Doctor and Patient, Now at Odds

Alternative healthcare practitioners such as chiropractors, classical osteopaths, acupuncturists, naturopaths and others usually spend time with patients and develop relationships.

This is a golden opportunity for physicians to take back what they have lost. Exactly how is not easy and debateable. What is not debateable is that public opinion about them is not very good. That's a shame because the vast majority of MDs truly care about their patients and are very well trained. The key problems are the influence of insurance and pharmaceutical companies.

Perhaps doctors need to start charging affordable cash fees and have the patients submit their claims to the insurance companies.

Doctor and Patient, Now at Odds

By TARA PARKER-POPE, NYT July 29, 2008

http://www.nytimes.com/2008/07/29/health/29well.html?_r=1&partner=rssyahoo&emc=rss&oref=slogin

A growing chorus of discontent suggests that the once-revered doctor-patient relationship is on the rocks.

The relationship is the cornerstone of the medical system — nobody can be helped if doctors and patients aren’t getting along. But increasingly, research and anecdotal reports suggest that many patients don’t trust doctors.

About one in four patients feel that their physicians sometimes expose them to unnecessary risk, according to data from a Johns Hopkins study published this year in the journal Medicine. And two recent studies show that whether patients trust a doctor strongly influences whether they take their medication.

The distrust and animosity between doctors and patients has shown up in a variety of places. In bookstores, there is now a genre of “what your doctor won’t tell you” books promising previously withheld information on everything from weight loss to heart disease.

The Internet is bristling with frustrated comments from patients. On The New York Times’s Well blog recently, a reader named Tom echoed the concerns of many about doctors. “I, as patient, say stop acting like you know everything,” he wrote. “Admit it, and we patients may stop distrusting your quick off-the-line, glib diagnosis.”

Doctors say they are not surprised. “It’s been striking to me since I went into practice how unhappy patients are and, frankly, how mistreated patients are,” said Dr. Sandeep Jauhar, director of the heart failure program at Long Island Jewish Medical Center and an occasional contributor to Science Times.

He recounted a conversation he had last week with a patient who had been transferred to his hospital. “I said, ‘So why are you here?’ He said: ‘I have no idea. They just transferred me.’
“Nobody is talking to the patients,” Dr. Jauhar went on. “Everyone is so rushed. I don’t think the doctors are bad people — they are just working in a broken system.”

The reasons for all this frustration are complex. Doctors, facing declining reimbursements and higher costs, have only minutes to spend with each patient. News reports about medical errors and drug industry influence have increased patients’ distrust. And the rise of direct-to-consumer drug advertising and medical Web sites have taught patients to research their own medical issues and made them more skeptical and inquisitive.

“Doctors used to be the only source for information on medical problems and what to do, but now our knowledge is demystified,” said Dr. Robert Lamberts, an internal medicine physician and medical blogger in Augusta, Ga. “When patients come in with preconceived ideas about what we should do, they do get perturbed at us for not listening. I do my best to explain why I do what I do, but some people are not satisfied until we do what they want.”

Others say the problem also stems from a grueling training system that removes doctors from the world patients live in.

“By the time you’re done with your training, you feel, in many ways, that you are as far as you could possibly be from the very people you’ve set out to help,” said Dr. Pauline Chen, most recently a liver transplant surgeon at the University of California, Los Angeles, and the author of “Final Exam: A Surgeon’s Reflections on Mortality” (Knopf, 2007). “We don’t even talk the same language anymore.”

Dr. David H. Newman, an emergency room physician at St. Luke’s-Roosevelt Hospital Center in Manhattan, says there is a disconnect between the way doctors and patients view medicine. Doctors are trained to diagnose disease and treat it, he said, while “patients are interested in being tended to and being listened to and being well.”

Dr. Newman, author of the new book “Hippocrates’ Shadow: Secrets from the House of Medicine” (Scribner), says studies of the placebo effect suggest that Hippocrates was right when he claimed that faith in physicians can help healing. “It adds misery and suffering to any condition to not have a source of care that you trust,” Dr. Newman said.

But these doctors say the situation is not hopeless. Patients who don’t trust their doctor should look for a new one, but they may be able to improve existing relationships by being more open and communicative.

Go to a doctor’s visit with written questions so you don’t forget to ask what’s important to you. If a doctor starts to rush out of the room, stop him or her by saying, “Doctor, I still have some questions.” Patients who are open with their doctors about their feelings and fears will often get the same level of openness in return.

