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 Your Doctor Wishes You Would do These 8 Things

We polled family doctors from across the country, and they laid down the law on eight things they wish we’d do—or stop doing.

According to our panel of general practitioners, Canadians aren’t always doing what they should to make the most of doctor visits—and skipping out on these crucial tactics could lead to a delay in diagnosing serious conditions. Here’s what our experts say you should add to your patient checklist.

1. Stop feeling shy

Many of us hesitate to talk to our physicians about sensitive issues (think substance abuse or sexual health—or even gender identity). But honesty and openness are important, both for fostering a good doctor-patient relationship and for ensuring that you get the best care, says Dr. Laura Pripstein, medical director of the Sherbourne Health Centre in Toronto and a staff physician on the family health team. That’s why it’s OK to try out a doc before committing. Dr. Pripstein recommends booking an initial visit to see if your potential doctor is a good fit. “You want to see if this person seems like someone you can talk to, someone you feel comfortable with,” she says. And if you don’t think your doctor understands or respects your concerns, don’t be afraid to find someone new. “If you feel you can’t ask questions that might be embarrassing, you don’t have the right provider,” says Dr. Pripstein.

2. Don’t come to your appointments unprepared

Get the most out of your time—and your doc’s—by arriving at your appointment with a clear plan for what you want to discuss, says Dr. David Ross, an associate professor of family medicine at the University of Alberta in Edmonton. “It’s good to have patients think about their problems from when the issue began, then look at it chronologically to the present,” says Dr. Ross. Making a prioritized point-form list in advance helps ensure that you don’t forget anything or mix up the order of events, he says. Then, work with your doctor to address the most serious issues first.

3. Choose your family doc over the walk-in clinic whenever you can

Yes, a clinic is convenient, but what we gain in easy access, we lose in familiarity. “I think it’s really valuable if people can connect with a family physician who they’ll be able to see long term, rather than just looking for the quickest way to access care,” says Dr. Maurianne Reade, a physician with the Manitoulin Central Family Health Team in Mindemoya and M’Chigeeng First Nation, Ont. A family doctor will know your medical history and will keep it in mind when suggesting treatment—so, for example, if you’ve recently taken several courses of antibiotics for a UTI, your physician will likely look for a different course of action if you come in with another infection. According to the most recent statistics, about 4.5 million Canadians don’t have a regular family doctor. If that’s you, contact your provincial College of Physicians and Surgeons, or check to see if your region has an online registry (Ontario has Health Care Connect, while Quebec launched a web-based family doctor finder last year). “It’s important to know that we doctors are privileged to share in your stories and to help you through difficult times,” says Dr. Reade.

4. Share what’s happening in your life

There’s a reason your doctor wants to know where you’re working, if you’re dating and how the kids are—and it’s not just because she likes you. (Though she does, we’re sure.) Physicians need a picture of their patients’ lives beyond their specific health symptoms and conditions, especially when they’re first getting to know you, says Dr. Stephen Wetmore, the family medicine chair at the Schulich School of Medicine & Dentistry at Western University in London, Ont. “Doctors need to know these things to understand how your lifestyle and habits may be influencing your health,” he says. So when you’re talking about your exercise habits, your health history and whether you smoke, drink or use drugs, mention your employment status, family obligations and intimate relationships, too, says Dr. Wetmore.

doctor

5. Be a better googler

Doctors know you do it (hello, late-night web searches), but they would prefer you to ask about good sources of information, rather than going rogue online. They also want you to be honest about your fears if you’ve read something particularly upsetting. Physicians can’t address your concerns or point you in the right direction if they don’t know what your fingertips have been up to. “The thing we want our patients to do is ask us for the most reliable Canadian websites to go to as resources,” says Dr. Heather Waters, an assistant professor of family medicine at McMaster University in Hamilton.

6. Don’t think your symptoms are “no big deal”

If you’ve noticed you are having more headaches than usual or are sleeping more or are eating less, you might not think to tell your doctor—but you should. There’s no set of rules for determining which symptoms are worthy of investigation or discussion, says Dr. Wetmore, but make a note to mention anything that is new or has changed since your last appointment. “You should bring up things like sudden weight loss or fatigue that seems excessive,” he says. “It could be a sign of a larger problem, or the cause of a developing problem.” Evenif it doesn’t end up being serious, seeing your doctor will help ease any anxiety you might be feeling, and that’s worth the visit, too.

