Monday, July 09, 2007

100% wash their hands. Congratulations.

There is medical RESEARCH, and there is MEDICAL research.

Sometimes , it' s the earth shattering type that says, that your ability to smell or lack of it is closely connected with your ability to develop Alzheimers. Other times its the type that simply overwhelms you. Like it happened , when one read the latest from the June 2007 issue of the Archives of Internal Medicine.

Forget cancer, aids, cholera, typhoid, whooping cough, AIDS, heart attacks, Parkinsons, Alzheimers, and other diseases named after smart folks.

The latest research says that , "Most people want doctors to shake their hand and be greeted by first name when they first meet but the expectation is not always met".

This is THE path breaking, mind boggling conclusion arrived at by several doctors from Northwestern University, lead by a Dr Makoul, who , along with several colleagues, surveyed 415 adults in the U.S. between 2004 and 2005 to learn what patients expect and prefer, and then analyzed videotapes of 123 new patient visits to doctor's office to see what actually happens.

The study goes on to say that , 78.1 per cent wanted physicians to shake their hand, while 18.1 per cent did not; 50.4 per cent wanted to be greeted with their first name, 17.3 per cent preferred their last name and 23.6 per cent favoured the doctor using both first and last names; 56.4 per cent wanted physicians to introduce themselves using first and last names, 32.5 per cent expected physicians to use their last name, and 7.2 per cent would like physicians to use their first name only.

They reached these landmark conclusions, by actually videotaping doctors meeting patients and officially eavesdropping on what everyone said to each other.

Is medical research all about a statement of statistical facts ? Where technology allows me today to push thin hairlike wires across paths worse that Lombard Street in San Francisco, to burst and clear plaque jams in arteries, and one can actually trace a drug being delivered to a tumor and confirm that the pharma companies are not fibbing, what prompted someone to fund this research, the conclusions to which could have been reached by any doctor , having an open house for friends and patients , say, on Fourth of July ?

Sorry. Thats Blasphemy. HOW can a doctor , whose fees multiply in powers of 10 , as the clock ticks away in minutes, actually spend time for FREE , with , (gulp, gulp), patients ?

What happened to the "bedside manner" ? What doctors of yore learnt about communication with patients, was not by taking a communications course. You learnt by taking a "whole view" of the patient's problems. You needed to be informal with some patients, very formal with others. What did not change is the rigour with which the case was exhaustively looked at.

Otherwise, do we now look forward to scholarly papers presented on topics as varied as "Recommended Decor for Pediatric Consultants offices west of the Sierras", or "Statistical Correlation between Age of the Physicians Assistant and patient Cure outcomes in a University Environment"?

Can we expect art dealers to offer a rotating system of prints for the doctors waiting room, based on the latest research "Waiting room patient demeanour as a function of scenery depicted in the paintings displayed there " ? What do you think of a company called U. P. Serotonin, offering different pictures each month, and giving you a 13th month free if you sign a contract for 12 months?

Maybe GE will offer refrigerators free to those gynaecologists who agree to store a specific brand of fruit yogurt ("buy one get one free") in their waiting room, as a complimentary offering to ladies in their various trimesters, uncomfortably changing their positions every 10 minutes; all this after the latest path breaking research on "Effect of lactobacillus and fruit concoctions on maternal and foetal stress levels in the first, second and third trimesters ".....

And what do you think about the group of urologists who displayed prints of various sportsmen in action in their Group practice reception rooms AND examination rooms, after the latest research about " Manifestation and perception of pain in higher middle class, marginally alcoholic, urogenitally compromised patients in the sixth decade of their life, in the presence of visually stimulating sports visuals : a landmark study"..............

Hats off to the ENT (Ear,Nose and Throat) consulting surgeon who had a permanent MTV transmission of Shakira ("Hips dont lie" (they actually stand up and shake, silly girl..) ) playing in his waiting room.

Music heals. Well, so say the doctors who recently published a paper on "Statistical correlations between Musical songs (played by groups with Insect names in the 60's and 70's), the anatomy related wording and tympanoplasty outcomes in postmenopausal females, NOT on HRT".......

Asthma is rising in the US. But did you see the latest publication on "Differential Analysis on swimming as a Asthma Treatment, as a function of the type of swimming stroke "; or better still , Speedo and TYR have joined up as a social commitment , and are offering 20% off if you buy your swimsuits and stuff from the entrance lobby of a wellknown metroplitan hospital in Los Angeles?

Whatever happened to doctors who knew your family members.? Not just who and how many, but also who was delivered by him, how the child was doing well in school ; and how it was no problem if you brought your visiting parents on your next appointment , as you were a bit worried about your Dad's intermittent loss of memory .

Nothing came free then. Least of all the fees . But you never felt the doctor was "acting" , if you know what I mean.

But what came free in the days of yore was an honest interest in your wellness, a professional interest in your family , in the interests of knowing your genetic predispositions ,now that you were reaching middle age. You never felt you were wasting his time. You did not get overcome by a feeling of being an ignoramus in a world populated by smart white coated scholars, who passed opinions without explaining things. And the decor in the office was what the receptionist, a 40 year old lady , liked to have around : a jar of gummy bears, some popular magazines, some games and toys for children, some nice scenic prints on the wall displaying the natural wonders of America, a hat and coat rack, some paper and pens/pencils for children to scribble and draw on (while waiting for their mothers maybe); and the doctor came to the door to wish you and see you off, congratulating you on your latest golf score, before he welcomed in another patient with a smile.

What we need to know is that no one taught the doctor this. He did no research on how to deal with patients; his entire learning and research was on how to TREAT the patient's sickness.

He was trained rigourously for the latter, where as the former came with years anf years of honest dedication to the wellness of those around him. If he felt that an expert opinion would help, he recommended you to another expert, and then got in touch with him himself. This was not done as a routine act to the mutual commercial benefit of all the doctors involved, and besides, every decision was taken after painstaking evaluation over a decent length of time.

Todays medical professionals, spend little time on a given case, reach conclusions in a half hour visit, and prescribe medication that brings a smile on the face of a pharma representative.

What would be very useful, is that graduating doctors should spend a year of their residency in a small medical set up, in a community away from the big cities. This would be priceless in teaching the new doctors , a way of relating to patients, that does not treat the patients, just as "laboratory values".

In the meanwhile, if you are one of the 78.1 per cent (that wanted physicians to shake their hand), and one of the 23.6 per cent (who favoured the doctor using both your first and last names), or, one of the 100% that wanted to get well, irrespective of the style of the doctor, lets just hope, that in all this greeting and hand shaking, ALL folks have remembered to thoroughly WASH their hands.......

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