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Does It Matter How Fit Your Doctor Is?
Does your general practitioner know whether you’re a runner or a Zumba junkie? If your answer is no, your doc’s probably sedentary, according to a new study. Healthcare providers who are physically active are more likely to talk to their patients about exercising, finds recent research presented at a conference hosted by the American Heart Association a couple of weeks ago.
Researchers did a systematic review of 24 observational studies that involved multiple types of healthcare providers, including physicians, nurses, and pharmacists. In 23 out of 24 of the studies, there was a significant association between healthcare providers’ activity level and their counseling. In the six studies that allowed for direct comparison, active doctors were two to five times more likely than non-active ones to have the fitness talk with their patients.
If a healthcare provider values exercise and finds time for it, it’s easier for him or her to discuss all of those details with patients, says Felipe Lobelo, MD, PhD, an epidemiologist with the Centers for Disease Control and Prevention’s National Center for Chronic Disease Prevention and Health Promotion and co-author of the study. “So in this sense, practicing what your preach makes a difference,” he says.
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The Mistake Your Doctor Might Be Making
You probably trust your doctor to diagnose and cure your symptoms. (It’s why you turn to her, not Dr. Google.) But even good doctors sometimes make mistakes—and it often happens right before your eyes: A recent study found that 80 percent of doctors’ diagnostic errors were made during the patient-doctor interaction.
Researchers from Baylor College of Medicine, Texas A&M, and University of Texas at Houston investigated the medical records of 190 patients at the Houston VA Health Services Research and Development Center of Excellence who ended up in the hospital or back at the doctor within two weeks of a primary care visit. Sixty-eight of the patients were diagnosed with previously-undetected health conditions as serious as cancer, heart disease, meningitis, dementia, iron deficiency anemia, asthma, and even HIV.
In 4 out of 5 of these cases, errors in the patient-practitioner encounter played a role in the missed diagnosis. For instance, doctors messed up diagnostic test orders and physical exams, and overlooked important parts of the patients’ medical records. And in 81 percent of cases, doctors skipped differential diagnosis, a routine but crucial part of the diagnostic process in which doctors reflect on their patient’s symptoms and exam, and record their thoughts on what the condition could be.
“It’s not that these doctors were negligible,” says lead study author Hardeep Singh, M.D., a research scientist at Baylor College of Medicine and chief of the Health Policy and Quality Program at the Houston VA Health Services Research and Development Center of Excellence. “It’s that the conditions that they’re treating are complex—even if they’re common.” Just think: Your pesky cough could be accompanied by any number of other symptoms. Plus, your aches and pains evolve over time: symptoms that scream bronchitis today could turn into pneumonia tomorrow.
And it doesn’t help that most doctors face the same work pressures as you. They, too, are pressed for time and pushed to be more productive—even though it’s your health that’s at stake.
While you can’t carve more time in your doctor’s day, you can help your physician help you with the best patient practices:
Bring a list of your symptoms
Doctors rely heavily on patient information, says Singh, so it’s important to present the most thorough picture of your health. If you’re on medication, feverish, or stressed, you might forget to mention the symptom that tips the scale toward the correct diagnosis. So make a list of your complaints before your exam, and whip it out when your doctor asks.
Answer questions thoroughly
During most medical exams, your doc should ask about your medications. The way she asks you is important–like, “Which medications do you take regularly?” or, “What meds have you taken today?”–but so is how you answer, says Singh. This is your time to take the mic and belt out a list of every pill you pop, from supplements to The Pill, and over-the-counter drugs. Even OTC cold medicines can quicken your heartbeat or disguise signs of sickness, says Singh.
Do your research
Spend too much time Googling your symptoms, and you’re bound to uncover a mild case of hypochondria (look it up!). But reliable, up-to-date resources like Medline Plus (not Wikipedia) can inform and empower you to ask smart questions (like, “Could I have strep?”). This creates a dialog that can ultimately help you and your doctor get to the root of your issue, together.
And if you have a preexisting health condition, or know of one that runs in your family? Stay abreast of its symptoms so you know what to look for. For instance, diabetics are prone to eye issues. If you have diabetes and haven’t had an eye exam in years, ask your doctor for an ophthalmologist referral.
Understand the plan
Before you leave the exam room, note your doctor’s answers to the following questions. Bring a pen and paper if it helps you remember.
• What do I have?
• What is the treatment and how long should it last?
• When should the treatment alleviate my symptoms?
• What should I do if I’m not feeling better then?
• What should I do if I feel worse?
