Archive for the ‘Doctor-patient relationship’ Category

Choosing a Family Physician-One of the Most Important Decisions You Will Ever Make

May 11, 2010

People are not just an amalgam of their body parts.  Men are not composed of large prostate glands, sclerosed coronary arteries, and rusty libidos, although sometimes it feels that way. We come in complex packets of various sizes, shapes and colors, and attached to families, jobs, communities and cultures. Just like everyone else, we need primary care physicians as our allies and advocates in staying healthy, and getting the best possible health care.

Your primary care doctor — either a family physician or a general internist — should be the captain of your healthcare ship. Primary care physicians not only can handle the majority of illnesses that you may experience, but they can work with you to keep you healthy. They can help you decide what makes sense in a world where numerous entities are hawking remedies for life’s ills, from pills to diets to operations. The primary care doctor can help you select from this bewildering array of options, and then be your advocate when you do need specialized care beyond his or her repertoire.

So what should the average man do to get the most out of the health care system? The following are my suggestions distilled from over 30 years of being a doctor:

1) Select a primary care doctor.

The time to choose a primary care doctor is before you need one. Ask your friends whom they go to. Check with local clinics and hospitals and see which primary care doctors work near your home or your job. Check and see if your wife or significant other or child has a family doctor who would take you into his or her practice.

Then go and interview the doctor, find out whether their philosophy of medical care jibes with yours. Discuss your approach to health and illness, and see whether they will support you in your quest. Check their training and references to make sure that they have the training and skill that you need. Make sure that they are board certified in their respective specialty. There are advantages to seeing the same doctor as other members of your family. But probably the personal chemistry between you and your doctor is the most important factor in this choice.

2) Visit your primary care physician before you’re sick.

Almost all doctors have health maintenance protocols that are aimed at men your age, and consist of a schedule of regular visits and diagnostic tests designed to catch important problems as early as possible. Make sure your health maintenance protocol is up to date. For most patients, this will involve a visit every year or two, depending on your age, back­ground, and the medical problems you may have accumulated along the way.

3) Negotiate a plan with your doctor.

Medicine is a team sport, you and your doctor share the quarterback duties. Your doctor has a set of guidelines that are based on medical science and the evidence it produces. You have a set of values and preferences that will determine which of those guidelines make sense for you. Work with your doctor to come up with an approach that makes sense for you.

4) When you do need specialty care, work through your primary care physician.

Specialists will give you their honest opinion about the best therapy for your problem, but your primary care physician will help you put it into context. Primary care doctors can also help to coordinate care among multiple providers, watch out for interactions among drugs or therapies, and will still be available to care for you after a more specific problem is resolved.

Bottom Line: It is almost impossible these days to sort out the best approach to health care. Your primary care physician is the strong­est ally in choosing a path that makes sense for you.  The few minutes you take to make this very important selection may just be the most important decision of your life.

How to Become a Better Patient

February 22, 2010

Communication between the patient and the doctor is crucial to your health and well-being.  The more information you can provide your doctor, the better he\she can help you lead a healthy lifestyle.

Write down what you want to discuss at the time of your office visit.  This may seem simplistic but so many times patients are unable to express themselves and not able to tell the doctor what are their problems. Start writing down the issues that you would like to discuss a few days before your appointment.  When the doctor enters the exam room, after the few seconds of perfunctory remarks, give the list of questions to your doctor or read it to the doctor.

Another suggestion for becoming a good patient is to always obtain copies of your medical records.  Keep a file of your test results, your current medications, your immunizations, your allergies, and a list of your medical conditions.  Every time you visit the doctor and have blood work or x-rays, you should request copies for your own records.

Arrange to have your tests performed several weeks prior to your scheduled office visit. Now when you meet with the doctor, he\she can analyze the data at the time of your visit and make the appropriate recommendations.  Failure to do so means you will meet with the doctor, then obtain your tests, and wait for weeks to hear from the doctor to review the results on the phone or using E-mail.

It is also helpful for older patients to bring a family member with them at the time of their office visit to help communicate various health issues with the doctor.   The family member can also write down the doctor’s recommendations.

If you really want to be a good patient, arrive 15 minutes before your appointment, complete your forms and questionnaires, and relax and enjoy the experience.

Finally, learn as much as you can about your illness or medical condition.  There are hundreds of websites that you can visit to find out about your medical problems.  Your physician can be a good resource for credible websites and educational material.

Bottom line:  It is not easy to be a good patient.  No one likes to go to the doctor but following a few of these suggestions will make you a better patient, will enhance your communication with your doctor, and will improve your health and well-being.

Dr. Neil Baum is a urologist at Touro Infirmary and can be reached at his website,, or at his office, (504) 891-8454.