The electronic medical record-asset or annoyance?

The increase in physician burnout has been directly linked to the introduction of electronic medical records.

You’re probably used to your doctor’s office using an EMR, electronic medical record (also called EHR, electronic health record) . By now most clinics, private medical offices, hospitals, labs, imaging centers, and other healthcare settings use computers exclusively for everything from scheduling, communication, to documentation and billing. If you are a young adult, you may not even remember a time when medical offices and hospitals used paper records.

Medical Record
Do you remember the stacks of charts in doctor’s offices and hospitals?

Dr. Danielle Ofri, author of several books about healthcare delivery, wrote an astute opinion piece about EMRs for STAT which I encourage you to read. I’m going to review her post adding my own ideas, , with the goal of helping you understand why we doctors, and maybe you, have a love/hate relationship with computers in healthcare; as Dr. Ofri says about electronic health records,

they all have their breathtaking assets and snarling annoyances

Dr. Danielle Ofri

In her piece, Dr. Ofri refers specifically to the use of electronic records in hospitals, but the issues are similar in clinics and other settings.

Breathtaking assets

  • more efficient storage of records than paper (taking up less physical space and time for sorting and filing)
  • ability to generate reports
  • improved hospital efficiency and financial margins (possibly by the ability to analyze data and generate reports)
  • able to analyze the health needs of large numbers of patients, called population health, so health systems can plan for and offer needed services more efficiently
  • communication- the ability to contact doctors by email, get test results through a portal, schedule appointments online, order med refills, etc.
  • legibility and standardization in documentation

Snarling annoyances

  • changes the way doctors work and make decisions; current software often does not reflect the way doctors are taught to approach patient diagnosis and treatment
  • less efficient retrieval of data than paper (due to larger amounts of data, which may be redundant)
  • little evidence yet that use decreases complication rates, or improves patient care in general
  • less personal interaction with healthcare professionals when communicating through a portal
  • increased time spent documenting on a computer , much of it simple data entry, compared to writing on paper

But the greatest disadvantages attributed to the use of computers in the medical setting, ones far more than “snarling annoyances” are

  • interference with doctor patient interaction and communication in the office or bedside; both doctor and patient may pay more attention to the computer than to each other
  • erosion of staff morale, often due to more time spent on the computer than with the patient, boredom with data entry, and stress of having to learn new systems and updates
  • contributing to physician burnout, which can have a negative impact on patient care

Doctors like me, who did not grow up in the computer age, went through the entire medical education experience without touching a computer. For us , the transition to computerization while maintaining a busy schedule of patient visits, was difficult and stressful. The increase in physician burnout has been directly linked to the introduction of electronic medical records.

Boldly going…

As Dr. Ofri points out, the EMR is not going away, and few if any of us want to go back to the old system, as annoying as the new system can be. The annoyances are slowly being worked through and resolved, and the assets are becoming truly helpful.

The younger generation of doctors who have never known a world without computers embrace their use readily. As we senior doctors wind down and eventually retire, we can pat ourselves on the back for being the generation that led the way into this strange new world.

a graphic showing various mobile computing devices
a graphic from the LIGHTSTOCK.COM collection, an affiliate

Where you, the patient, fit in

You as a patient have a stake in this endeavor too. As already mentioned, being able to access your records, make appointments, manage payments, and send messages on your computer or mobile device brings efficiency and convenience to a process that formerly was time consuming and cumbersome. I now routinely use my doctor’s office portal for my own medical needs and my patients use my office’s online services . Here’s what you can do to help make EMR use better.

  • Use whatever online healthcare resources available to you. The more we all use them, the easier they will be to use, and feedback will help developers make them even more helpful.
  • Be patient with your doctors and other healthcare providers as they transition to EMRs, from one to another, or when problems occur. Like any piece of technology, they don’t always work perfectly, and occasionally they don’t work at all.
  • Give constructive feedback. A thoughtful critique will help more than irate criticism.