• What’s the best way to reach you?
• Do I need any follow up tests, referrals, or visits?
Follow Doctor’s orders
If your doctor says to call or return if you’re not better in two days, do it, says Singh. And even if doctor doesn’t ask you to follow up, always call her if you’re not feeling better or feeling worse.
Be skeptical
“Doctors try their best, but we work in imperfect systems and are imperfect beings,” says Singh. “There’s a lot of uncertainty, and doctors make their best judgments. But mistakes happen.” If your doctor seems unsure about your diagnosis, it’s OK to return for a follow up visit or seek out a second opinion.
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An Avocado a Day Keeps the Doctor Away?
Guacamole lovers, rejoice! People who eat a daily dose of avocado are typically healthier than those who don’t, according to a new survey conducted by the Centers for Disease Control and Prevention.
Researchers asked 17,567 adults to record everything they ate in a 24-hour period, then analyzed their diets and health. The 347 people who ate an average of half a medium-sized avocado reported more balanced diets containing more fiber, good-for-you fats, vitamins, and minerals. What’s more, they also weighed less and had lower BMIs, smaller waists, and healthier cholesterol levels than those who didn’t eat avocados. And the good news just keeps on coming: Avocado-eaters were also 50 less likely to suffer from metabolic syndrome, a collection of health measures that predict your risk of heart disease, stroke, and type-2 diabetes.
It makes sense that avocado eaters would get more of the good stuff found in the fruit, like monounsaturated fat, vitamin K, folate, potassium, vitamin E, lutein, magnesium, vitamin C, and vitamin B6—but that doesn’t tell the whole story.
“Avocado-consumers appear to be more health conscious than non-consumers,” says study author Victor Fulgoni, III, PhD, senior vice president of the food company consultancy Nutrition Impact. They tend to eat more fruits, veggies, and healthier fats—in addition to avocados—which leads to better health overall, Fulgoni says.
While loading up on avocados won’t work wonders on its own, a daily serving can give your diet a nutrition (and flavor) boost—all for just 25 calories per tablespoon. Amp up your intake at any meal with these eight recipes:
Photo: Travis Rathbone Egg, Avocado, and Spicy Mayo Sandwich
Photo: Adam Voorhes
Grilled Cheese With Chicken and Avocado
Photo: Melissa Addison
Photo: Con Poulos
Photo: Con Poulos
Photo: Con Poulos
Photo: Mitch Mandel
Chocolate-Avocado Vegan Cupcakes
Photo: Joy Wilson
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What Your Doctor Isn’t Telling You
Everyone is human—including your doctor. Unfortunately, that means that even the men and women in white coats make mistakes sometimes. But here’s the scary thing: A new study from Johns Hopkins University shows patients are rarely informed about medication errors. In addition, while men and women in Intensive Care Units (ICU) are most likely to experience harmful mistakes, they’re the least likely to be told about them.
Researchers looked at a database of more than a million medication errors from 1999 to 2005, voluntarily disclosed from 537 hospitals. Prevalent mistakes mostly involved omissions, like failing to administer medication to a patient. The most costly errors had to do with incorrectly dosing a patient and problems with IV lines. About 6.6 percent of the errors occurred in ICU, while the rest happened in non-ICU areas of hospitals. While blunders didn’t hurt the patient 98 percent of the time, the rate of harmful errors doubled in the fragile Intensive Care Unit.
Worst still, hospitals only took action half the time just after a mistake, and only let families in on the error in 2 percent of cases. “What surprised us most was what we do about [errors] regardless of where they happen, at least in the immediate time around when they occur,” says lead researcher Asad Latif, M.D., assistant professor of Anesthesiology and Critical Care Medicine at Johns Hopkins. “We need to really look into what the consequences of medication errors is in our hospitals.”
While Latif acknowledges that hospitals may have taken corrective action after the error was reported to the database studied, the resolutions need to happen faster. “Many of the actions we looked at, such as informing the involved staff and the patients and their caregivers, would best be taken in the immediate aftermath of any mistake, when it is still fresh,” he says.
You can play a role in making sure you get the necessary updates regarding mistakes, and also prevent them before they happen. Latif suggests the following:
Do a Double-Check
Before you take new meds in a hospital setting, ask your doc the specifics of what you’re getting. The study revealed most mistakes happen during the administration phase, so asking will both inform you and remind your doctor to look twice at what he’s doling out. “This can act as a final double-check,” Latif says.
