Part 1

By Barbara Ficarra, RN, BSN, MPA

Before the 15 minute doctor visit is up...what you can do

Kevin Pho, MD, primary care physician in Nashua, N.H., blogs at KevinMD.com, member of USA TODAY’S board of contributors and a guest to the Health in 30® Radio Show, writes about the importance of doctors engaging in social media to communicate with patients.

He writes in an op-ed in USA TODAY “Doctors ignore Internet at their own peril” on January 27, 2010:

“Raise your hand if you’ve ever left a physician’s office without fully understanding what the doctor just told you. According to The New England Journal of Medicine, half of patients admit to not understanding what their doctor told them during an office visit.

As a primary care physician, being unable to clearly communicate with patients is frustrating. The typical, 15-minute office visit often is not sufficient for a thorough discussion. A better way to connect with patients is needed.”

Patients value face-to-face connection with their doctor (and other health care professionals) and the amount of time with your doctor will vary depending on your reason for the visit.

Yes, it’s frustrating when time is limited. Since time is limited, too many of us have left an appointment only to remember a question we planned to ask.

Unless your doctor is engaging in social media to communicate with you online, it’s important that you’re prepared for your face-to-face office visit.  Bring a notebook with your questions.

Make sure you write your questions down before your visit

By writing down your questions in advance you won’t leave without the answers you need necessitating a follow-up visit or a string of phone-tag calls with your doctor.

Here is a list of questions that may help you get the conversation started:

• What are the causes of my symptoms?
• Will the symptoms go away?
• How long will they last?
• What tests are needed to determine the cause of this condition?
• How is this condition diagnosed?
• What are the criteria for diagnosis?
• What is the treatment?
• Are there alternative therapies?
• What over-the-counter medications would be helpful?
• What prescription medications would be helpful?
• What are the side effects?
• Will my present medications interfere with any of these new medications?
• Should my diet change?
• Are there certain foods that I should be eating?
• What lifestyle changes should be made?

Don’t forget to ask for a copy of your test results.

We’d love to hear from you

Have you ever left an office visit and forgot to ask important questions? Do you write your questions down in advance? How do you make the most of your visit with your doctor or other health care professional?

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[Part II will focus on participatory medicine, patients partnering with their doctor].

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I’d like to thank our sponsor, Scrubsgallery for their continued support.

Scrubsgallery offers a special 15% discount for Elastic Scrub Pants, please use code “healthelastic”.

By Barbara Ficarra, RN, BSN, MPA

A Spoonful of Medicine:  Not a good thing

A recent study in the Annals of Internal Medicine found that people who use a kitchen spoons to pour liquid medicine aren’t getting the right dosage. Here’s what to use to get it right.

Use your kitchen spoon for food, not to measure medicine

Measuring Precisely is Vital

Ask any pastry chef or professional baker, and they’ll tell you that using exact measurements in baking is critical for a successful end product.

Using the proper measuring tools in the kitchen can make all the difference between a delectable dessert and a disastrous one.

Nurse or Doctor

Ask any nurse or doctor, and they’ll tell you that using exact measurements when it comes to pouring your child’s medication is critical.  Using the proper measuring tool is extremely important to provide accurate administration of the dosage.

Don’t reach for the kitchen spoon

When you need to give your child liquid medicine (or even yourself), do you reach for the kitchen spoon?  If you do, you’re not alone but you’re most likely not measuring the dosage accurately and it could be disastrous.

A proper measuring tool is NOT a kitchen spoon that you use for food.  It may be the first thing you want to reach for, but it’s not the most accurate.

Using a kitchen spoon to measure liquid medicine has caused major dosing errors and pediatric poisonings, according to a recent study in the Annals of Internal Medicine.

Researchers found that people administer the wrong dose of medication when using a kitchen spoon.

During cold and flu season, Cornell University researchers asked 195 university students, who were recent patients at the university health clinic to pour out 5 ml (1 teaspoon) of cold medicine into varying size kitchen spoons.

Kitchen spoons are not all the same size.  The researchers found that people underdosed by 8.4% when using a medium size spoon and overdosed by 11.6% when using larger spoons.

Pouring 1 teaspoon or 5 ml or 5 cc of liquid medicine into a large spoon is difficult to do and it’s not an exact measurement.

Make sure you use the proper tools.

Measuring tools to use to administer liquid medications

• Dosing Spoon
• Measuring Dropper
• Dosing Syringe
• Dosing Cup

My favorite is the dosing syringe but the dosing cup is really easy to use also.  Find what you like and use what is easiest and best for you.

Like the professional baker, moms need to make sure they use the proper measuring tools when administering liquid medications.  They need to make sure the exact dosage is given to their kids to avoid any dosing errors that can be potentially hazardous.

I checked out Walmart online and found that you can purchase the dosing syringe, dosing spoon and medicine dropper there.

We’d love to hear from you.  How do you measure your child’s medicine?  What measuring tool do you use?