Here is the link to Dr. Ofri’s article-

The EMR has changed the doctor patient relationship into a menage-a-trois

you have a role and a vested stake in communicating your concerns, questions, and even grievances to the physicians who care for you; that without such information, your physicians cannot provide optimal diagnosis and treatment for you.

from my review of Dr. Ofri’s book -at this link

What Patients Say, What Doctors Hear

Danielle Ofri, M.D., is a physician at Bellevue Hospital, a clinical professor of medicine at the New York University School of Medicine, editor-in-chief of the Bellevue Literary Review, and author of the forthcoming book

When We Do Harm: A Doctor Confronts Medical Error

Another physician explores the EMR

MAN’S 4TH BEST HO$PITAL By Samuel Shem

Samuel Shem (pen name of Stephen Bergman, M.D.) is a novelist, playwright, and, for three decades, a member of the Harvard Medical School faculty. His other novels include The House of God, Fine, and Mount Misery .

In this novel about a hospital dominated by computer screens and corrupted by money, an idealistic doctor has one goal: to make medicine humane again. Here is an excerpt-

“Cynical? me? I feed on ideals, on ideal care. I’m so idealistic, to you I sound cynical! And I do not call ’em Electronic Health Records, ’cause they don’t help with health, and may well harm it. With a screen between you and your patient, you get distracted, right? It’s like texting while driving.

So, to remind us of the danger let’s call ’em EMRs, the ‘M’ for “Medical’. “

After a student asks why the computer systems at the VA (Veterans) and the Indian Health Service hospitals, both government agencies, are more user friendly, he goes on to explain,

“Nobody’s makin’ money offa it. So we all gotta get together and unhook care from billing. So nobody makes an obscene profit offa the sick.”

available on Kindle (affiliate link)

exploring the HEART of the health record

I hope you found this discussion enlightening; maybe it answered some questions you had about electronic health records and maybe raised some issues you’d like to know more about. Please contact me with questions and I’ll answer them in a follow up post.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

                              Dr. Aletha 

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“Welcome home and thank you for your service.” Veterans Day

The public’s anger at our government for pursuing an unpopular war was often directed at the service members who believed they were doing the right thing by serving their country. They were blamed, and unfortunately felt shame for the mistakes made by those in authority.

On the 11th day of November every year, we in the United States pause to honor the men and women who have served in our armed forces. We call it Veterans Day.

Military veterans today are held in high regard, and receive public and private recognition in many ways. This was not the case 40-50 years ago, when Vietnam veterans like my husband were not respected or appreciated.

The public’s anger at our government for pursuing an unpopular war was often directed at the service members who believed they were doing the right thing by serving their country. They were blamed, and unfortunately felt shame for the mistakes made by those in authority.

When called upon, they served their country but their country did not serve them well. Perhaps saddest of all, they received little if any welcome when they came home.

Vietnam veterans statue in Washington, D.D.

A national monument honoring Vietnam veterans now stands in Washington, D.C., as well as memorials elsewhere, like the one in Angel Fire New Mexico. There is a travelling “Wall” , a replica of the one in the nation’s capital.

a replica of the Vietnam Memorial Wall with an American flag and a wreath of red, white, and blue flowers
a travelling replica of the Vietnam Memorial Wall in Washington, D.C. visits towns throughout the United States

My husband has caps and shirts identifying him as a veteran; when he wears them in public, people will come to him and thank him for serving. Sometimes they will ask about his service experience, especially if they are also a veteran. Fellow veterans always offer a hand, saying “Welcome home.”

A ceremony honoring a fallen soldier at the Vietnam veterans memorial in Angel Fire, New Mexico

We meet relatives of service members who eagerly share their loved one’s story. Sometimes, it is a story of one who did not come home. These stories are often heart wrenching and we walk away choked up and silent.

To all of you who do or have served in the military, and to your loved ones-

“Welcome home and thank you for your service. We can never repay our debt to you. “

My husband, Raymond Oglesby wrote a personal account of his military experience, here is an excerpt-

” I didn’t want to ever go to Vietnam again when I came home in 1972 after a one-year tour of duty with the United States Army. I was stationed with the Americal Division, 3/18 Field Artillery Battalion near Tra Bong, a major village located about 25 miles west of Chu Lai, the headquarters of the Americal Division, on “China Beach” at the South China Sea.

When I came home, I did not talk about my involvement in the Vietnam War for over fifteen years. I only told two or three people what really happened. I thought only  another Vietnam vet could understand. “

Continue reading at-

From Bullets to Blessings-One man’s journey to recovery from war

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

                              Dr. Aletha 

Meet the new doctors caring for you soon

Who will be your next doctor? What will your future doctor look like?