Ask After a Change
Any environmental changes — you move floors, find yourself dealing with a new doctor or start a new medication — should prompt you to ask medication questions again. For instance, ask the doc what dose you should be getting, and for how long, Latif advises.
Write Down Home Meds
Even if you’re not hospitalized and don’t plan to be, continuously keep track of all pills you’re taking to keep physicians accurately updated in an emergency. “Keep home medications written down, along with their dose and timings, to guarantee that hospitals get them right if they are admitted,” Latif says.
Don’t Become Paranoid
While fear of being kept in the dark is scary, do realize that medication errors are few and far between, and even fewer result in harm to the patient. Latif says not to become alarmed if your doc informs you of a mistake, but you should “inquire about the nature of the error, and what was done as a result of it.” Keep notes to help you to remember exactly what happened, in case you need to ask further questions about it later.
More from WH:
3 Tricks to Alleviate Pain
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3 Ways to Have a Better Doctor’s Office Visit
Discover surprising walking tips, tricks, and techniques to melt fat fast and get a tighter, firmer butt with Walk Your Butt Off! Buy it now!
What Your Doctor Isn’t Telling You
Everyone is human—including your doctor. Unfortunately, that means that even the men and women in white coats make mistakes sometimes. But here’s the scary thing: A new study from Johns Hopkins University shows patients are rarely informed about medication errors. In addition, while men and women in Intensive Care Units (ICU) are most likely to experience harmful mistakes, they’re the least likely to be told about them.
Researchers looked at a database of more than a million medication errors from 1999 to 2005, voluntarily disclosed from 537 hospitals. Prevalent mistakes mostly involved omissions, like failing to administer medication to a patient. The most costly errors had to do with incorrectly dosing a patient and problems with IV lines. About 6.6 percent of the errors occurred in ICU, while the rest happened in non-ICU areas of hospitals. While blunders didn’t hurt the patient 98 percent of the time, the rate of harmful errors doubled in the fragile Intensive Care Unit.
Worst still, hospitals only took action half the time just after a mistake, and only let families in on the error in 2 percent of cases. “What surprised us most was what we do about [errors] regardless of where they happen, at least in the immediate time around when they occur,” says lead researcher Asad Latif, M.D., assistant professor of Anesthesiology and Critical Care Medicine at Johns Hopkins. “We need to really look into what the consequences of medication errors is in our hospitals.”
While Latif acknowledges that hospitals may have taken corrective action after the error was reported to the database studied, the resolutions need to happen faster. “Many of the actions we looked at, such as informing the involved staff and the patients and their caregivers, would best be taken in the immediate aftermath of any mistake, when it is still fresh,” he says.
You can play a role in making sure you get the necessary updates regarding mistakes, and also prevent them before they happen. Latif suggests the following:
Do a Double-Check
Before you take new meds in a hospital setting, ask your doc the specifics of what you’re getting. The study revealed most mistakes happen during the administration phase, so asking will both inform you and remind your doctor to look twice at what he’s doling out. “This can act as a final double-check,” Latif says.
Ask After a Change
Any environmental changes — you move floors, find yourself dealing with a new doctor or start a new medication — should prompt you to ask medication questions again. For instance, ask the doc what dose you should be getting, and for how long, Latif advises.
Write Down Home Meds
Even if you’re not hospitalized and don’t plan to be, continuously keep track of all pills you’re taking to keep physicians accurately updated in an emergency. “Keep home medications written down, along with their dose and timings, to guarantee that hospitals get them right if they are admitted,” Latif says.
Don’t Become Paranoid
While fear of being kept in the dark is scary, do realize that medication errors are few and far between, and even fewer result in harm to the patient. Latif says not to become alarmed if your doc informs you of a mistake, but you should “inquire about the nature of the error, and what was done as a result of it.” Keep notes to help you to remember exactly what happened, in case you need to ask further questions about it later.
More from WH:
3 Tricks to Alleviate Pain
6 Traits of a Good Doctor
3 Ways to Have a Better Doctor’s Office Visit
Discover surprising walking tips, tricks, and techniques to melt fat fast and get a tighter, firmer butt with Walk Your Butt Off! Buy it now!
The Worst Way to Find a Doctor
When searching for a new doctor, you’re probably hoping for a bedside manner that’s more McDreamy than Dr. House. And while it’s tempting to scour online reviews, they may not lead you to the best choice. It turns out that physician review websites aren’t always reliable, according to a new study from Loyola University Medical Center.
