Archives for the month of: February, 2015

Global Health Reach Foundation, LLC. Westerville, Ohio, USA.
Empowering people to improve their health through education in the United States and other developing countries around the world.

Our Community Healthcare Education Series: (1) Informed Patients Making Informed Healthcare Decisions: Improving proper communications between patients and their doctors.
A Presentation to the Community of People by Dr. Samy Veluchamy, MSc, MS, ScD, CCE.
Author of the Book: The Incredible Human Machine: Your Body and Its Health (Volume 1 & Volume 2)—now available from Amazon.com and other online booksellers including book stores in the United States.


 

How Informed Patients and families can make Informed healthcare decisions?
I. What do we mean by the term Informed Patients?
People who have developed certain level of understanding about their personal health situation (diseases /disorders) and associated symptoms, and are able to share with their doctors about their health problems reasonably well.
In addition, they are able to: (1) follow their doctor’s instructions, (2) ask reasonable questions of their doctors related to the disease diagnosis, recommended treatments and prevention measures , and (3) further improve their understanding about the needed care for them.

II. What is Informed healthcare-decision making?
After developing more disease specific understanding on the diagnosis and treatment options including associated relative risk/benefit aspects, they are empowered to make educated-care decisions in partnership (based on trust, understanding and mutual respect) with their doctors.

III. What you need to know about healthcare-providers, in general?
1. Health care field in general, draws men and women who are not only intelligent, hardworking, ambitious and capable, but also who have genuine desire to help others with health problems.
2. Medical practitioners have gained extensive medical sciences knowledge and obtained necessary clinical training pertaining to their chosen specialty.
3. A doctor has the ultimate responsibility for delivering appropriate health care to his/her patients, while acting as the captain of the healthcare delivery team.**
4. Remember: Doctors also are under constant stress from time constraints imposed from their practices’ business as well as peer review perspectives, on top of medical malpractice liability concerns.
** Healthcare delivery team includes: doctors, dentists, nurses, pharmacists, physical therapists and others who provide clinical, technical and related support functions in healthcare facilities.

IV. About establishing a good “patient-to-doctor” relationship with your doctor(s) through proper communication.
1. Make it a priority to work with a primary care physician who fosters open communication–in both directions.
2. A doctor’s ability to explain, listen and empathize has profound impact on a patient’s care and treatment outcome.
3. Your doctor will ask questions and also should listen carefully to your answers.
4. Likewise, the more specific information you can provide about your health and lifestyle, the more accurately your doctor can assess your health situation and plan preventive care or identify a problem.
5. Your honesty and diligence are important, since misinformation can lead to misdiagnosis and /or wrong treatment.

The following Patient case history illustrates how misinformation from a patient had resulted in misdiagnosis by several doctors.
V. A case history of Ms. Betsy Miller, from Harrisburg, Pennsylvania.
• Betsy, a 39-year-old patient came to see DR. Martin for a second—or rather, a sixth opinion– after experiencing “rapid heartbeat and feeling stressed.” After going through multiple testing recommended by five other doctors previously, and had been referred for Psychological counselling for an anxiety disorder.
• But, the careful evaluation of the patient history and thorough questioning by Dr. Martin, a caring physician revealed that Betsy was taking an over-the-counter weight loss product that contained a chemical ephedrine. When she stopped taking that product, her symptoms also stopped.
• When asked why she had not mentioned that information before, she said “she had never been asked by her previous doctors.” Until then, her providers would sooner order tests than take time to talk with her about the problem.
• Betsy was fortunate; poor communication often can have much worse health consequences to the patient.

VI. Listen to your body and tell your doctor about your symptoms
1. You intuitively know what is normal for you–and what is not. Even a general sense of “ not feeling right” can be a tip-off to a serious condition, especially if you are over 50 years of age and/or if you are a post-menopausal woman.
2. When you experience unexplained symptoms, write them down, as well as anything else you feel may be relevant and note when the symptoms started and whether you have experienced them before.
3. Take this information with you when you go to see your doctor.

VII. Be prepared to share with your doctor(s) the following information
1. Your family and personal medical histories, current lifestyle habits, including typical eating habits, level of physical activity, smoking and drinking frequency, and sleeping patterns
2. Recent changes in your usual routine living conditions (family & work environment, relationship issues etc.)
3. Other factors that may be affecting your health, such as stress or emotional problems.
4. Medicines taken—both prescription and over-the-counter products including dietary supplements, vitamins, as applicable—and their dosage, frequency etc.
5. Any recent visits to other providers, including results of any tests ordered by those doctors and their recommendations.

VIII. What you should know from your doctor(s)?
1) When your doctor recommends certain tests, (especially certain major imaging tests or invasive diagnostic procedures) —ask what those test results mean to your condition and whether there are alternatives.
2) If you are given a diagnosis, ask how the condition will affect you, and what treatment options are appropriate
3) If you are given prescription(s) for medication(s), ask when to take each medicine, with or without food, what to do if you miss a dose, when to expect results, what side effects to expect, and which foods or other drugs to avoid.
4) After you begin a new medication, ask when to return for a progress check to be sure the medication is working as it should. If not ask why.
5) When you are given a medication by a specialist or any other health care provider, let your primary care doctor know of it. Always keep a list of all medications (both prescription and non-prescription types), their dosages and frequencies. Always ask your doctor or pharmacist about any contraindications.
6). If you are facing a decision about invasive diagnostic procedure or treatment, ask what the desired goal is, what the options are, and what is involved in each alternative. Ask about unintended side effects (potential risks and relative benefits of each option).
7). Whether the treatment requires hospitalization, and if so, which hospital/medical care facility your doctor recommends and why.
How long you will need treatment, and whether you need to plan for recovery time.
8). When you do schedule a test or procedure, ask how you will be given the results and who to contact if you have questions.
9) When you do schedule an invasive procedure, ask for emergency contact information in case of severe problems after leaving the medical facility to home.
10). Discuss your lifestyle habits and ask about recommended changes in diet, and physical activity or other things to avoid in behavioral aspects going forward and for how long.

