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Seven tips to have a successful doctor’s apointment January 19, 2006

Posted by medicalanswers in patient-doctor relationship.
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I had clinic today, and one of my patients, a very active elderly woman, brought a printed list of medications and had written the questions she had for me. We went over most of them in the visit and she seemed happy when she left.

This got me thinking, if you go see your accountant, it is likely you will bring all important documents for him to give you the best assessment of your situation. If you think of your doctor as something as an “expert advisor”, then the more information you give him, the more likely he will be able to assess correctly your needs and provide an appropriate plan of action.This is an incomplete list of the things you can do to get more out of your doctor’s visit:

  1. The night before your appointment, make a list of the questions you want to ask.
  2. If you think it will not interfere with your privacy, bring along somebody who is close to you. Studies have shown that we do not retain all the information our doctor gives us. A “chaperone” will not be as nervous, and will probable retain more information.
  3. Have with you a current list of your medications. If you haven’t had time to do this, bring the bottles!
  4. If you have copies of any tests, take them with you to the doctor. There is a chance she/he has not gotten the results.
  5. Remember to ask questions. If you do not understand something the doctor said, ask for him to repeat it, or to explain it better. It will help you understand more of what is going on. It is definitely not a waste of his time.
  6. Ask for written recommendations. This will help you remember later when you get home.
  7. Find out what is the best way to contact your doctor. Sometimes just calling their office will be fine. Other possibilities include calling the hospital where the doctor works. One of the physicians I work with gives his e-mail to patients, he checks it regularly (compulsively!) and has yielded very good results for both parts.

I guess the most important thing to do it’s to think in advance, particularly of what you want to get from your visit to the doctor. The more you get out of it, the better for you.


Why I do not post my name in this blog. January 19, 2006

Posted by medicalanswers in Uncategorized.
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My name is not available to the public. You could argue that I am making one of the Ten Blog Design Mistakes, as noted by Problogger. The answer to this is simple: privacy.

Of course my privacy is a component of this, but most important is the privacy  of my patients.

By not making my name available, I decrease, maybe not to zero but considerably, the chances of you deducting any information about my patients. My first responsibility is to them.

And that way I can be truthful about what I see on a daily basis, otherwise, I would either have to be too vague or change too many details.

The only objection I have with remaining anonymous is that you could thing I am trying to avoid responsibility of my opinions. I guess the only way to deal with that is just asserting the honesty of my intentions, and that if is needed, I will present myself as the author of this blog.

Since this blog will be mostly information, I expect it not to be too controversial in content.

I will have to put a disclaimer, remember, our society is pretty litigious!

So here it goes: Disclaimer: The information contained in this blog is for educational and informational purposes only. It does not constitute medical advice for a specific patient. If you need specific medical advice, you shoud contact your physician. (you will be able to see this disclaimer on a separate page later).

Is it good enough? If you think otherwise, please let me know.

These Ugly Statistics are killing us January 7, 2006

Posted by medicalanswers in Statistics.
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godzillaWe can’t start discussing health without finiding which are the diseases that are affecting us the most.

The CDC’s National Center for Health Statistics has detailed statistics of mortality in the United States. The top 5 ranking causes of death for 2003 were:

  1. Diseases of the heart.
  2. Malignant neoplasms (a.k.a. Cancer).
  3. Cerebrovascular diseases (a.k.a. strokes plus bleeding in the brain).
  4. Chronic lower respiratory diseases (including COPD – a component of which is emphysema).
  5. Accidents (unintentional injuries). Approximately 40% of these are from motor vehicle accidents.car accident

“Honorable” mentions include Diabetes Mellitus (Number 6) and Suicide (Number 11).

Note that these are the causes of death of the whole population. Since older people die in much larger numbers, their diseases are ranked higher.

The results therefore change according to the population you observe. If you look at Children ages 1 to 4 years, the causes are different:

  1. Accidents.toddler
  2. Congenital Malformations, deformations, chromosomal abnormalities (a.k.a. birth defects, some of which are genetic).
  3. Malignant neoplasms (Cancer).
  4. Assault (homicide). Unbelievable!
  5. Diseases of the heart. It is important to note that the diseases of the heart that children get are different than the ones adults get.


Violence, either unintentional -accidents- , and intentional -both homicide and suicide-has a very intense presence in the following three age groups. Only when we reach the age group of 44 to 64 is that accidents leave the #1 spot.

These statistic tell us not only about what we are doing but also what we should be doing. 

Sometimes simple interventions result in impressive changes in the patterns of disease of the population (think clean water = decreased diarrhea = decreased infant and child mortality).

In the following posts will attempt to discuss those categories of disease that are most frequent.

Welcome! January 7, 2006

Posted by medicalanswers in Uncategorized.
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So another blog on the internet. What is new about that?
I guess not much.
Let me justify its creation.
I am a physician in training, working as a resident in internal medicine. I love my job, and I love the human side and the science behind it. And this last years of training have been very intense. Not only because I have had to work a lot of hours, and study on my free time, but also because I have met many, many patients. I agree with a fairly commonplace opinion that our best teachers are our patients (it is probably an expression from a very famous doctor, William Osler -here is a link to the wikipedia entry for him-)
Over the last year, I have been noting how important education is in the work of a doctor.
I hope this does not sound condescending and believe me that is not my intention (although I agree that because of my profession I should be presumed guilty of this charge).
Not only we need to educate ourselves and newer generations of doctors about medicine, but also, and perhaps much more importantly, we have to educate our patients about their health. It is a fundamental part of medicine, and I think we have done a poor job over the history of our profession (or “piss poor” as one of my attendings would say).
Over the last couple of years, I have heard of blogs, maybe read a couple or two, but very sporadically. It was only two weeks ago, when my (very smart) girlfriend decided to create a blog of her own, that I started taking a closer look at them. And the natural result was the desire of creating a blog of my own.
So the idea is to create a place where you can find answers to your questions about health, disease, healthcare, doctors (and their sometimes unhealthy lifestyles!).
I am not an expert. Remember, I am still training.  But this may be an opportunity to learn together.