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.

Go to this link to try RoboForm Free; if you like it you can upgrade to RoboForm Everywhere version with all the features I mentioned above. With Roboform, you will have one less thing to feel stressed about.

Do you know the best questions to ask about your healthcare?

expectations, concerns, obstacles-medical communication #askthedoctor

I blog about healthcare communication because you need to understand your doctor better and  we doctors need to understand our patients’ expectations, concerns and obstacles.

Physicians should  use clear understandable plain language with patients. Patients should also be clear and specific when they talk to their doctor.

You may think your doctor knows exactly what you mean, but sometimes we are left trying to read between the lines of what you tell us.

Dr. Aletha talking to a mother and her son
Talking to a patient through an interpreter makes communication extra challenging.

You know it’s important to tell us details of your symptoms, medical history, family history, habits, and other medical facts.   But besides medical information about you , we need to know

Your expectations about your care,

Your concerns about your care,

Your obstacles to getting care,

You may wonder, won’t or shouldn’t my doctor ask me theses questions? Sure, we can ask and probably will, but by volunteering it , you start dialogue that gets you and your doctor communicating effectively much faster. Your doctor knows about disease, but you as the patient know the experience of the illness much better. 

Let me illustrate by giving you some examples. These are all statements patients say  to me in my daily practice. The original statements aren’t bad or wrong, but by rephrasing to add some additional detail they  give your doctor valuable information that will help provide you the best care possible.

The underlined words can be substituted for others listed in parentheses.  The exact words aren’t as important as the  message they convey. 

Hello doctor, I’m here because I want my thyroid checked.

(substitute heart, lungs, cholesterol, blood sugar, kidneys, etc.)

Instead try-

Hello doctor, I’m tired a lot, and wondered if it might be a thyroid problem or something else. What testing would help us find out what’s wrong with me?

It’s better not to limit your doctor to checking just one thing, when there are many possible explanations for your symptoms. You expect a thyroid check, but you’re open to other possibilities.

tubes used to collect blood samples in a lab

 

Doctor, I feel terrible and think I have  pneumonia. The last time I felt like this the doctor said it was pneumonia, so it must be that again.

( sub kidney infection, strep throat, sinus infection)

But if you say this

Doctor, I feel so sick. This illness is similar to when I was diagnosed with pneumonia and I’m afraid I have it again. I am concerned it’s pneumonia again so  I’m here to find out what is wrong, as I realize it may be something else.

You’ve told the doctor your concern about pneumonia but you’re not trying to diagnose yourself.

 

 

I have a family history of cancer so I want to have a mammogram.

(sub any other cancer, heart disease, stroke and other tests)

That’s good, but this is better.

Doctor, I’m concerned about breast cancer as it runs in my family. My grandmother was diagnosed at age 45 and now my sister has been, and she is 40. Do I need a mammogram or any other testing now?

Knowing who in your family had a disease and at what ages helps the doctor make an accurate recommendation. It also tells your doctor this may be an emotional issue  (concern)  for you.

Top 10 cancers in the U.S.

 

 

I need an antibiotic (anti-inflammatory, muscle relaxer, steroid, shot )  for this; I know because my previous doctor always gave me one for this.

Please try this instead:

When I had this before my doctor prescribed an antibiotic; I wonder if that would be appropriate this time?

This tells the doctor your expectation, but also that  you are open to different  advice/recommendation. (and avoid getting a medication you don’t need.) 

6 smart facts about antibiotic use

 

 

 

Will my insurance pay for this? How much will this cost me? Is this an expensive drug?

Patients may expect us to know about insurance and cost, but often we don’t. We can work with you on financial issues if we know more about your obstacle. Try asking-

I need to find out if this is covered by my insurance. Can someone in your office look that up, or help me find out?

I’ve had a lot of medical bills this year that have stretched my budget. I will need to find out what my out of pocket cost will be before scheduling this test. Can your office help me with that?

If there is a generic version of this drug that will work just as well, I would like it, to minimize my out of pocket cost. If not, is there another alternative?

 

 

Is this drug safe? (effective, good, best, dangerous, harmful)  

Few things are 100% safe. But what we can discuss with you is –

What are the risks and side effects of this drug? Is the benefit I get from the drug worth the risks? Are there alternatives that would be effective and less risky?

We always should be concerned about drug use, and safety isn’t the only issue. Don’t hesitate to ask questions.

medication capsules

 

 

 

 

 

How long will I be off work? When can I go back to work?

Here’s what your doctor needs to know –

My job requires me to stand and walk for several hours?

(sit and type; talk on the telephone; drive long distances in my car)

And here’s what you need to ask:

How soon should I expect my stamina to return so I can work part time? Full time?

When can I safely work without interfering with my recovery?

What can I do to hasten my recovery so I can return to work sooner?

Both  you and your employer, need to know when it is safe to return to work.  We have to balance health concerns with your financial concerns and what is expected and allowed by your employer and the law. 

If you are clear  with your concerns and obstacles  and flexible in your expectations it will be easier for your doctor to make the right decision.

 

 

These are just a few examples. I’m sure you can think of others.

Whenever you have a need to consult a physician, think ahead of what your

expectations, concerns and obstacles are before you make the visit so you’ll  be

prepared to share .

Here are  more tips on talking with your doctor-

How to talk to your doctor to improve your medical care

How to tell your doctor what’s wrong with you.

I invite you to follow this blog as we explore the HEART of health together.

 

Dr. Danielle Ofri’s book  What Patients Say, What Doctors Hear,

details the reasons doctors and patients don’t communicate well

and offers ways to improve our interaction.

What Patients Say, What Doctors Hear by Danielle Ofri, MD
written by Danielle Ofri, M.D.

(this is an affiliate link)