Your doctor within the next 10-20 years is likely in medical school or a residency program in a United States medical center right now. Within 1-10 years, they will join the ranks of practicing physicians, while some currently in practice will change to a non-clinical job, retire, or die.

In a previous post I told you about the students and residents in U.S. medical schools, the surprising new doctors caring for you. Here is an update.

 

Your doctor within the next 10-20 years is likely in medical school or a residency program in a United States medical center right now. Within 1-10 years, they will join the ranks of practicing physicians, while some doctors currently in practice will change to a non-clinical job, retire, or die.

More women physicians are coming

For the academic year 2017-2018,  83,000 students, attended United States medical schools ,  slightly more males than female. However, in 2017, the entering class of medical students was slightly over 50% female, for the first time ever.

UPDATE

For the second year in a row, more women than men started their journey as physicians, 11,382, 328 more than last year. From 10,752, the number of men decreased to 10,634.

According to the Association of American Medical Colleges, since 2015 the number of women students has increased by 9% while the number of men has decreased by 2 %.

And already, the majority of  young practicing physicians-under age 40 years old-are female.

So you are likely to be treated by a female physician eventually, if you haven’t already,  especially if you go to a primary care doctor. Gynecology and pediatrics  residency programs are now overwhelmingly comprised of female residents.

 

Ethnic diversity is still low but is improving

Entering classes at the nation’s medical schools continue to diversify.

Medical students and residents, both male and female, are still predominantly white. The ethnic percentages of most other students is far below their representation in the general population. Based on self-identification, race and ethnic origin of medical residents in 2017 was

a male doctor holding a tablet
  • White-60%
  • Black- 7%
  • Hispanic(any race)- 6%
  • Asian-26%
  • Multiracial- 3%
  • Unknown/other-7%
  • Native American/Alaskan/Pacific Island -less than 1%

UPDATE

In 2018, the numbers of black, Native American/Alaskan, Asian, Hispanic/Latino, and white women increased, while the number of white males decreased. 51% of students in medical schools are white.

original source at this link

 

How many U.S. physicians are foreign born ?

Will your physician come from another country?

Female doctor looking at an xray

70% of  U.S. medical residents are native citizens,  8% are naturalized citizens and 6% are permanent residents. ( adds to less  than 100% due to some status’ unknown.) These numbers remain the same as last year.

 

 

Credentials of today’s physicians

The average grade point of entering medical students was 3.56.

77% had done some type of volunteer medical service .

77% have experience in medical research.

These statistics gleaned from JAMA, December 19, 2017 

Goals of new physicians

“Most students, including minority, disadvantaged, and marginalized students, enter medical school pursuing a lifelong dream of practicing medicine with little sense of projected incomes or what specialty they would like to pursue.

Most students do not make specialty choices solely on the basis of the high cost of medical school or the overall potential revenue based on specialty.

Most specialty choices are likely based on social, educational, and health care experiences; experiences in medical school; and the prospect of a 30-plus-year career in an area of medicine that provides a level of personal comfort, support, and fulfillment.”

Thomas B. Free Medical School Tuition: Will It Accomplish Its Goals? JAMA. 2019;321(2):143–144. doi:10.1001/jama.2018.19457

 

The specialization of medical care- the good and the bad

March 16 was Match Day. Not a match as in color choice for an outfit nor a match as in finding a spouse, but the concept is similar.

On Match Day,  graduating medical students learn which  residency program they will enter through the National Resident Matching Program , which “matches” them with available positions in residencies at medical centers all over the United States. A kind of medical “matchmaking” you could call it.

Why should you care? This matching process determines who will care for our medical needs in the next 30-40 years; our family physicians, internists, pediatricians, general surgeons, obstetricians, and the multitude of other medical specialties. Most doctors will continue in the same speciality their entire career, although some  switch after a few or many years.

doctor talking to a woman
Ted Epperly, M.D., consults a patient at his practice in Boise, Idaho.photo compliments American Academy of Family Physicians

 

Some medical students know what speciality they want to pursue before they enter medical school, while others decide after trying the different types of medicine while students. We still have the traditional specialities that most students enter- (there are also many subspecialities under each of these categories.)

