Originally Posted by
GeorgeBMac
As a travelling nurse I saw that all too frequently and it is often a manifestation of our fragmented health care system: a person with diabetes often has multiple issues (heart, BP, cholesterol, kidney, etc...) and sees multiple physicians and/or is in and out of the hospital. And, every time she sees a physician she complains of something else and so he prescribes yet another pill...
Actually, the worst culprit were the hospitals: the patient would come out of there with new or changed meds that their family physician knew nothing about and would not have prescribed.
A big part of my job was coordinating all those different physicians and their treatments; The conversation went something like:
"Hey, Dr. X, I'm a nurse working with this patient: Dr Y (or hospital Y) prescribed this and this and this. Do want her taking this stuff?" The answer was almost always: "Hell No!".
My patients were fortunate to have a nurse who knew the conditions and the treatments.
Otherwise they would have to do that by themselves and most people either don't have the inclination or assume: "the doctor always knows what's right"...
Healthcare needs to be a partnership. People need to watch out for their own medical care just as they would their house when they have multiple contractors coming in and out of it... But, the typical patient just doesn't have the knowledge to challenge the physician. So that is why the best physicians welcome a knowledgeable patient who participates in his own health care and asks questions. It makes his job a lot easier and it makes your life a lot better and longer...
Most physicians WANT you to be healthy. But they know they can't do it alone. They do their best work when they have an interested, involved partner in your health -- not just a passive pill-taker... (And, if your physician wants you to be just a passive pill-taker, I would recommend finding another physician).
My wife is (was) an excellent certified RN Case Manager, and a legal review nurse. She still, at 75, maintains her RN license. My son is an attorney, very bright and very successful.
We have been working 7 years now to try and get assistance with her extreme PHN (post-herpetic-neuralgia, from Shingles) pain - so painful that she cries at night.
We have a University Hospital here. We see a neurologist there, and there is a so-called "pain clinic" - which is actually an "injection clinic." There is also a NP who works in pain. Do any of them talk to each other? Nope. There is NO team approach, no nutritionist, no pain psychologist. Our son goes with us to all appts. We get conflicting info. The Neuro does not read the notes of the other docs and nurses, and vice versa. No one with comprehensive knowledge of all modalities. No "team" meetings regarding difficult cases. The NP has never met the neuro.
We are currently on a nationwide search for the very best, coordinated approach. We have located a company, that, for a fee, arranges for conversations with the top docs in the US of A. The docs also charge for their time in these conversations. Yesterday, my son spoke with the top Doc at Johns Hopkins for about an hour, in an attempt to figure out where we should go for a truly comprehensive and knowledgeable approch to pain control and management, and to review current treatment modalities, and, most importantly, how they have been applied. What he learned is that, according to the JH doc (rated as the best in the US of A), much (almost all) of what has been done so far has been done incorrectly.
Yes, she takes pills. Not a lot. But if you were to sit with her, as I did 3 nights ago, and she is literally crying (and sometimes screaming) from the pain, you would understand why. And, in the final analysis, it is up to the PATIENT to find the medical care really needed. We are now making decisions as to where to go as there is nothing in this state that is top notch.
In a recent review by a national magazine on the top 200 pain "clinics" in the US of A, our state was not mentioned.
By the way, get your Shingles vaccination - please. They were not available 7 years ago.