“All of us, the patients and the doctors, ultimately want the same thing,” Dr. Chen said. “But we see ourselves on opposite sides of a divide. There is this sense that we’re facing off with each other and we’re not working together. It’s a tragedy.”

well@nytimes.com

A Cancer Cure?

This sounds very simple but very plausible. Wouldn't it be great if it's really true? Current cancer therapies kill all cells. The patient has to survive both the disease and the treatment! This treatment really seems to target only the cancer cells. And this goes for any type of cancer.

A List of Drugs That Increase Falling Risk

From the New York Times, a blog on researcher's reporting on drugs which inrease the risk of falling. NEVER take yourself off a drug without the knowledge of your medical doctor! Use this information to present to your physician and discuss your concerns.

By Tara Parker-Pope

July 11, 2008, 9:26 am

Researchers at the University of North Carolina have published a lengthy list of prescription drugs that increase the risk of falling among older patients.

Falls are the leading cause of both fatal and nonfatal injuries in adults 65 and older. An estimated 300,000 hip fractures occur each year, often as a result of falling. Head injury is also a problem among adults who fall.

Adults who take four or more medications at a time are at highest risk for falling. But certain types of drugs can also make someone more prone to falling, said Susan Blalock, an associate professor at the U.N.C. Eshelman School of Pharmacy.

The medications on the list cover a wide range of common prescription seizure medications and painkillers, among others. Also on the list are popular antidepressants like Celexa, Effexor, Wellbutrin, Prozac and others.

Researchers said the “common denominator” among the drugs on the list is that they all work to depress the central nervous system, which makes patients less alert and slower to react. The list was published in the June issue of The American Journal of Geriatric Pharmacotherapy.

Stefanie Ferreri, the lead author of the paper and a clinical assistant professor in the pharmacy school, said that patients need to be wary of more than just prescription medications, because many over-the-counter medications can also contribute to falls.

“Some allergy medications, sleep aids and some cold and cough remedies can have the same effects as prescription drugs,” Dr. Ferreri said. “Anything that can cause drowsiness can put you at increased risk of falling.”

The researchers warned that if patients see a drug they are taking on the list, they should not stop taking it. Many drugs can trigger serious side effects if stopped abruptly. But patients should talk to their doctors about falling risk and possible alternative medications, the researchers said.

Physicians should look for medications that have been proven safe and effective in older adults and look for medicines that have less of a sedating effect. Physicians should be especially wary of anticholinergics, a class of drugs that affect nerve cells used to treat a wide range of conditions.

To download the complete list of the prescription medications that increase the risk of falls, click here.

Do schools kill creativity?

I’m Nuts for Almonds

Recently published work by the Institute of Food Research has identified potential prebiotic properties of almonds that could help improve our digestive health by increasing levels of beneficial gut bacteria. The study found that finely ground almonds significantly increased the levels of certain beneficial gut bacteria. This effect was not seen when the fat content was removed from the almond preparation, suggesting that the beneficial bacteria use the almond lipid for growth, and this is the basis for the prebiotic effect of almonds.

80% of the immune system is located within the gut. The average healthy person has about 3 pounds of beneficial bacteria in the gut. One type of bacteria most people are familiar with is acidophilus but there are many more. There are more bacteria in the gut than cells in the body. These bacteria are critical for digestion and absorption of nutrients, immune function, and much more.

Unfortunately most people have a deficiency of beneficial bacteria due to poor diets, stress, lack of sleep, chlorinated water, environmental toxins, etc. When the levels of good bacteria decrease "bad" bacteria flourishes and this provides a platform for viral and bacterial infections, parasitic infections, yeast infections, systemic acidity etc.

This imbalance is called dysbiosis. Signs and symptoms of dysbiosis include abdominal bloating and gas, constipation or diarrhea, foul smelling bowel movements, headaches, dizziness, confusion, skin conditions, etc.

If this becomes a chronic lifelong problem then the person can be at risk for all the major diseases; cancer, diabetes, heart disease, neurological problems such as Parkinson's and Alzheimer's, etc.

Probiotic (meaning "promotes life") bacteria need food to live. One food they like is certain types of healthy fats found in nuts. Almonds and other nuts and probably fatty fish, flax, coconut, and avocados provide these healthy fats for the probiotics to munch and thrive on.

Source: Investigation of the potential prebiotic properties of almond (Amygdalus communis L.) seeds.