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

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.

Advertisements

A simple way to help your doctor beat burnout

 

What would you say to your doctor on your deathbed?

Would you remind them of the times you waited weeks  for an appointment or sat  in the waiting room long past your scheduled appointment time?

Would you ask them why they didn’t try harder to cure you? Would you ask why all the tests and medicines they ordered didn’t work to save your life?

Or would you ask, “How was your vacation?”

family skiing on mountain

one of many vacations with my family 

 

 

A patient named Rosemary

One woman did. In a JAMA  essay (Journal of the AMA), Dr. Wendy Stead , an internal medicine physician, described her patient, Rosemary, who “never had a bad interaction with any of her health professionals. After a clinic visit, or hospital stay, she will rave about the excellent care she received from the many teams involved.”

“This is not because we are all such exceptional caregivers.” she admitted. “It is because of the kind of patient she is..the kind who probes for the person behind the doctor.

When Rosemary was terminally ill, Dr. Stead left on a family vacation, fearing that her patient would die while she was gone. As soon as she returned, she went to Rosemary’s home to visit one last time.

Now so weak, Rosemary was confined to bed, and could barely speak. As Dr. Stead leaned over the bed straining to hear her, Rosemary asked,  “How was your vacation?”

 

Probe for the person behind the doctor

 

Dr. Aletha dancing

I actively pursue a hobby-ballroom dancing.

 

 

Do you know if your doctor has children or grandchildren?

What hobbies they pursue?

Who is their favorite sports team?

 

 

 

 

My husband and his eye doctor share an interest in  the Oklahoma City Thunder basketball team. At each visit, he and Dr. Nanda spend a few minutes discussing the team’s progress, good or bad.  It makes what otherwise would be a dry, routine visit into a special occasion. I think Dr. Nanda enjoys it as much as Raymond does.

Chesapeake Arena

Chesapeake Arena, home of our beloved Thunder Basketball team – Dr. Nanda has season tickets and follows the team closely.

 

 

 

 

 

 

 

 

 

When I was expecting my second son, William and Audrey became my patients. William had multiple serious health conditions but he was always positive and never complained.

During his frequent office visits, they never failed to inquire about the progress of my pregnancy. After I delivered they always asked about my new baby boy.

When I walked into the exam room, William’s first words were always, “How are you Doc?” And the next words were, “How’s the baby?”- even though by the time William passed away, my “baby” was in kindergarten.

woman with a toddler

Me with “the baby”

 

 

 

 

 

 

 

 

Seeing doctors and patients as people

For physicians, our patients’ “social histories” help us understand factors in your life that impact your health -where you live, your job, your family, your hobbies . Besides that, we enjoy getting to know you, especially the things that make you and your life unique and interesting. Dr. Stead points out that when our patients learn our social history we “build an even stronger bridge that goes both ways.”

Now you probably won’t have the time or interest to “probe” every doctor you see, maybe just those you see regularly . Exchanging a few social words can make the encounter more satisfying for both of you. Some of us will be more open about sharing our personal lives, and some subjects may be off limits. But I don’t think any of us will object to honest, caring interest in our lives outside of medicine.

“As healthcare professionals we like to think of compassion as a limitless resource, but some days even the deepest well can feel like it’s running dry. Patients like Rosemary refill the well. They make us better doctors for all our patients.” Dr. Stead 

 

Burnout- bad for doctors and patients

Leaders in the medical community recognize the high and increasing rate of burnout in physicians. In burnout, physicians feel exhausted,  lack enthusiasm about work, lose motivation, and feel cynical about the value of the medical profession. Some estimate as many as 50% of physicians in the United States experience burnout.

Perhaps even more common among physicians is compassion fatigue, which can affect anyone involved intensely in helping others. Compassion fatigue occurs when a helper begins to feel overwhelmed and stressed from their efforts to relieve the pain and suffering of those they help. As they give more of themselves and neglect self care, they in turn become traumatized by their own efforts.

(Photo credit-American Academy of Family Physicians)

 

Doctors on the “front lines” of medicine -family physicians, emergency physicians, internists, pediatricians, psychiatrists- are especially vulnerable to burnout and compassion fatigue as are other health care workers, police, social workers, teachers and disaster workers.

 

 

 

 

 

Why should you care about physician burnout and compassion fatigue?

Factors causing physician burnout include the technological and bureaucratic hassles in medical practice that hinder doctors from spending adequate and quality time with patients and interfere with our ability to care for patients in the way we believe is best.

Studies suggest that burnout causes physicians to spend less time providing direct care to patients, and that care may be less efficient and effective. 

 

According to observational studies of physicians at work, we spend 50% of our time doing paper/computer work about the care we provide the other 50% of the time. (photo credit- American Academy of Family Physicians)

 

 

 

 

 

March 30 is National Doctor’s Day, a day designated by Congress to honor doctors.

One way you can honor your doctor is by trying to connect personally next time you visit. By doing so, you may get a glimpse of the “person behind the doctor” ; empathy can go both ways. If you see your doctor as a person with a life not that different from yours, you may see your interaction as a partnership and  find it easier to communicate .

And better communication can lead to better care for you. See my previous post

3 keys to effective communication with your doctor

Why patients sue their doctors

Dr. Aletha examining an infant on a volunteer trip

Volunteering to serve where we are most needed is one way physicians can recover from burnout and compassion fatigue.

 

Read  here about how government regulations contribute to physician stress

And here about efforts to reverse and prevent physician burnout

 

 

 

 

 

Thanks for exploring the HEART of health with me. Please consider these affiliates which help this blog inform and inspire wellness and wholeness throughout the world.

Dr.Aletha a world globe with two crossed bandaids

 

 

 

 

The doctor will NOT see you NOW

Among the things about medical practice that both patients and physicians dislike, probably the most annoying is tardiness. We have all (and I mean me also) waited much too long in doctors’ waiting rooms and/or exam rooms. Sometimes I don’t mind waiting, at a doctor’s office or anywhere else. It may be the only few minutes of the day I get to sit, relax, read a magazine, or catch up on Words With Friends on my phone. But no one likes having their time wasted.

There are probably as many reasons why doctors run late as there are doctors. Sometimes it’s patient load, practice style, support staff, interruptions, electronic medical records, hospital rounds, emergencies, scheduling pattern.

In this engaging article , Dr. Sanaz Majd describes  a typical family physician’s day- running late of course.

via House Call Doctor : Why Is My Doctor Always Late? :: Quick and Dirty Tips ™.

 

I once worked with a physician who was habitually late; but his patients didn’t seem to mind, they were loyal, and he always had a full schedule. He took his time and patients knew that when it was their turn, they had his full attention for however long it took.

Ultimately you have to decide how important punctuality is to you and choose your physician accordingly. And if your usually prompt doctor occasionally runs behind, I hope you will be understanding, knowing next time you may be the patient who caused the delay.

Some of the Vietnamese people who waited to see our medical team who travelled there  as volunteers with Vets with a Mission