Primary care 

  • Family medicine
  • Internal medicine -(adult medicine)
  • Pediatrics-children and adolescents
  • Obstetrics/Gynecology- care of women’s health and pregnancy

Surgical specialities

  • General Surgery-  surgery on skin and internal organs
  • Orthopedics-bones and joints
  • Otorhinolaryngology- ear, nose, throat
  • Ophthalmology-eyes
  • Neurosurgery-the brain, spine, nerves
  • Plastic and Reconstructive surgery
  • Cardiac and vascular surgery

Others 

  • Dermatology-skin
  • Psychiatry-mental health
  • Anesthesiology-surgical sedation and pain relief
  • Emergency medicine- emergencies and trauma
  • Radiology- xrays and other imaging-CT, MRI, US
  • Pathology-laboratory medicine
  • Allergy
  • Physical medicine and rehabilitation
  • Oncology-treatment of cancer
  • Integrative and complementary medicine

As medical care has become more complex and technological, so have the specialties of physicians. This has produced a plethora of new highly specialized fields of practice.

  • Sleep medicine
  • Medical genetics and genomics
  • Pain management
  • Geriatrics- care of the elderly
  • Palliative care-managing diseases that cannot be cured and are likely terminal
  • Hospital medicine-care of patients admitted to a hospital
  • Critical care medicine-care of patients in an ICU (intensive care unit)
  • Aerospace medicine
  • Wound management
  • Medical informatics – use of computers and medical software in medicine
  • Bariatrics- treatment of obesity with or without surgery
  • Sports medicine-treatment of athletic injuries and fitness training
  • Transplant medicine- surgery to transplant organs and after care
  • Addiction medicine

A recent viewpoint in JAMA suggested that we need a new specialty, virtual medicine, to describe physicians who treat patients through a virtual medium, telemedicine or  web based, on a computer or a mobile app.

Consider that in the early 1970s, there were only 20 medical specialties !

THE SURPRISING NEW DOCTORS CARING FOR YOU
photo from Lightstock.com(affiliate link) graphic created with Canva

 

 

 

What this means for you as a patient

According to the New England Journal of Medicine,

“the progress of biomedical science is a major factor in the emergence of new subspecialities. There are some patients who benefit from highly focused knowledge and skills.”

All of these specialities mean more medical  knowledge and experience will be  available to both treat and prevent a diverse and growing  variety of disorders.

Today’s new specialist will have a high degree of expertise in their field, making them better able to treat your problem in the most efficient, effective, safest way.

You may find your doctor recommends more testing which may lead to more treatment than might otherwise have happened; some of which may not necessarily improve outcomes. More specialized testing and treatments may increase the cost of medical care.

Dr. Sandeep Jauhar addresses this issue in this article from Time.

One Patient, Too Many Doctors: The Terrible Expense of Overspecialization

With a more narrow focus of experience, that doctor may be less familiar with other aspects of your medical status.

So, to close this gap, primary care physicians have become increasingly important to oversee and coordinate care, especially for complex patients.

So there was good news in the Match this year. The upward trend in students matching into family medicine continued for the ninth consecutive year . In 2018 more students matched into family medicine than in any  previous year, 3,535 compared to 3,237 in 2017. 

3,848 medical students and graduates matched to family medicine residency programs in 2019, the most in family medicine’s history as a specialty, and 313 more than 2018. The results marked a decade of growth in overall positions offered and filled for family medicine in the Match.

“The number and proportion of U.S. medical graduates going into family medicine is the strongest indicator of the future of the primary care workforce because family medicine is the only specialty completely devoted to primary care,”

said Michael Munger, MD, president of the American Academy of Family Physicians.

graphic provided by the American Academy of Family Physicians

 

My specialty-Family Medicine

I’ve often been asked ,”Why didn’t you specialize?” My answer, “I did. I specialize in Family Medicine.”

Once called “general practice”, Family Medicine is now a recognized specialty, requiring a residency and certification by  the American Board of Family Medicine.