7. Talk about what you’re taking

Tell your physician about any herbal medications and alternative treatments you take, says Dr. Mel Borins, a University of Toronto associate professor and author of A Doctor’s Guide to Alternative Medicine: What Works, What Doesn’t, and Why. It’s important for patients to share what’s working for them and for doctors to be open-minded about therapies outside their own practice or traditions, he says. This is also a concern when it comes to conventional meds, especially if you’re pregnant; there are only 23 medications specifically approved for use during pregnancy— yes, out of every available drug—which can leave women feeling anxious about taking prescription or over-the-counter drugs when they’re expecting, says Dr. Robyn MacQuarrie, an obstetrician-gynecologist in Bridgewater, N.S. But don’t stop taking your meds as soon as your pregnancy test comes back positive. “It’s really important to talk to your doctor instead of stopping cold turkey,” says Dr. MacQuarrie. Physicians can help you determine the risks and benefits of using different drugs, and they can let you know when the effects of not taking a medication while pregnant may be worse than taking it— which is the case with some antidepressants.

8. Avoid diagnosing yourself

You know doctors don’t like it when you come in prepared with a diagnosis you’ve made thanks to the aforementioned Dr. Google. But do you know why? It’s not because they think you’re encroaching on their territory! Rather, they worry that a serious medical problem might get missed or you’ll cause yourself unnecessary anxiety over something not serious. That’s because not everyone has the most common symptoms of a particular condition. Plus, men, women and different ethnicities can have varying symptoms for the same problem. For instance, Dr. Reade’s community has a large proportion of people with diabetes, which can affect the warning signs of cardiac disease, a major killer in Canada. Instead of the usual pain or pressure on the left side of the chest or arm, men and women with diabetes may instead have spells of profuse sweating with weakness. And, of course, women who don’t have diabetes can have differing symptoms, too; sometimes, a heart attack can feel like acid reflux or come with sudden nausea, vomiting and lightheadedness. So always tell your physician if your symptoms are surprising or strange—like a headache that feels different than usual, for example. And if you’re worried about a specific diagnosis, be sure to bring that up, too.

BY: TERRI COLES
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Preventive health care for unhealthy could save billions

‘Focus on illness treatment has made illness and disease a growth industry,’ says study author

The Canadian Press    Jun 19, 2013 

Billions of dollars could be saved in Canada’s health-care system with the introduction of preventive programs that focus on those individuals in poor health, says a study by the School of Public Policy at the University of Calgary.

“Canadian medicare with its focus on illness treatment has made illness and disease a growth industry,” lead author Herb Emery told reporters Wednesday.

“It’s one of the fastest growing parts of our public system…. Where we see retraction in education and other areas, we’re seeing continual five per cent growth per year in treating illness and we can’t keep up with demand.”

The report evaluates the costs and benefits of an alternative approach by examining the preventive health-care program run by Pure North S’Energy Foundation, a not-for-profit organization that pays for and provides personalized, preventative health-care services.

It includes lifestyle counselling, dietary supplements and dental services for Albertans from groups of people who tend to be in poor health.

The report found the annual health-care bill for a Canadian in poor health is more than $10,000 higher than for someone in good health.

The Pure North program achieved positive health outcomes at a cost of $2,300 per participant — far less than treating people once they become sick.


Health care costs unstable

“People in poor health tend to use more health care,” Emery said. “The minority of the population, 20 per cent, is generating 80 per cent of the costs and these are generally people who are in poor health.”

Individuals who are healthy tend to stay in good health, and those in poor health tend to stay that way, said Emery.

“What we’re really talking about is chronic conditions … diabetes, cardiovascular disease and cancer. If we can intervene sooner, we can change lifestyles, we can change health. We can potentially restore the fiscal sustainability of the health care.”

Emery said about 250,000 Albertans describe themselves as being in poor health. If even 45 per cent of that number showed an improvement, it would cut the number of their days in hospital by 25 per cent. He said that would save the system $500 million a year.

