DOCTORS ' LOUNGE
DOCTORS ' LOUNGE
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FIRST : DO NO HARM , SECOND : DO NOT INTERFERE . AUTHOR Elizabeth A . Amin , MD
34 LOUISVILLE MEDICINE
During the past couple of years I have become what I call a patient support person . Friends facing unanticipated and often serious medical problems ask what the doctor really meant , how test results can be accessed , how the new medicine should be taken and whether there
will be any side effects or interactions with other prescriptions they are currently taking . It is not that these friends are unable to understand their physicians or that they are unaware that the pharmacist can be of help . It just seems that in the quiet of their own homes , where they feel comfortably in control , they just want to run things by me , to get some sort of order in their mind and some sort of organization into their new situation . Occasionally one or other of them has asked me to accompany them to doctors ’ appointments , pre-op interviews and even emergency room visits . I am happy to help and mindful of the fact that I must not interfere with a course of treatment .
In my interactions with these friends , I have learned that simple tools can often help clarify what they feel are complex situations . I categorize these as follows :
Review the information shared by the physician , as understood by the patient . Sometimes there is a simple misunderstanding of a medical term which , if explained , resolves the issue .
Review all specific instructions whether a change in meds , preop / post-op directions , changes in activity . Lists are helpful as long as they are specific and discarded or filed away when no longer relevant .
Keep names and telephone numbers of key people easily accessible .
Create medication schedules if necessary , including relationship to meals , special timing , water requirements , accidental missed doses . The methods can range from a paper calendar to an iPhone alert . It just needs to be whatever the patient is most comfortable with and will use appropriately .
Make lists of specific questions to ask physicians at each faceto-face encounter . Note down the answers . Optimize the use of the physician ’ s time . An accompanying person can make notes and jog the patient ’ s memory if something discussed in preparation for the visit has not been addressed . Later ask the patient to review the information learned and the next steps to be taken . Be patient when the same questions are asked over and over .
Encourage the use of the patient portal in the electronic chart . This can be tough . Older patients expect to be contacted by phone . If they need to contact the physician they expect to speak to the physician personally not via an agent . Many do not realize that messages can be sent via the patient portal . Most do not want to read lots of reports , they expect the doctor to explain the results of medical tests . I have heard all of these reasons . I have also noted that when I suggested that perhaps a trusted family member could be present with the patient during the chart review or be given remote access this was seldom met with agreement – at least initially .
Patient compliance is a much-used term in health care , often with a negative connotation . Enabling personal agency over an individual ’ s health is , I believe , a worthwhile endeavor , even if it is just one person at a time .
Dr . Amin is a retired diagnostic radiologist .