Archive for category Inadequate time with provider

Clinic Pharmacist — great idea

Pharamcist pictureWow — a pharmacist called me before a visit with a new doctor to review my medications.  What a great idea.

This clinic has a pharmacist on staff to discuss medication issues with patients.  And, that pharmacist calls all new patients to review ongoing medications, record them in the medical record and make recommendations that the new doctor will review at the upcoming visit.   Recommendations like problems with drug interactions, newly available generics, less expensive alternatives and contraindications.

That same pharmacist arranges refills and responds to drug questions on the clinic Internet Portal.

What a great service.  Discussion of medications by physicians is usually too brief.  And, any input from the pharmacist is usually after the fact so physicians are not too happy to call the patient and admit a problem with prescriptions they just wrote.

Sometimes great ideas just need a SHOUT-OUT. This idea is super — an actual partnership between a prescriber and a pharmacist.

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Inadequate Face Time – 5 minutes is not enough

Nearly 7 in 10 Americans want their doctor to spend more time with them and talk about more than just the problem at hand.  No doubt 5 minutes is not enough time for a health care visit.  Remember, just like the taxi driver, the meter is running.  Both providers and patients need to be better prepared for a visit.

  • On the provider side all data should be reviewed before the visit – not during the visit.  And, the least expensive provider should be engaged, based the nature of the visit.  Simple problems (e.g. well baby checks, blood pressure checks, and acne) should be addressed by physician assistants or nurses. Health care literacy needs to be assessed — some groups need a lot of attention by a nurse, some groups should be getting information from the Internet — giving the patient an Internet link for education saves time.  If the provider’s skill is well matched to the problem more time is available for the visit itself.  The provider should always ask “any other questions?”
  • On the patient side any patient should come to a provider visit with a written list of just 3 issues they want  to be addressed then check them off as a response is obtained.  For example:  1) my cough 2)my knee pain and 3) any less costly alternatives to my current medications.  A person should think about the issues and look in a book or on the Internet before the visit to be able to ask reasonable questions.  A visit to a surgeon is a little different.  It is always focused a single problem and the surgery to fix the problem.  The three issues usually are 1) the chance surgery will fix the problem 2) the reasonable alternatives and 3) what will the surgeon do to prevent complications (a good answer is to follow hospital protocols and use a surgical safety checklist).
  • Visits need to be on time and on task.
  • Patients are more satisfied with a provider visit if there is “discussion of broader health issues” as the poll indicates.  This finding corresponds to other work indicating America has a large problem with health literacy.  People need reliable health information and they certainly don’t get it on TV (“miracle ___ cure”, ”ask your doctor if you need ___”)

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