Emery said if that was expanded across Canada, the savings would be “in the billions.”

“I think the interest in making people healthier and avoiding chronic diseases is Canada-wide. Everyone agrees that if you can figure out how, it has a higher return for the medicare system. The piece that is missing out there is how do you make people healthier?”


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HEALTH CHECKLIST: 10 TESTS TO KEEP YOU HEALTHY

With early detection, many serious illnesses can be treated or managed before they turn into major health crisis.


Check this list of routine medical tests. Tests like these are important because they help you and your doctor detect problems early. If you’ve missed any tests listed here, or can’t remember when you had your last physical, talk to your doctor. Bring this list with you to help you remember what each test is for.
  1. Blood pressure test identifies high blood pressure, which can lead to heart attack or stroke. Most doctors will check your blood pressure at every visit.
  2. Professional breast exam, like a monthly self-examination, detects lumps or unusual tissue. A mammogram is also recommended as an early breast cancer screen for women over 40 — earlier for women at high risk.
  3. Regular dental exam and cleaning helps guard against dental decay and periodontal (gum) infections, and may detect mouth cancer.
  4. Pap smear helps detect cervical cancer, uterine cancer, and herpes. This is done as part of a routine physical.
  5. Eye exam checks eye functioning for good vision, cataracts, and glaucoma (increased pressure within the eye that can lead to blindness).
  6. Blood cholesterol test checks the level of cholesterol (fatty deposits) in your blood. High cholesterol can clog your arteries and put you at risk for heart disease.
  7. Booster shot helps maintain immunization against tetanus, diphtheria and polio, hepatitis B (if you’re sexually active), and the flu.
  8. Digital rectal test checks for early signs of colorectal and/or prostate abnormalities, including cancer.
  9. Stool blood test detects early signs of colorectal cancer. Your doctor may also recommend a colonoscopy or sigmoidoscopy, where a small camera examines your colon.
  10. Bone-density test determines if bones are fragile from poor calcium intake, hormone replacement therapy, or low hormone levels. This test is for post-menopausal women, men with low testosterone levels, and people with prolonged exposure to certain medications.


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Obesity rates rise, threaten health in OECD nations

LONDON Tue Feb 21, 2012


(Reuters) – More people in developed countries are overweight or obese than ever before, dooming them to years of ill health, pushing up healthcare costs and piling more pressure on health systems, a report by the OECD found on Tuesday.

The Paris-based Organisation for Economic Co-operation and Development found obesity rates vary widely from a low of 4 percent inJapan and Korea to 30 percent or more in the United States and Mexico.

But in more than half of the 34 OECD countries, at least one in two people is now overweight or obese, and rates are projected to rise further. In some countries, two out of three people will be obese within 10 years, the report said.

A man walks past the New York Stock Exchange after trading hours in New York August 17, 2009. Credit: Reuters/Lucas Jackson“(These people) will die early, and send healthcare costs ever higher,” the report’s authors wrote.

Experts say severely obese people die on average eight to 10 years sooner than people at normal weight, with every 15 extra kg increasing risk of early death by around 30 percent.

Obesity, defined by the World Health Organisation as a body mass index of more than 30, is estimated to be responsible for between 1 and 3 percent of total health spending in most countries – and for between 5 and 10 percent in the United States – and “costs will rise rapidly in coming years as obesity related diseases set in,” the OECD report said.

Body mass index or BMI is a measurement which compares weight and height. People are defined as overweight if their BMI is greater than 25 kg per meter squared (kg/m2) and obese if it is greater than 30 kg/m2.

A large global study last year found that more than half a billion people, or one in 10 adults worldwide, were obese and that the obesity epidemic was rapidly spilling over from wealthy into poorer nations.

This report, which the OECD said was a 2012 update to its 2010 report on the economics of obesity prevention entitled “Fit Not Fat,” did however find some good news.

New data for 10 of the 34 OECD countries showed that over the past decade, obesity rates slowed or stopped growing in England, Hungary, Italy, Korea and Switzerland, and grew by only 2 to 3 percent in France and Spain. Yet in Canada, Ireland and the United States obesity rates rose by 4 to 5 percent.

