The Doctor is in . . . a Bad Mood
I’ve got some bad news, folks – or good news, depending on your doctor’s mood. A 2010 study presented at the 14th Annual Conference of the Israel National Institute for Health Policy found that the quality of care a physician provided on any given day was significantly influenced by his or her mood at the time s/he saw the patient.
We’re not just talking about a short fuse or a gruff comment, either. A survey of 118 primary care physicians found that stressed, tired or anxious doctors were more likely to talk less to patients, prescribe more medications, send them for more diagnostic tests, and refer them to a specialist. Not surprisingly, the more burned out the physician already was, the more vulnerable s/he was to letting his or her emotions dictate treatment decisions.
You May Not Be a Physician, but You Know Your Body
I hope your memories of childhood visits to your pediatrician evoke Santa-Claus-like images and warm-and-fuzzy feelings. However, some of us grew up in an era where interpersonal skills weren’t a residency requirement and questioning our doctor’s opinion bordered on insubordination. If so, it may be time to change your relationship with your doctor.
Approach your next doctor’s visit as a job interview rather than a confession to your priest. Be prepared. Before you get in the car to drive to your appointment, take your temperature. Write down a short list of symptoms you would like to discuss, including details about when they started, how severe they are, and how long they last. Bring a list of the names and dosages of any prescriptions, over-the-counter medications or supplements you are taking. Also write down any questions you have; for example, if you’re concerned that your bronchitis has turned into pneumonia, write that down as well as the reasons for your question.
Three Magic Words: I Don’t Understand
According to The New England Journal of Medicine, half of patients admit to not understanding what their doctor told them during an office visit. Given the limited amount of time doctors can spend with their patients these days, and given those doctors uses terms that are second nature to them but may not always translate well to us lay folks, it is critical that we not leave that office until we know what our doctor is saying.
This means asking questions and taking notes. What diagnosis is your doctor giving you? Based on what criteria? What is the treatment? Are there alternatives? Why is the doctor prescribing this particular medication? What side effects should you expect? When should you start to feel better and what should you do if you don’t?
Never worry about asking for clarification about something your doctor says. If you’re not sure you understand, repeat back what your doctor has told you and ask if you’ve got it right. (You can also ask if he or she recommends any specific reading materials about your condition).
The Bottom Line
It’s scary to think our physical health could be in the hands of a doctor in a bad mood. Doctors, though, are just as human as the rest of us; how they feel influences how they see things and what they decide to do. We can help them, and protect ourselves, by shifting our role from passive patient to active partner – educating our doctor about our bodies, asking questions when we need to and, when all else fails, getting a second opinion.
Depression and Anxiety Treatment in the Real World
There is a fascinating article in the July 2010 issue of Consumer Reports Magazine that reports the results of a 2009 questionnaire surveying 1500 respondents who had received treatment for anxiety, depression, or both. Specifically, this enlightening questionnaire asked the respondents this very important question: WHAT WORKED?
Viva la Talk Therapy
First of all, the anxiety and depression sufferers who went to therapy for at least 7 sessions reported more benefit that those who simply took antidepressants. It didn’t matter if the therapist was a licensed professional counsellor, a social worker or a psychologist. Although not reported, I suspect what did matter was a) the “fit” between the therapist and the client (how good of a relationship they developed) and b) the kind of therapy the therapist did. (Cognitive behavioral therapy and interpersonal therapy tends to work better on depression and anxiety).
Hey, Drugs Work Too!
Antidepressants were also generally effective, especially when used in combination with psychotherapy. Side effects continue to be a bummer, though, espcially with some of the newer antidepresants like Effexor and Cymbalta. Apparently, most people who take antidepressants continue to get their prescriptions from their family practitioner or internis, which makes it hard to know if the side effect problems are partly due to an inappropriate dosage. (Just as we wouldn’t to to a psychiatrist for cancer, I don’t think a family practitioner is the best person to diagnose and/or treat depression/anxiety.)
The Bottom Line
It’s comforting to know that some people are getting help, especially in light of the January 2010 article illustrating, again, how many depressed people in the U.S. are suffering needlessly. I hope this article will not only shed light on what treatment works best, but will help sufferers realize they’re not alone – and they can get better.
Trying to Set Diet Goals? Put the Main Course before the Desert
I’m a planner. Maybe it’s because I like to do so many different things but if, I don’t have a “to-do’ list, I tend to flail from one thing to another.
I’m sure it’s also a way to cope with anxiety; my Nana always said I was a “pessimist first so I could be an optimist.” It’s true; I tend to think through – and plan for – for every possible thing that could go wrong. That accomplished, I could give Pollyanna a run for her money.
Motivation is the Main Course
Recent research suggests that we planners are on to something as long as we keep the big picture in mind. In fact, a recent article in the Journal of Consumer Research found that, when we get too caught up in how we are going to get from point A to B, we may lose sight of the why. As a result, we may lock ourselves in to a certain action plan and not see – or know what to do – when other opportunities arise that would also help us reach our goals.
Let’s say you’ve decided once and for all to lose that last ten pounds before the official start of the often-dreaded bathing suit season. You put together a plan – go the gym every day, clear your pantry of junk food, order healthy meals when you go out to lunch with your coworkers.
So what do when the gym is closed? When your birthday-celebrating work colleague choose the last restaurant in town that refuses to offer healthy menu options? Without a clear and constant focus on why you want to lose weight, you’re more likely to either a) succumb to temptation (what could I do? The Buffalo wings seemed like the healthiest thing on the menu) or b) fail to consider alternatives (Yes, the gym is closed but I can still go for a walk with a friend, exercise at home, etc.)
Dessert is Important, Too
Don’t despair, fellow planners. The plan, a.k.a., the dessert, is a very important part of our success. We’ve just got to keep the fires of enthusiasm burning while we’re executing it. We’ve got to constantly remind ourselves of the good things that will happen if we reach our goal, of the reasons why we made the decision to shed weight to begin with.
In fact, if we’re smart, we’ll incorporate this into our diet plan. Perhaps we’re going keep a list of all the reasons we want to succeed in our wallet or on our computer. Perhaps we’re going to begin each day writing a quick letter of encouragement and support to ourselves, painting a picture of how great we’ll feel once we reach our goals. Maybe we’re going to call our best friend every day at lunch so she can remind us of why we started on our weight loss journey.
It doesn’t matter how we keep the why in mind as long as we do it. And here’s the bonus; this strategy seems to be effective no matter what our goals are. In fact, the initial study dealt with people who were trying to save money!