 

Dr. Sandeep Jauhar wrote about his first year as a resident in

Intern: A Doctor’s Initiation

“In Jauhar’s wise memoir of his two-year ordeal of doubt and sleep deprivation at a New York hospital, he takes readers to the heart of every young physician’s hardest test: to become a doctor yet remain a human being.” ― Time

Lightstock photos

Unless otherwise stated, the doctor photos in the post are from the Lightstock.com collection . Get a free 30 day trial at this affiliate link. (This blog can earn a commission if you buy photos which helps support the mission of Watercress Words.)

sharing the HEART of health

Thank you for joining me to explore the surprising new doctors caring for you. I hope you’ve learned something. Please contact me about topics you want to read about.

Please share this and other posts on social media and consider my affiliates and ads that help fund this blog and support projects to deliver the HEART of health around the world.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

my regards, Dr. Aletha 

 

What women doctors want you to know about healthcare

September is Women in Medicine Month, so in this post I’m introducing you to some women physicians who promote health in creative ways-writing, speaking, coaching, and advocating.

September is Women in Medicine Month, so in this post I’m introducing you to some women physicians who promote health in creative ways-writing, speaking, coaching, and advocating.

At Dr. Momma Says, Dr. Deborah Burton, pediatric ENT surgeon reviews her reasons for recommending vaccination.

“The growing antivaccination (anti-vax) movement has me confused.  I think it is a developed world thing to celebrate where we are, but we forget where we came from.

As an ENT surgeon who has studied and worked in the healthcare field for about 30 years, I have borne witness to the miracles that vaccines have done. There is no question in my mind that vaccines work.” She goes on to describe

MY AUTHENTIC 30 YEAR JOURNEY REVEALING SPECTACULAR WAYS THAT VACCINES WORK

Recommended Child and Adolescent Immunization Schedule
2019 Recommended Vaccinations for children and adolescents

Psychiatrist Dr. Melissa Welby writes

“Anxiety is a treatable condition. Depending on the intensity, some people can get better on their own and others need therapy and/or medications to help with anxiety. Either way, recovering from anxiety is possible! There are great self-help options available to assist with the treatment of anxiety which includes websites, apps, and books on overcoming anxiety.” Find her list at this post-

48 Resources to Overcome Anxiety for Adults and Children

From Charmaine Gregory, M.D., an ER doctor and fitness coach blogs at Fervently Fit with Charmaine with nutrition and fitness tips.

“Trips to the grocery store are almost as crucial as trips to work. We all need to eat. Some people have stress when they try and go in without a plan. Creating a routine is a good step. Following a few helpful hints can make your shopping easier on you.” Read her tips at

Quick Tips for Easier Grocery Shopping

a basket filled with fruits and vegetables
Will you commit to buying, preparing, and eating more fruits and vegetables? image from LIGHTSTOCK.COM, stock photo site, an affiliate

Dr. Aletha Maybank , a pediatrician, served as deputy commissioner for the New York City health department and now is the first chief health equity officer for the American Medical Association. She believes

Good Health Goes Beyond Having a Doctor and Insurance

“Health is created outside of the walls of the doctor’s office and at the hospital. What are patients’ jobs and employment like? The kind of education they have. Income. Their ability to build wealth. All of these are conditions that impact health. “

(And I’m thrilled that Dr. Maybank and I share our first name.)

The Frugal Physician, Dr. D. writes about finances, specifically how to live debt free. Her main audience is other physicians but she offers advice to patients too.

“Take note of the deductible for your plan and whether your employer chips in. High deductible plans can be alluring because of their low cost and the option to enroll in a Health Savings Account (HSA).  But, if you sign up for one of those, make sure you have the cash to spend the deductible during the year. ” Read the other 9 tips at this link-

10 Ways to Maximize your Doctor’s Visit

a woman in white coat with mask over mouth
Know your health history and medications.

Dr. Eileen Sprys is a family physician who wants you to know

When you have a cold, why I’m not giving you an antibiotic

“I want you to know that as a physician, I feel a pang of insecurity, guilt, and sadness when a patient tells me they’re upset because I won’t write an antibiotic.  I don’t want you to be sick or miserable.

I understand how inconvenient and sometimes life altering a cold can be. I desperately, desperately wish that I had a cure for your cold, but none of us do.

