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Saturday, December 19, 2009

My advice to physicians

Doctors are among the most respected profession on the planet, and rightfully so. Still, to continue to deserve that respect, doctors must earn it. There's nothing I hate more than when a doctor orders something that's not indicated, and yet a patient says something like, "Well, if the doctor ordered it, I must need it."

That's some pretty good respect. Literally, I've seen doctors order invasive procedures, and the patient just lets the doctor do it. I've seen suction ordered for a patient whose awake and alert, and the patient says, "Well, if the doctor ordered it."

I've seen BiPAP ordered on a patient with normal blood gases and no respiratory distress, and the patient said, "Well, if the doctor ordered it." Sure this is also a sign of ignorance among the patient community, but it may also be a sign that doctors, however well respected, must continue to better themselves.

That in mind, I've come up with a list of my humble advice to those among this greatly respected profession:

  1. You ought to take a step beyond just assessing, diagnosing and prescribing.
  2. By that, you ought to educate, educate, educate. Whether this is done by you or your staff, you ought to be sure that every patient understands fully their disease.
  3. You ought to follow up with each patient to make sure they understand their disease and are following the treatment plan you prescribe.
  4. If a patient is not being compliant, you ought to inquire of them as to what you can do as a physician to help them become more compliant. "What advice do you have for me?" Every doctor should ask that question of their patients.
  5. You also must monitor prescription usage. If you see, for example, that an asthmatic is using three Albuterol inhalers a month, then you ought to be aware of this. If your patient has hardluck asthma, you need to know this. If your patient has poorly controlled asthma, you need to know this too.
  6. You need to use common sense in your approach to medicine
  7. You need to be open minded in your approach to medicine
  8. You need to continue the education process yourself (for one thing, you need to read up on the real purpose of bronchodilators. You can learn about this by hanging around this blog, or clicking here).
  9. You need to be proactive. Don't wait until a crisis hits to act.
  10. You need to teach the people you rely on: such as RNs and RTs.
  11. You need to learn to trust and rely on those who are with the patient: such as RNs & RTs
  12. Other than that, continue doing what you're doing.

I understand that most doctors are the best at what they do. I respect most surgeons, because I know I'd never want that job. I respect Internists and family doctors, because I certainly wouldn't want to be bothered at 2 in the morning each night. Plus I wouldn't want the liability.

Still, I think all physicians, no matter how well you are at what you do, should take the next step at improving the patient/physician relationship.

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