Monday, January 18, 2010

Proposal about involving patients about medications they are taking

I just read National Clearing House Guidelines: Medicines adherence. Involving patients in decisions about prescribed medicines and supporting adherence.

This guideline was developed by the National Collaborating Centre for Primary Care (NCC-PC) on behalf of the National Institute for Health and Clinical Excellence (NICE).

The article discusses how to encourage more patient involvement in decisions about medicines. Physicians need to establish better communication with the patient encouraging them to participate if they choose in a dialog about their prescriptions.

Reasons why this type of communication is important is that patient's who have information about their medications and feel free to bring up concerns, side effects and problems they may have in taking their medication.

This improves quality of care for the patient. The more knowledge that doctors can obtain from the patients about side effects, concerns and problems taking the medication then it makes it easier to know how to treat the patient and also protects the doctor from potential liability.

Doctors and patients also need to communicate about any medications prescribed by other doctors.

Thursday, January 14, 2010

Status Report of this Professional Patient

I haven't been to this blog in awhile. I just wanted to check in and say hi. We have moved to another state and are still in the process of finding a place to live.

Of course with any move for someone who has a chronic illness, finding new doctors can be a hassle.

I can't search for new doctors so my husband who is busy with a new job has to find doctors for both of us. He has two chronic medical conditions so it is important that he finds a doctor also.

Right now, we are getting medications by refills but that will soon end. We have been informed by one pharmacy that use to ship some of my medications to me that we are now outside their "shipping" range, therefore, we need to find another pharmacy to provide my medication.

Indirectly, I blame the War on Drugs for this nonsense. My pain management doctor is in New York. For five years we lived within driving distance to be able to see him.

Fortunately, when we moved, he was kind enough to work out an arrangement with us by teleconference and flying out to see him regularly, he is willing to still see me as a patient.

Those of you who have a chronic pain condition understand why we are going to great time and expense to keep my pain management doctor. Read the following article Pain Management Suffers Due to Fears of Drug Abuse.

Due to governmental regulations including the DEA raiding doctor's offices (see my previous posts) many pain management clinics no longer prescribe opioid medications to chronic pain patients.

So, we will have to check to see if our state or a state nearby has a reciprocal agreement with the state where my physician practices to take opioid prescriptions.

I am seeing in the future from what information is available that the FDA has put off their institution of REMS for certain narcotic medications (two of which I take) until spring because not enough information was provided by the governmental entity who is actually going to initiate the REMS.

I've recently read even though the FDA does not have all the information and they also are aware that there is tremendous opposition among doctors, the health care field, and patients, they plan to go ahead with the REMS on specific narcotics because it is their goal to get doctors to stop prescribing these narcotics. Who cares about all the people in chronic pain?

I know that my pain management clinic has the right attitude regarding pain management. They are very involved in the movement to assure that people receive adequate pain management so I know that they will be one of the last to go down with the ship.

Even though I may have "more time" before I have to worry about adequate pain management, I know that there are others out there right now suffering day by day in enormous pain that no human being should have to bare.

We are actually closer to my FTD specialist and that is a blessing.

Also, as I mentioned above, we both need a primary care physician. This brings up the subject of locating a good primary care physician. How does a person do that? Good question, that never has really been answered to the health care consumer's satisfaction.

If you are one of the fortunate to have a good primary care physician, what happens when you have to relocate for a job which is happening more in today's economy. Here is an article in the New York times, New York Times regarding doctor shortages.

Today I tried to Google "Finding a good primary care physician." Up popped an article from 1995. As others have said, when a person tries to locate a doctor they often find outdated, not useful information.

What about magazines that have special "doctor issues" that recommend the best physicians in each field? Many doctors and health care providers have admitted in blogs that these lists are basically a popularity contest. It is usually doctors voting for other doctors.

How much does one doctor know about how well another doctor practices medicine? Not much. Think about it. How many busy doctors are going to leave their busy medical practice to go over to another doctor's practice to "watch" him or her practice medicine?

Then picture something even more ridiculous. Let's say that Dr. Jones has decided he is going to go over to Dr. Smith's office to watch him treat his patients. Does Dr. Jones call Dr. Smith's office staff to try to schedule a time to come watch his or her treat their patients? Or maybe she or he just storms into the office and demands to see the patient's records to assure quality of care? Yes, hell would have to truly freeze over plus the four horseman would have had to plod their way across the entire earth before such a thing would ever happen.

So what about these sites that rate physicians? Most of them are not much more than physician directories that contain addresses, phone numbers and convenient google maps. The others are places for individuals to complain about their doctor.

We as health care consumers will never have a way to locate good physicians until consumers have information from patient's medical records that can be complied into electronic medical records and have a system that will sort the data and give true profiles of care regarding physicians and hospitals.

For too long, information regarding the outcomes of patient care has been hidden from the patient. How can we find out which hospital or doctor who can best treat us if we have no information regarding outcomes of patient care?

It is like betting on a horse without knowing anything about the horse's history of performance in other races.

As I have stated before and will state again, new governmental regulations and incentives are not and will not fix the problems with our health care system. It is only when we take our power back as a health care consumer that we will be able to have good health care for all people.