Blood Pressure

In many ways I yearn for the old days when my doctor checked my pulse and blood pressure himself. The smell of Old Spice and cigarettes combined with the comfort of his huge furry hands holding my wrist and looking at his watch gave an immediate sense of comfort.

In many cases automated equipment does as well or better than the old fashions manual methods. A Canadian group has recently validated another automated blood pressure monitor. Physicians must use caution when interpreting these results. All of these patients were ambulatory. The monitor has no track record for surgical or very ill patients.

It’s OK for patients to ask about the use of technology in thier health care. It’s your health take part and take charge.

Medical Education

What traits would you like to see in your doctor? This deceptively easy question haunts medical educators every day. Medical school admissions ideally must screen for but academic ability and ethical behavior. A recent editorial from England suggests that cognitive ability is a better predictor.

As we have noted previously, medical schools in the United States have very small attrition rates, particularly compared to law schools. Having done both I am hard pressed to see any reason to account for this discrepancy except the obvious conclusion- medical schools do not effectively “eliminate” inappropriately chosen students. Instead they are promoted and graduated.

I applaud the English proposal. Anything to improve the quality of medical school entrants should improve the quality of the product.

Ask your doctor where he/she went to school. Ask how long it took him/her to graduate. It’s your health- take care of it.

Questioning

It is hard to question your doctor or other health care provider. This becomes harder if your physician is sufficiently impatient, arrogant, and narrow-minded to believe that he or she should be making your decisions for you in some archaic paternalistic fashion. Despite Dr. Haig’s rant patients generally have a small number of diseases. Physicians, in contrast, must care for a much larger number of diseases in more patients. Therefore many patients will, in fact, know much more that the physician about their own disease.

Yet you must ask questions. If your questions are not answered in a timely, accurate, and satisfactory manner then you need a new doctor. A recent survery indicates that some of the most important questions are also the hardest to ask. If these questions make your doctor uncomfortable then it’s his/her problem. It really is OK to “bother” the doctor- after all that’s what he/she gets paid for.

It’s your health. Take charge.

More Error Protection

Here at Safer Health Care we link to a large number of articles. The only rules are that the material must be accurate and useful to patients and potential patients in makiung health care decisions. The writers over at RNCentral have recently posted very usable information. Thier tips for protecting your self are HERE.

As we’ve noted before modern medicine is a very dangerous place. Modern physicians are frequently more concerned about bank statements and boat payments than patient care. You and your family may be the only things preventing your physician from becoming you executioner.

It’s your health- Take it seriously and take charge.

Simply Wrong

Peeking into someone’s medical records just out of curiosity is wrong. It’s actually against the law. Unfortunately the federal law does not provide a private cause of action under such circumstances. You’d have to find another reason to sue. Fortunately most states recognize privacy torts for just these kinds of circumstances.

But it’s still wrong. It does not matter if you’re a physician or lay person. IT’S WRONG. It doesn’t matter that UCLA medical centers choose not to protect the rights of patients and conform to federal law by only slapping the wrists of snooping physicians.

Even Governor Schwarzenegger believes that his medical records have been violated. Physicians could be disciplined by the California Medical Board even if the physician or hospital is not sanctioned by the federal government. The irony in this situation is that the medical board is an executive agency that answers to the governor.

Californians, indeed all citizens, deserve better. They have the right to expect that state medical boards and federal agencies will protect their rights when physicians fail to properly discipline themselves.

I urge Governor Schwarzenegger to press the state medical board for swift and aggressive penalties for the scofflaw physicians involved. I urge the federal government to impose similarly harsh penalties on UCLA hospitals. You should take an active role and join me in this call to action.

It’s your health. Take it seriously.

Awareness Redux

Our previous post regarding awareness under anesthesia received enormous numbers of comments. Some were vacuous and vitriolic and so lacking in educational value that they were simply deleted.

We also heard simple heartfelt stories from those who had suffered. To each of you we offer our sincerest apology. As you will see from my final comment to the previous post no one should be awake unnecessarily. I say “unnecessarily” since there are time when the patient’s survival requires that low doses of anesthesia be used to avoid death or severe physical injury.

As a follow-up we sincerely hope that there may be a way to eliminate the possibility of awareness associated with accidental unesthetic underdoses. Currently however there continues to be growing evidence that the consciousness monitors are ineffective- in fact they may increase the risk of awareness under anesthesia. An abstract of the most recent study can be found HERE. As I have asserted previously the current monitors fail the first criterion for cost-effectiveness- they are not effective. (See comments associated with THIS post.)

We appreciate the willingness of individuals to bear the cost of monitoring but who would pay extra for additional risk? Would everyone like value for the cost? Doesn’t each patient deserve better care for more cost? As I have noted previously I would not let someone use the current monitors on me.

Until there is reliable monitoring you must rely on your anesthesiologist. Check him out- thoroughly. Don’t hesitate to fire him/her. He/she has your life and future in his/her hands.

It’s your health, take charge and take it seriously.