Researchers randomly selected 500 urologists in the United States and examined 10 free physician review websites (like Healthgrades.com or Vitals.com). They found that 79.6% of the doctors were rated on at least one of the sites, with 86% receiving positive ratings and 36% boasting highly positive ratings. Unfortunately, those composite scores were based on an average of just 2.4 ratings! That glowing recommendation doesn’t seem so legitimate coming from less than three people, does it?
“Patients should absolutely be cautious if they’re using this to assess their physicians,” says lead study author Chandy Ellimoottil, M.D., urology resident at Loyola University Medical Center. “They’re based on very few ratings, and you have no idea who put those ratings in.” For instance, you’ll never know if a negative score was from an angry patient or just a competing physician. And even more concerning for patients, those stellar reviews may have been written by the doctor himself. “Until you have hundreds of patients writing reviews, you can’t be sure of the accuracy,” says Ellimoottil.
So leave online review sites for a less serious search—like the best Thai takeout—and stick to traditional methods for finding a great doctor.
Start the search before you’re sick
It may seem like a hassle, but the best time to search for a new doctor is actually when you’re healthy. That way, you can explore your options without settling for the nearest nurse with a prescription pad. “At least for primary care doctors, it’s always a good idea to try a couple and find someone you’re really comfortable with,” says Ellimoottil. “That needs to be worked out before you get sick.”
Hit up friends and family
Word of mouth is always an option, says Ellimoottil. But, as with blind dates, this introduction needs to come from someone you trust. Ask your girlfriends or family members if they know any great physicians in the area. They’re more likely to tell you the truth when it comes to long wait times or a not-so-gentle dentist.
Get a referral for specialists
If you already have a primary care doctor you love, it’s wise to get his recommendation for a specialist, says Ellimoottil. Since they’re likely familiar with your insurance and medical history, they have all the information they need to make an informed suggestion.
Use online tools sparingly
If you absolutely must go online to find a doctor, be smart about it. Pay special attention to the number of ratings that contribute to a doctor’s score. “Somewhere between 50-70 reviews would be a safe point,” says Ellimoottil. And feel free to look there for objective information, like a doctor’s education and board certification. But when it comes to the written reviews, take them with a grain of salt.
Don’t hesitate to get a second opinion
Even though it may feel like you’re cheating on your doctor, you shouldn’t feel bad about scheduling consultations elsewhere if you’re unsure about something. “If you have a diagnosis that requires surgery, I always recommend getting a second opinion,” says Ellimoottil.
Trust your gut
Regardless of the reviews, your physician needs to be someone you can trust. “You have to feel good about your doctor, and you have to know they care about you,” says Ellimoottil. Plus, a positive doctor-patient relationship will ensure that you actually go to your annual check-ups. If the chemistry isn’t right, it may be time to dump your Dr. and find a better fit.
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6 Traits to Look for in a Doctor
Is your doctor less than friendly? It might be time to find a new one. Having an empathetic doctor can actually decrease your pain awareness, according to a new study published in Patient Education and Counseling.
Michigan State University researchers assigned nine women to one of two types of interviews with a doctor prior to an MRI brain scan. Some of the participants talked to doctors who asked only very clinical information (such as their medical history and what medications they took), while the rest talked to doctors who also asked open-ended questions about their home life and work as well as addressed any concerns they had about the upcoming procedure.
Then, the participants received mild electric shocks while looking at a photo of a doctor—either the doctor with whom they had just interviewed or one they didn’t know—whom they were told was supervising the procedure. Throughout the process, MRI scans measured activity in the participants’ anterior insula, the region of the brain that makes people aware of pain.
The participants whose doctors had asked them about their lives and answered their questions before the procedure experienced less anterior insula activity when they looked at a photo of their interviewing doctor than when they looked at one of an unknown doctor. They also reported feeling less pain from the shocks and being more satisfied with their doctors than the participants who had interviewed with strictly clinical doctors.
Previous research has shown that patients who have empathetic doctors have better health outcomes, but this is the first study to explain why, says lead researcher Issidoros Sarinopoulos, Ph.D., a professor of radiology at Michigan State University.
“The degree to which patients develop a positive relationship with their doctors determines how their brains react to stress and experience pain,” Sarinopoulos says. That relationship influences how the body recovers, and can affect your health. “Patients should pay attention to how their doctor makes them feel and recognize empathy as a desirable characteristic in a physician,” Sarionopoulos adds.