[Source:  Spoons Systematically Bias Dosing of Liquid Medicine. Brian Wansink and; Koert van Ittersum. Ann Intern Med January 5, 2010 152:66-67]

By Barbara Ficarra, RN, BSN, MPA

Empowered health consumers know how to take charge of their health and are proactive in their care.

Whether they’re surfing the web for health information, visiting their doctor or health care professional, or a patient in the hospital; empowered health consumers know how to question and communicate.

This blog is a continuation of the “He Said, She Said” post where I promised to give you tips about how to be an empowered health consumer.

Sabriya Rice, CNN Medical Producer had a similar idea.

Here are my 3 tips to help you become an empowered health consumer:

1.  Ask tough questions when it comes to the web and on-air health reports

Don’t believe everything you read or hear without questioning it.  Listen to a health report with ears wide open and don’t be afraid to question it.  When searching for health information on the web, check out sites such as cdc.gov, fda.gov, clevelandclinic.org, and mayoclinic.org, but don’t stop there.  There are some other great sites that are not so well known, and offer exceptional information.

“Always read an article with a critical eye. Does what the author say make sense?  Check the facts and get the facts from more than one source”, says Kevin Soden, MD, medical journalist and author.

If news shows aren’t asking the tough questions; go ahead and ask your own questions.  Ask questions when you’re searching for health information on the web or listening to a health report.

When health consumers surf the web for health information, Matthew Holt, founder of thehealthcareblog says, health consumers should, “Check multiple sources. Ask questions in consumer forums and look for multiple answers.”

Gary Schwitzer, Associate Professor, University of Minnesota School of Journalism & Mass Communication and is the Publisher of HealthNewsReview’s mission is to review health news coverage every day to make sure news stories are accurate.

There is plethora of health information circulating the web, and network news broadcast serious health information in only a couple of minutes or less.  Since some news health segments may only be a few minutes long, viewers may not be getting all the information they need.

Here’s an example where critical information is missing.

In a recent blog by Gary Schwitzer, “CBS Early Show should read us the health news right out of the paper”, Schwitzer questions the validity of this health report.

“Did it come from a study? Or straight out of the Wall Street Journal? Last week the CBS early show brought on another physician-correspondent to talk about the benefits of coffee drinking. Anchor Harry Smith referred to “this new study.” What new study? None was referenced.

What the segment was apparently based on was a Wall Street Journal story that same day that had ALL of the same information. No attribution was given.” [source: Healthnewsreview Blog]

Take a look.  What do you think when you hear a report that refers to a “new study?”  Perhaps at the end of this segment “New Research on Java’s Health Perks” Harry Smith or Dr. Alana Levine  (Primary Care Physician) perhaps could have said, “For more detailed information on this topic, visit our website…”  Unfortunately, there isn’t any detailed information on CBS’s website.  Here’s what you’ll find, “Coffee: New Health Benefits.”

“Primary care physician Dr. Alanna Levine spoke to Harry Smith about new research on the health perks of drinking coffee including lowering the risk of heart disease and depression.”

To be an empowered health consumer you need to question what you read and hear.  It’s important to know the source.  What study and who funded the study?

Watch now

Watch CBS News VideosOnline
2.  Ask a lot of questions, don’t sit quietly in the doctor’s office or hospital

Before your appointment write down any questions you may have.  Ask questions about your diagnosis, medications, tests, and follow-ups.  Be in charge and know what’s going on.  Ask for a copy of your test results. And write down your questions.

Here are some questions that you may want to ask your doctor:

• What are the causes of my symptoms?
• Will the symptoms go away?  How long will they last?
• What tests are needed to determine this condition?
• How is this condition diagnosed?  What are the criteria for diagnosis?
• What is the treatment?
• Are there alternative therapies?  Over-the-counter medications? Prescriptions?  What are they?  Will my present medications interfere with any of these new medications?
• Should my diet change?  Are there certain foods that I should be eating?
• What lifestyle changes should be made?

3.  Be Prepared – Carry your personal medical history & medication form with you and give your child’s care-giver a consent-to-treat form

Medical History & Medication Form

Don’t leave home without your list of medications and current medical history & medication form.

Know your medications and keep a personal medical history form with you

Understanding your medications and keeping track of them is critical.  It’s a great idea to have these listed on your personal medical history form that you carry with you at all times.  Just in case you end up in the ER or are directly admitted to the hospital, you will be asked multiple times by multiple staff for a list of your medications, past hospitalizations, if you have any allergies and emergency contact numbers.

Where can you find a medical history form?

There are some sites where you can create a small information card; however some people are on many medications that the small size isn’t sufficient.  For a 6×4 size that you can simply carry in a photo style wallet, I’ve created one for you.  You can download it for free by clicking this link.  Simply print, complete and carry.  Moms, this form will fit nicely into the popular 6×4 photo wallets.  Keep a list for you, your kids and spouse or significant other, parents and grandparents. It’s great for college students as well.  Men, simply fold to carry in your small wallet.

(As an expert medical contributor to Real Simple Magazine, “In an Emergency,” this was my number one tip).

Consent to Treat Form

Give your child’s care-giver a consent to treat form

It can be found at Emergencycareforyou.org.