I also want you to know that for every antibiotic I over-prescribe, that I run the unnecessary risk of making someone even more sick, even to the point of hospitalization or death. I went into medicine to help you and to relieve your suffering with integrity — and that by giving you antibiotics without indication, I am betraying my own purpose.”

six-facts-graphic

Emergency medicine physician K. Kay Moody, M.D. wants you to know she is not a “provider” (and neither am I).

“Hi, my name is Dr Moody and I’m NOT a “provider.”

.

Here’s why your doctor isn’t your “provider”.

“The term “provider” levels distinctions and implies a uniformity of expertise and knowledge among health care professionals. The term diminishes those distinctions worthy of differentiation such as education, scope and range of ability.

Generic terminology implies an interchangeability of skills that is inappropriate and erroneous, as well as conferring legitimacy on the provision of health services by non-physician providers that are best performed by, or under the supervision of, physicians.”

position of the American Academy of Family Physicians

a nametag reading ALETHA OGLESBY, M.D.

Women physicians are sharing the HEART of health

I appreciate my female colleagues who share their knowledge and experience through writing in addition to caring for patients. I am honored to share their insights here.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn. Thanks so much.

Dr. Aletha 

August Timely Topics- back to school

August is a strange month. It’s the only month without a major holiday. Although it still feels like the height of summer, by the end of the month kids are back in school. I remember the struggle to get my sons into bed early when it’s still daylight at 9 PM.

August is a strange month. It’s the only month without a major holiday. Although it still feels like the height of summer, by the end of the month kids are back in school. I remember the struggle to get my sons into bed early when it’s still daylight at 9 PM.

Photo by Pixabay on Pexels.com

August Timely Topics

Most schools encourage and even require vaccination to protect all children from disease. This has become a controversial and contentious topic so we’re going to visit the medical reason vaccinations make sense.

Measles-not gone, not forgotten

Recommended Child and Adolescent Immunization Schedule
from the Centers for Disease Control and Prevention

The start of school in August reminds me of my college days- especially since I met my husband in college, the University of Oklahoma. I was studying pre-med; he was in graduate school, using his veterans’ educational benefit after discharge from the Army. Here are a couple of posts about his military service and our courtship.

Bullets to Blessings

Two Words and Two Left Feet

Of course, the main goal of school is education- lectures, textbooks, assignments, studying, projects, experiments, and tests. Reading is vital to all of these-books are the basic building blocks. That’s why Dolly Parton gives books away- read why here.

Overcoming the Dream Killers

Overcoming the dream killers-Watercress Words.com

Can medical knowledge make you a better patient?

And speaking of tests, here’s one for you. Find out how much you know about medicine by taking this quiz that I wrote especially for blog readers.

CAN MEDICAL KNOWLEDGE MAKE YOU A BETTER PATIENT?

sharing the HEART of health

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

                              Dr. Aletha 

These are affiliate links you may find helpful and which help fund this blog with a commission when a purchase is made using them.

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My Reader Rewards Club is a great way to earn free books and Bibles for yourself, friends, and family! Your journey to earning free faith-based products starts HERE.
(When you sign up through these links, I can earn free books too.)

As a member, you’ll have access to inspiring literature, Bibles, special promotional offers, and much more. Earning points is easy—you’ll receive 25 points just for signing up!

Get active

Summer is the perfect time to start or increase physical activity. I’ve been using a fitness app on my phone, Aaptiv. Consider trying it. I’d appreciate you using this affiliate link through which you can help fund this blog. Thanks and enjoy.

July Timely Topics- Celebrations and Souvenirs

For July topics we’ll look at summer safety and wellness. We often call winter the cold and flu season, so we could call summer the poison ivy, sunburn, and blister season. Unfortunately, it’s also the season for drownings and water sport accidents.

Where I live, we just saw the first day of summer come and go. It was the longest day of the year and so far one of our hottest. Summer activities are in full swing. Many of the patients I see now are either just coming back from a vacation or getting ready to leave. I envy them because I am staying home since my husband is recovering from a broken ankle that dashed our plans for a summer trip.

Join My Reader Rewards Club to earn free books and Bibles
Check out MY READER REWARDS CLUB– it’s free and you can earn free stuff

For July topics we’ll look at summer safety and wellness. We often call winter the cold and flu season, so we could call summer the poison ivy, sunburn, and blister season. Unfortunately, it’s also the season for drownings and water sport accidents.