Still, empathy’s not the only quality to look for in a doc. Here, 5 additional traits all good doctors should have:
1. He takes his time
Faster isn’t always better. It takes time to listen to, diagnose, and prescribe the best treatment—and sometimes the 17 minutes the average doctor spends doing the job just doesn’t cut it. You should leave your appointment with answers to all of your questions, says Richard Klein, M.D., author of Surviving Your Doctors: Why the Medical System Is Dangerous to Your Health and How to Get Through It Alive. If you feel your physician is trying to push you through your visits in warp-speed time, consider looking for one who has fewer patients, he says.
2. She’s well-rested
It’s no secret: A sleepless night clouds next-day judgment. You want your doc to always be alert and well rested. If she’s constantly yawning or has horrendous circles under her eyes, you might want look elsewhere, says Charles Christopher Landrigan, M.D., director of the Sleep and Patient Safety Program at Brigham and Women’s Hospital in Boston. Remember: It’s within your rights as a patient to ask if your doctor is rested.
3. He’s up-to-date on the latest research
Doogie might be the best doc, after all. “If you’re getting a procedure involving a laproscope, robot, or other new technique, the doctor who just finished his or her training could be your best bet,” says Janet Pregler, M.D., director of the Iris Cantor-UCLA Women’s Health Center. When it comes to your general practitioner, who won’t be performing newfangled tests or procedures, mid-career doctors have a good balance of current knowledge and work experience. Check out your local teaching hospital: Physicians who work there are regularly vetted by their peers and have to stay up-to-date to continually teach interns.
4. She doesn’t judge you or dismiss your concerns
You should be able to talk to your doctor about your sex life, drinking habits, and anything else that can affect your health without feeling judged. If you feel she criticizes your lifestyle choices or dismisses your concerns, look for someone else, Klein says. It could affect your treatment: A study in The Journal of Law, Medicine & Ethics found that women who have the same pain symptoms as men are less likely to receive appropriate treatment because their physicians assume they are exaggerating.
5. He keeps it professional
While a friendly doc is great, a flirtatious one can hurt your health. If Dr. McDreamy starts making eyes at you, you’ll be less likely to bring up the vicious gas you’ve been battling, says Pamela F. Gallin, M.D., author of How to Survive Your Doctor’s Care. Also, keep in mind that more doctors than ever are now Googling their patients, according to the Harvard Review of Psychiatry. If you hear your doctor discussing personal details you didn’t divulge, ask how he got the info.
– Additional reporting from Kristen Dold
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The Doctor Tried To Make Me Fat With Processed Food
I honestly don’t know why I was surprised, but I was. Here I am, sitting in an emergency care center waiting for the doctor to come examine my knee when there was a knock at the door. I assumed it would be the doctor or a nurse, so imagine my surprise when…
The assistant walked in pushing a snack cart asking if I wanted anything. That sounds all grand, right? Except that on the cart were chocolate chip cookies, buttered popcorn, and bags of chips… oh yea along with sodas and fruit juices (and not the good kind).
“No thanks” was probably out of my mouth too fast to be polite.
I looked over at Dan (such a good husband for taking me and keeping my company) when the room was empty again and announced, no wonder people are fat… their own doctors give them crap food.
Doctors Don’t Know Health
With all the education that doctors have to go through you would think that they would be educated on preventing illness all together. But to be honest, they are only educated in helping illness once it strikes.
What’s more is that most diseases and conditioned are derived from unhealthy lifestyles and obesity. So then why can’t doctors just educate patients on the importance of healthy living through exercise and nutrition?
Because they don’t know.
In fact, it’s hard to believe but med school doesn’t cover diet or exercise. And what’s more is that 53% of doctors are oveweight. With more than half carrying extra pounds, would patients even follow their advice when or if given? Probably not.
If doctors would simply learn and follow healthy habits themselves then the obesity epidemic just might start moving back in the right direction instead of continuing to climb.
I mean let’s face it, I said no to the cart but most people would see it and rationalize that if the doctor is offering it then it must be good for you! Right?
It’s a shame!
So what can be done?
f you know you’re carrying extra pounds or feel you are moving in that direction check with your doctor to make sure you can handle an exercise program.
From there talk with the people that know how to help you transform not just your body but your overall lifestyle as well like personal trainers (that’s me!) or a certified nutritionist.
We all want to believe that doctors hold the answers to everything, but clearly the don’t.
What’s To Eat?
For breakfast I had the same ole oatmeal but with only a teaspoon of sunflower butter on top! I am working on controlling the urge to scoop the biggest amount possible.
Lunch
Dinner
Questions of the Day:
- Has your doctor ever done or said anything that made you raise an eyebrow?
- What’s your favorite condiment? (Mine being sunflower butter, of course!)