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August 17, 2010
When my three-year old son began having recurrent coughing fits and shortness of breath after exercise, my wife and I knew the probable diagnosis. She and I are both doctors, and my wife has asthma. We made an appointment with our family doctor who confirmed that our son, indeed, had asthma. After prescribing medications to prevent and manage the symptoms, our doctor would have—had we not been medical professionals—taken just 10 or 15 minutes to explain how to administer the medications and avoid triggers like tobacco smoke, mold, pollen, and hairy pets. She would have also had to cram in lessons on recognizing the early warning signs of an asthma attack, what actions to take to treat it, and when to call the office or go straight to the emergency room.
Our son's doctor didn't have go into detail about any of those things and, given her crowded waiting room, I suspect she was grateful. But what about the 7 million other parents whose children are diagnosed with asthma? Or those who live with chronic conditions like diabetes and heart disease who don't have the benefit of my medical school training? Even seeing your doctor several times a year isn't enough to keep you well versed on keeping your disease under control. That's a major reason why so many with diabetes and heart failure wind up in the hospital again and again with complications related to their condition.
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August 10, 2010
During my eight years seeing patients as a family physician, I've found that their individual health beliefs often played a big role in important decisions such as starting a new medication or undergoing an invasive test or procedure. Some patients were more willing to endure potentially risky procedures in order to learn their diagnosis quicker, for example, while others preferred "watchful waiting," or monitoring symptoms that were unlikely to be a sign of anything serious. Unfortunately, in a typical 15-minute office visit, I barely had enough time to establish a friendly rapport with my patients, much less probe them deeply about their beliefs. As a result, I'd often find myself making assumptions about the care they preferred.