Looking at childhood obesity, rates have stabilized England, France, Korea and the United States and the OECD said this was partly due to governments stepping up efforts to tackle the root causes of obesity.

It noted that some governments, including those in Denmark, Finland, France, Hungary, had passed legislation in 2011 imposing higher tax rates on high-fat or high-sugar foods.

(Reporting by Kate Kelland)

source: reuters


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Cold and Flu: When Should I Call Our Doctor?

You’ve nursed yourself and your family through a few cold and flu episodes in your time. But how do you know when you need to call in for a consult? What are the signs that signal it’s time to see a doctor?

More often than not, a cold or flu will resolve itself. No matter your age, you’ll likely sniffle through congestion, suffer through sore throat pain, or groan your way through the body aches of the flu. But sometimes it comes to a point where you should call the doctor. And though adults and children share many of the same cold and flu symptoms, the signs that signal when to see a doctor can differ.

Infants:
When an infant gets a cold, a parent must act quickly. A newborn’s cold can swiftly turn into something more serious or make it difficult for a baby to properly nurse or to be bottle-fed. See a doctor as soon as you notice symptoms.

Babies older than 3 months of age:
Seek your doctor’s advice if you notice:
changes in wetting habits
eye or ear symptoms
coughing or nasal discharge that refuses to go away
a fever over 38.1°C that lasts longer than one day
a fever that persists for more than 3 days
Urgent symptoms include:
difficulty breathing
refusal to feed
coughs that cause vomiting, bloody mucus, or a change in skin colour

Children:
Seek a doctor’s help for:
cold or flu symptoms that last 10 or more days
a fever that peaks at or above 39.4°C
a fever that persists for more than 3 days
fast or laboured breathing or wheezing
ear pain or discharge
listlessness or irritability
vomiting or abdominal pain
changes to skin colour

Teens and adults:
Head to the doctor for:
symptoms that persist beyond 10 days
a prolonged fever of 38.9°C accompanied by aches and fatigue
glands in neck or jaw that feel very swollen
laboured breathing or chest pain or pressure
confusion, disorientation, faint-headedness
severe vomiting
intense sinus pain

McNeil Consumer Healthcare, division of Johnson & Johnson Inc. 2010


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Advocate for Your Health

Too much information?

The abundance of information available has made it possible for us to take a more active role in our health care. In today’s technological age, the Internet is often our first resource for health information.

However, this is not always the best approach for several reasons. First, anyone with Internet access can call themselves “experts,” providing health or medical advice with no real medical background. Second, using the Internet as a medical research tool can induce stress in those prone to worrying. In fact, because of the Internet, a new condition dubbed “cyberchondria” has emerged whereby hypochondriacs surf the net, increasing their anxiety.

But the Internet is not all bad—in fact, there are several online resources that are backed by scientific research and are vetted by health professionals.

Sharon Gurm, naturopathic physician and founder of Port Moody Naturopathic Health & Wellness, says, “Generally, medical websites tend to be the most reliable sources on the Internet.”

However, she still touts old-fashioned research strategies: “I would advise reading appropriate literature—books authored by credible medical [and health care] professionals—available at the library or at your local bookstore.” Should research reveal conflicting information, Gurm suggests discussing it with your health care practitioner before making any changes to your treatment.

Further, ask your health care team for recommended reading materials as well as any take-home materials they may have in-office.

Be prepared

A health care practitioner’s time is valuable. Try these tips for getting the most out of your appointment.

Fill in the blanks
When seeing a new practitioner, patients are required to fill out a plethora of forms. Many of these forms are now available for download on clinics’ websites and can be filled out ahead of time. If this option is not available, arrive early to the appointment or request the clinic fax a copy for your attention.

Make a list and prioritize
Prior to the appointment make a list of questions to ask the health care practitioner. Then prioritize the questions in order of importance. Chances are the time restrictions of an appointment will not allow all questions to be answered, so it’s necessary to determine which are most important to you.

Seek support
An appointment with a health care practitioner can often be overwhelming. If this is the case, consider bringing a supportive family member or friend along to the appointment.

Take note
Even those with sharp memories can have a hard time recalling what was discussed in an appointment. Note-taking is an excellent solution to this problem.

source: Alive.com