In case of an emergency, having a notarized consent-to-treat form signed by the child’s caregiver will prevent treatment from being delayed.  Of course any life-threatening illnesses or injuries are always top priority, but for a non-critical case having the proper forms will help expedite the process. Find the consent-to-treat form at Emergencycareforyou.org, the American College of Emergency Physicians (ACEP) website.

Question what you read and hear, communicate with your health care professionals and be prepared in case of an emergency or for your next doctor’s visit.  By following these simple tips you can be an empowered health consumer.

We would love to hear from you.  Do you think you are an empowered health consumer?  What are your tips?

Thanks for your time.

Best,
Barbara

By Barbara Ficarra, RN, BSN, MPA

Here’s the best HealthIn30 content of 2009.  Thank you all so much for your continued support, comments and enthusiasm.

The swine flu takes the lead as the most read blogs on HealthIn30.  Let’s take a look at the rest of the popular content here on HealthIn30.

Swine Flu- H1N1 Category

H1N1 Swine Flu Vaccine Fears Addressed – Single vs. Multi-Dose, Adjuvants, Thimerosal and More – H1N1 Swine Flu Vaccine Q&A with Medical Expert Bruce B. Dan, MD

Swine Flu: H1N1 Flu Vaccine – Who Should Get It, Who Shouldn’t Get It and Is It Safe?

Medical Experts Respond to Swine Flu: H1N1 Flu Vaccine – Who Should Get It, Who Shouldn’t Get It and Is It Safe?

H1N1 Flu Vaccine Questions and Concerns Continue on Thimerosal and Pregnancy

Google Helps You Find Locations for H1N1 Swine Flu Vaccine and Seasonal Flu Shot

H1N1 Vaccine Frustration – Can’t Have It Both Ways

[For more on the swine flu and H1N1, click here to read additional blogs].

The rest of the best

Wash Your Hands With Elmo: Stay Healthy, Wash Your Hands!

Hope for Smokers

Dr. Sanjay Gupta, CNN’s Medical Correspondent is Looking for 5 Eager People to Get Fit

New Mammogram Guidelines Cause Confusion and Debate

Are Doctors in the Minority When it Comes to Social Media? Kevin Pho, MD Explains…

Medical Errors: Nurse’s Tips Can Help Prevent Medical Errors

Feeling Completely Worn-Out and Extremely Tired? Find Out What It Could Mean

TV Nursing Dramas: ‘Nurse Jackie’ Needs Healing, ‘Hawthorne’ Offers Hope

Empathy for Family Members

Prescription Drug Abuse Keep Out of Reach of Teens

After 40 Years Patients Still Crave Attention

Questions Every Woman Should Ask Her Doctor

Sweet Potatoes – A Superfood Takes Center Stage

How to Engage Your E-Patients Like a Rock Star

FDA Gets Tough With Misleading Front Food Labels

And some more popular content

Personal Medical History Form Free Downloads

Real Simple Magazine Taps Experts for Emergency Care Advice

5 Easy Ways to Improve Your Health

3 Ways to Boost Your Health: Meditate, Connect With Friends & Smile

Live in the Moment or Envision the Future?

Are you “Down for Maintenance”? Maybe you should be

Happiness: It’s Contagious

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Thank you again for following HealthIn30.

I wish you all a very Happy and Healthy New Year!

Best,

Barbara

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[I'd like to thank our sponsor Scrubsgallery for their continued support.  Here's a special offer for our health professionals:  15% off Cherokee Body Scrubs.  Please use code "body15".  Thank you so much.]

By Barbara Ficarra, RN, BSN, MPA

Dr. Sanjay Gupta and Barbara Ficarra

I was thrilled to be invited to Dr. Sanjay Gupta’s book party at Rouge Tomate in New York City on December 14, 2009.

Many people were there to help celebrate the New York Times Best- Selling Author’s book, Cheating Death.

Larry King, Dr. Mehmet Oz, Deepak Chopra, Joan Lunden, Soledad O’Brien, Dr. Nancy Snyderman, and Cindy Adams were some of the many recognizable faces.

President of CNN, Jonathan Klein introduced Sanjay and I had the pleasure of meeting Philip Kent, Chairman and CEO of Turner Broadcasting.

It was a terrific event and I was honored to be there to help celebrate.

Stay tuned as I will be bringing you an interview with Dr. Gupta.  Dr. Gupta was originally scheduled to be my guest on the Health in 30 Radio Show on October 15th, but I was live on-air with no guest.   We shared a few laughs and I joked with Sanjay how Bonnie Hunt must have had him tied up since he was shooting a segment of her show prior to mine. Dr. Sanjay Gupta is one of the nicest people you could meet.  Very down-to-earth and very humble.

Cheating Death is an intriguing book that deals with how science has made it possible to defy the odds and cheat death.  From hypothermia techniques used in hospitals to new CPR techniques for the general public to the fascinating concept of suspended animation, Cheating Death is a fascinating read.

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We would love to hear from you.  Have you read Cheating Death?  What are your thoughts?