A recent article on CNN is worth taking note of (http://www.cnn.com/2009/HEALTH/09/24/hand.washing.helpful/). Why? Because it makes one thing very clear — one of the best ways to stop the progression of N1H1 is by ensuring that ill individuals stay home. No one is saying that hand-washing isn’t important. In fact, scrubbing your hands for a good 20 seconds is highly recommended. But, especially in the case of children, how many of us really scrub that long? Or as often as we should? We an make handwashes available in school and tell our children to avoid touching their eyes, nose and mouth throughout the day — but it takes one uncovered sneeze, in one classroom to spread infection.
Not everyone can stay home with their sick children — that is a serious problem and one that needs to be addressed. If you’ve had the flu, let alone N1H1, think of how terrible you felt. Do you really expect your child to sit in a classroom feeling like that? Now is the time for people to work with their employers to discuss options, and for employers to put in place family-friendly plans that make it possible for parents to tend to their children. If possible, discussion childcare options with family members who may be available. Be proactive.
So be vigilant. Wash your hands. Watch your family for signs of headache, sore throat and fever — keep them home and let them rest. It’s time for us to come together in our communities to make this possible.
As the nation debates a new health care plan, there is one critical element to consider - reducing unnecessary trips to hospital emergency rooms (ERs). According to the National Association of Community Health Centers, each year in America unnecessary trips to the ER cost $18 billion. Emergency rooms are designed for those with injuries and illnesses that demand immediate care and/or are life-threatening.
It can be difficult to know whether you should visit a walk-in clinic or an emergency room - following are some guidelines. In the event that you are uncertain whether urgent care is necessary, call your doctor. If you are unable to reach your doctor, then visit the Emergency Room.
Call 911 or immediately go to the Emergency Room if you experience the following.
Over the past several years, the practice of medicine has changed because of the ease with which medical providers can access current research. Access to research has allowed physicians to better practice evidence-based medicine — medical diagnosis and treatment based on the most recent scientific research and measured outcomes. Patients benefit from this greater focus on quality of medical services and patient outcomes. They should also be certain that their physician is guided by evidence-based medicine principles to be certain their treatment is guided by practices that have been scientifically researched and proven.
Because of the depth of information now available to physicians, they can alter diagnoses and treatments as needed, based on current research. Access to medical research has changed dramatically with the advent of the Internet for both practitioners and patients. It is important that patients be careful of the Internet resource they are using when researching medical symptoms, conditions or treatments.
Physicians commonly utilize a subscription service that most hospitals provide, called Up-To-Date. This service evaluates approximately 300 textbooks and 500 peer reviewed journals. The Up-To-Date medical writers then summarize the current information and post it to the service.
Each article reviews the diagnosis and treatment of a specific condition and evaluates the most current research on treatment. As a physician, it is always interesting to note when an established treatment protocol is replaced by another more effective treatment based on current research. It’s evidence of the medical community’s advancing knowledge. It also means better outcomes for our patients — perhaps a shorter course of illness or less chance of complications. It may mean a more cost-effective approach for both the patient and the insurance company, or even an improved chance for surviving a once fatal disease.
As an example, recent research has shown that certain treatments improve survival after a heart attack, stroke, or pneumonia. Based on this research, new initiatives have been implemented at community hospitals with excellent success. At the same time, other treatments are studied at community hospitals, providing information that can effect how physicians treat patients.
It’s important for physicians to deliver health care based on current medical literature — it is our responsibility to treat patients as best we can. As a patient, it’s your right to question your health care practitioner about the safety and efficacy of proposed treatment. Be sure that it is guided by sound scientific principles.
Over the past 18 years as a physician, I have witnessed a wide variety of tragedies involving young and old alike. For this reason, people frequently ask me how I manage my emotions when dealing with medical emergencies. The answer is that, in the best interest of my patients, I must put my personal feelings aside and focus on using my training to care for my patient.
When the medical situation has come to a close, I take the time to reflect on how I handled the situation and personally assess what went well and what could use improvement. In the Emergency Department, we often do the same as a team – discussing our performance in an effort to continuously improve the quality of care. We also participate in Critical Incident Stress Debriefings after traumatic events in the ER. These are large group sessions, moderated by a mental health professional, in which medical professionals discuss their feelings and address their concerns.
And while I am a physician, I am also a parent and a son. For me, tragedies involving children, or witnessing the death of an elder spouse, will raise a host of feelings. Unfortunately, I must notify families of bad news. I do so with empathy and tact, while at the same time giving them the facts they need to know. When I walk into the “Quiet Room,” all eyes are upon me. I sit down and deliver the news directly because families immediately want to hear the end result, whether good or bad. Once their emotions have settled, I explain what has happened and what can be expected.
Recently, I had to deliver very unfortunate news to the parents of a young boy. In order to assist the family, I worked with the child’s mother to help her bring family members from afar to Central Wisconsin. I wanted to help provide direction for them during a time of chaos. It is my hope that I was able to lessen the burden of their pain and that I was of some help to them.
I have since learned that their son provided several organs for critically ill people. The family gifted others with a chance for life and I hope that someday soon they can reflect upon this with peace.
A majority of my articles focus on a specific medical problem, including the pathophysiology, disease process, signs, symptoms and treatment. This is because I practice evidence-based medicine–which means that what I do on a daily basis is founded on medical literature and current recommended practice guidelines.
Those guidelines are constantly evolving with advances in science. The treatment I may have recommended six months ago, can be different from what I would advise today. Thus, keeping abreast of the science of medical practice is important in providing the best possible care. But, emotion and empathy are just as important. It is my hope that I am able to provide emotional support during a time of crisis that parallels the quality of my medical care.
Recently, I was involved in a case that has had a tremendous emotional impact on me and my staff. In nearly 20 years of practice, I have not experienced such a situation. Let me share some of the details.
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