Here in the United States we have our most important holiday of the year-Independence Day, or commonly called the 4th of July. On this day in 1776, the North American colonies of England declared political independence, and the rest, as they say, is history. Much has happened in the 243 years since, and the United Kingdom is now an ally; an American citizen, Meghan Markle, recently married into the British royal family. Friendship is worth pursuing between people and countries.

Statue of Liberty
Lady Liberty lifting her torch in New York harbor

Here are links to July’s Timely Topics, or just search for what interests you

Life, Liberty, and the Pursuit of Healthcare

Don’t drink the water-how to avoid water related illness

Safe and healthy cruising-keys to an enjoyable vacation

5 insect repellents to keep you safe this summer

Christmas in July

Happy Campers

sharing the HEART of health

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

                              Dr. Aletha 

My Reader Rewards Club is a great way to earn free books and Bibles for yourself, friends, and family! Your journey to earning free faith-based products starts HERE.
(When you sign up through these links, I can earn free books too.)

As a member, you’ll have access to inspiring literature, Bibles, special promotional offers, and much more. Earning points is easy—you’ll receive 25 points just for signing up!

Get active

Summer is the perfect time to start or increase physical activity. I’ve been using a fitness app on my phone, Aaptiv. Consider trying it. I’d appreciate you using this affiliate link through which you can help fund this blog. Thanks and enjoy.

Can medical knowledge make you a better patient? Take this quiz.

The purpose of board certification is to make sure you, the patient, are getting the best care possible from a physician.

Parents and educators in my state have been debating the merits of standardized testing for school children and maybe where you live also. And it’s not just a question for children, adults can be subjected to professional testing also.

After I finished my family medicine residency, I took an 8 hour paper multiple choice written exam to become certified by the American Board of Family Medicine (ABFM). And every 10 years since I have taken the test to re-certify. (Originally it was every 7 years).

The purpose of board certification is to make sure you, the patient, are getting the best care possible from a physician. According to the ABFM,

We promise that board certification means that the family physician you choose for your care meets high standards. 

My certification expires at the end of 2019.

Eventually the Board transitioned to a computer based exam taken at a local testing center, still 8 hours long. This year they are trying something new- doctors can take the test on their own computer or tablet whenever and wherever they choose.

The new system is a trial and voluntary. Those of us who have chosen to do it give feedback on the process, what we like and don’t like about it. They hope this will prove to be a workable system that eventually everyone will do.

Here is another experience and opinion about the exam from Clif Knight, M.D. , who is the AAFP’s senior vice president for education.

Certification Pilot Proves Worthy Alternative

a male doctor using a tablet while working
Doctors can answer questions on a computer or tablet any time of day or night.

This exam consists of 25 questions posted quarterly over 3 years, with a 5 minute time limit for each question . Besides being able to take the exam in my pajamas, I can research the answers online if I need to-as long as I can do it in 5 minutes. The rules prohibit me from discussing the questions with another person, based on an honor system that I attest to before beginning each session. Being able to look up information is more like actual medical practice.

More aligned with adult learning principles, this approach allows for use of references and promotes greater retention of new knowledge to be applied in daily practice.

ABFM web site

You can learn more about the value of board certification at this link

American Board of Family Medicine Patient Page

While board certification is a voluntary process, many organizations prefer or require the physicians they hire or work with to be board certified.

Take an “exam” designed for patients

I thought I would give you a taste of what I am doing by creating a patient certification exam for you. The rules prohibit me from sharing actual test questions so I have written my own, in simple medical terms, but using a format similar to the questions I answer.

When I answer questions, I get immediate feedback if my answer was right or wrong, with an explanation and a reference. So I have done the same for you. In this case, the reference is from a blog post I have written.

There’s no time limit for each question and for this exam, feel free to discuss your answers with someone else, I encourage you to. Choose the single best answer. Check at the end for the correct answers.

I had fun writing these questions so I hope you have fun answering them. Good luck! I hope you pass.

