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1. Bring a long list of complaints.  Many popular articles I’ve seen recently encourage patients to bring a long list of problems to their doctor appointments.  Don’t.  Physicians just do not have time to appropriately address numerous complaints during one office visit.  If you try to do to much, each complaint does not receive the attention and evaluation it deserves.  Instead, make a list of your complaints and health issues at home, and prioritize it.  Try to address the top two at your next office visit, and schedule a follow up visit soon after to address the next two.  On the other hand, a list of questions pertaining to a single problem is o.k., but wait to start firing them off until your doctor has had his or her say, as he’ll likely answer a number of them in the course of the initial evaluation and discussion.
2. Become irate when you’re doctor is running late.  Understand that your physician is doing his best to stay on time.  Many factors contribute to your doctor running behind schedule.  Emergencies, office visits running longer than expected, multiple patients arriving late, and the constant stream of test results and phone calls that flow in are just a few.  If you’re still in the waiting room thirty minutes after your appointment time and don’t feel like waiting any longer, politely ask to reschedule.  Making a scene or becoming angry with the receptionist will achieve nothing, and trust m Read the rest of this entry »

“Scientific studies have shown. . .”

“Recent research suggests. . .”

“A study presented recently reported. . .”

These types of phrases are used daily in the popular media to report on medical and scientific studies which produce results the general population may find interesting. They’re also used regularly by those trying to convince you to buy certain products (e.g., supplements), follow certain diet plans, or take prescription drugs. Unfortunately, such references to scientific evidence are frequently misleading.

In medicine, there are many different types of studies and reports that are used as evidence to support a given treatment recommendation. The thing that most people (especially those writing media reports) don’t seem to realize is that some types of evidence are considered much stronger than others. Many times the media doesn’t seem willing or capable of distinguishing very weak evidence from very strong. Those who’re trying to sell you snake oil are much worse, and will often mislead you by using such phrases while really referring to virtually nonexistent or at least extremely limited evidence.

Some general categories of clinical medical evidence, presented from weakest to strongest, are reviewed below.

Anecdotal evidence. This is literally when recommendations are just based on the experiences of a few patients. A Read the rest of this entry »

A patient called me on the phone while I was on call recently demanding a “Z-pak.”  A Z-pak, as many of you may know, is a popular prepackaged course of antibiotics commonly used for respiratory infections.

“Hello Ma’am, I’m Dr. Odom, what can I do for you?”  I asked.

“I need a Z-pak.”  Remarkably, this was her chief complaint.

“And what makes you think so?” I said.

“Well, I woke up this morning with a scratchy throat and runny nose.  Everyone in my office has been sick and they’ve called their doctor’s office and are taking Z-paks of antibiotics.  I don’t have time to be sick, so I need you to call in a Z-pak for me.”

After a few more questions to make sure she didn’t have any other symptoms or underlying conditions that would raise my concern level, I told her that her symptoms sounded viral and I didn’t think antibiotics of any kind would do her any good, but that she was welcome to come to the office the next day for further evaluation in person, or to go to a nearby walk-in clinic with weekend office hours.

Unfortunately, she then became quite agitated.  As I tried to explain my decision to her calmly and rationally, she interrupted with a few rude comments questioning my medical knowledge, then hung up on me.

A few useful points you can take away from this exchange: Read the rest of this entry »