility, family doctors are excellent primary care physicians. They are able to diagnose and treat many different problems and refer to specialists when needed. They provide continuous routine medical and preventive healthcare. Family doctors may also perform minor surgical procedures in the office. These may include excision of small skin lesions such as warts, opening drainage of a small abscess, and even suturing (sewing up) minor lacerations like cuts. In addition, some also take additional training to perform procedures such as a colonoscopy.

Everyone should have a family doctor as their primary health care source and resource.  You will be guaranteed the most comprehensive care and compassion you deserve. Join the Family Medicine revolution!

Best health!

Home Health Testing

Getting access to your doctor or health service may be a greater challenge than your health problems these days.  More patients are turning to home health care, treatment and diagnosis.  Preliminary self diagnosis aids are as close as the Internet and the corner drugstore.  DIY medical test kits are accurate and may aid your doctor in the final diagnosis.  Studies show that home testing may save your health, time, and money by making a correct diagnosis and starting treatment sooner.  Home health tests help many find answers to your healthcare concerns quickly and conveniently in the privacy of your home.

Home health testing is a mega billion dollar business which is an indication of their popularity and use. Many reliable test products crowd retail and drug store shelves across the world.  These tests enable you to screen, monitor, and/or diagnose yourself. 

As good as it may sound, DIY home testing is not a replacement for professional health care especially if the symptoms worsen or persist.  Once you have positive tests consult with your doctor or other health provider.  Get the tests repeated along with the others your doctor gets.  If a health care provider ignores your request, get another, or check at independent facilities that do testing for you.