Question 1

A woman came to her doctor with a skin rash soon after starting to take a new medication. The medication is most likely

  1. An Antidepressant
  2. A blood pressure lowering drug
  3. An anti-inflammatory drug
  4. An antibiotic

Question 2

A 25 year old woman notices that the skin on her face has darkened over the past several months. This condition is called

  1. Melasma
  2. Eczema
  3. Psoriasis
  4. Tinea

How common meds hurt skin

Skin: Epidermis and Dermis illustration
Line drawing showing cross-section of dermal and epidermal skin layers. National Cancer Institute Creator: Unknown Illustrator This image is in the public domain and can be freely reused. Please credit the source and, where possible, the creator listed above.

Question 3

A mother brings her 8 year old daughter to her family doctor. The child has a cough, runny nose, and mild sore throat. Her temperature is 100.2 degrees. The doctor diagnosed the illness as a cold, or upper respiratory infection and explains this is caused by a virus. She does not prescribe an antibiotic because

  1. The child is allergic to penicillin
  2. The family does not have health insurance
  3. The mother has left over antibiotic from another child at home.
  4. An antibiotic will not help an infection caused by a virus.

How to cope with winter illness

Question 4

A 30 year old woman comes to her doctor because she is losing an excessive amount of hair. She is afraid she will become bald. Most likely she

  1. Started using a cheap shampoo
  2. Delivered a baby
  3. Needs vitamins
  4. Should investigate hair implants

Effective solutions if you experience hair loss

Question 5

Dr. Oglesby believes that certain medications should be used more often because of their benefit to patients. These drugs include all except

  1. Antibiotics
  2. Vitamins
  3. Sleeping pills
  4. Stop smoking drugs

7 underused drugs

Question 6

A young man who is a computer programmer has difficulty falling asleep. His doctor may recommend

  1. Buy a new mattress
  2. Taking a sleeping pill an hour before bedtime
  3. Regular exercise and relaxation techniques
  4. Watching television until he falls asleep

Expert advice to sleep

a simple bed, window shade down, small lamp on a side table

Question 7

Author and motivational speaker Nick Vijucic was born with amelia. This term means he lacks certain parts of his body which are his

  1. Limbs
  2. Eyes
  3. Ears
  4. Teeth

Light and life without limbs

Question 8

A woman sees her doctor because she researched her symptoms online and believes she has endometriosis. She thinks this because

  1. She does not have regular periods.
  2. She had a miscarriage.
  3. She has not been able to get pregnant.
  4. Her sister has it.

Women’s health update

Question 9

The HPV (human papilloma virus) causes cancer. Vaccination against this virus decreases the risk of cancer of the

  1. Cervix
  2. Uterus
  3. Breast
  4. Ovary

Women’s health update

Question 10

Kristin Chenoweth, Tony Award winning actress and singer, suffers from Meniere’s syndrome. She was born in a small town in Oklahoma named

  1. Muskogee
  2. Broken Arrow
  3. Ada
  4. McAlester

Kristin Chenoweth– a review of her memoir

a letter jacket, bag, and shoes, belonging to Kristen Chenoweth
Kristin’s jacket from high school on display at the Performing Arts Center

ANSWERS TO QUESTIONS

  1. The most common drug that causes a skin rash is an antibiotic.
  2. Melasma
  3. Antibiotics do not help a cold or any other viral infection
  4. delivered a baby; hair loss is common after pregnancy
  5. Stop smoking drugs can be useful to help smokers quit. The other drugs listed are often overused.
  6. Exercise and relaxation can improve one’s sleep.
  7. Nick was born without limbs.
  8. Infertility is a common symptom of endometriosis.
  9. Cancer of the cervix is caused by the HPV virus.
  10. Broken Arrow. The other Oklahoma towns produced Carrie Underwood, Blake Shelton, and Reba McIntyre.

testing the HEART of health

Thanks for testing your knowledge with this first ever Watercress Words Certification Exam. If you liked it, let me know, maybe we’ll do it again.

I appreciate all of you who follow this blog; there are numerous other blogs to choose from so I am honored you chose to spend some time here. A special welcome to all my new followers from this past month.

To start following Watercress Words , use this form to get an email notification of new posts . Please find and follow me on Facebook, Pinterest and LinkedIn, links are on the left side bar here and the Home page. Thanks so much.

                              Dr. Aletha 

(This post contains affiliate links which, by paying a commission if used for a purchase, help fund this blog. )

RoboForm Password Manager. What I use to manage passwords.

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