IX. After asking reasonable questions with your doctor (s), be proactive.
• After you share information about your health, it is your turn to ask questions and expect clear answers that satisfy you. However, if you feel that your symptoms or concerns are being dismissed or you need reassurance about a diagnosis, keep asking questions until you get your concerns cleared.
• If you feel that your concerns are not being addressed, consider seeing another doctor for a different perspective—a second opinion (only under non-emergency situation). Don’t be afraid that your first doctor will be insulted. More physicians welcome the opportunity to confer with their peers for another opinion.
• Having comfortable working relationship with your doctor (s) will increase your ability to recognize your developing disease symptoms in time or prevent it. That enrichment of knowledge enables you to make educated treatment choices as needed, and enjoy reassurance of being cared for by a medical professional you trust.

X. Commit to your health care partnership with your care-providers.
1. You need to become an active partner with your healthcare delivery team and play an important part in your care process.
2. Patient treatment outcomes research findings have shown that when patients actively participated in their health care decision-making, they are more likely to follow through with the lifestyle changes, diagnostic testing, and drug and treatment therapies their doctor(s) recommend. As a result, those patients experienced improved treatment outcomes for several major diseases, including heart attacks, pneumonia, and heart failure, and also resulted in increased patient satisfaction .
3. Having a comfortable working relationship with your doctors will increase your ability to identify your developing disease symptoms in time or prevent it, make educated treatment choices as needed, and enjoy reassurance of being cared for by a medical professional you trust.

This offers satisfying professional careers to your care-providers as well—A win-win situation for both patients and their doctors.

XI. Now, I am providing for your guidance the following simple: Symptoms Checklist—Quiz+++

What are the typical symptoms of a person suffering a heart condition—warning signs?
Chest discomfort, shortness of breath, fatigue, changes in heart rhythm, fainting or dizziness in both men and women.

1. Chest discomfort: Most heart attacks involve discomfort in the center of the chest that may last more than a few minutes, or that goes away and comes back. The discomfort can be felt like uncomfortable pressure, squeezing, fullness, or pain.
2. Discomfort in other areas of upper body: Symptoms can include pain or discomfort spreading to one or both arms, the back, the neck, the jaw, or the stomach.
3. Shortness of breath: this may occur with or without chest discomfort.
4. Other signs: These may include sweat, nausea, or light-headedness.

Heart Attack Symptoms—Are there differences between men and women?
1. As with men, women’s most common heart attack symptoms include chest pain and discomfort,
2. But women are somewhat more likely than men to experience other symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain,
3. In addition, research has shown that indigestion and increasing fatigue may be experienced by some women having a heart attack.
4. Caution: Their heart attack symptoms can be easily mistaken for gastro-esophageal reflex disorder (stomach acid reflex or heartburn problem.)

Likewise, it is important that you develop an understanding about the Warning Signs of a Stroke.
+++ Caution: This information drawn from American Heart Association sources on Heart Attack symptoms, is for educational purpose only and is not intended for medical advice to people and readers should not use this as a substitute for their consultations with their trusted doctors.

We have provided more details in our Book in chapter 2 : Understanding the Importance of Doctor-to-Patient Relationship. Topics covered are: How proper communications can help foster a Good Doctor-Patient Relationship; Patient Rights and their Responsibilities as Informed Participants; Informed Consent process to Medical care and Treatment; and Understanding Medical Professionalism and the need for Humanities in Medical education in the United States and the developing world. Additional details on Patient Safety Issues in Healthcare Settings including “Patient Tips” to prevent those mishaps from happening to them are provided in Chapter 3, in the book.

Finally, on behalf of the Global Health Reach Foundation, I wish you success in your fruitful learning of the helpful information presented (in patient-friendly language) in our books to better manage your personal and family healthcare and I thank you for your support to the Global Health Reach Foundation toward  improving other people’s health through education and empowerment so as to have a healthier-world community around us.
Thank you again for your kind attention.
Dr.Samy Veluchamy, MSc, MS, ScD, CCE.
President and Founder, Global Health Reach Foundation, LLC.
P. O. Box: 2651, Westerville, OH-43086, USA.

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Welcome to the Global Health Reach Foundation.

We are happy to share with you our Foundation’s Mission, major goal and our action steps toward realizing that major goal, including our publication of two health care books during the year 2014.

I thank you for your encouragement and ongoing support during the year 2015 and beyond toward realizing a healthier world community around us.

Dr. Samy Veluchamy, MSc, MS, ScD, CCE.

President/Founder, Global Health Reach Foundation LLC

Westerville, Ohio, USA.