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.

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March Timely Topics-doctors, spring, and sleep

March comes “in like a lion and goes out like a lamb” -at least where I live. But March also concludes with Doctors’ Day on March 30, a day to recognize physicians and their service to our health needs.

March comes “in like a lion and goes out like a lamb” -at least where I live. But March also concludes with Doctors’ Day on March 30, a day to recognize physicians and their service to our health needs.

Rather than waiting til the end, I will share stories by and about physicians all month long here and on social media.

March timely topics include

  • winter health concerns
  • spring health issues
  • sleep changes due to Daylight Saving Time change

faith, hope, and love

And in the faith, hope, and love selections we’ll remember St. Patrick and meditate on devotions for Lent.

Good-by Google+

Sometime in April the Google+platform will end. Thanks to all of you who followed and shared my posts there. Please continue following me here and on other social media.

I am most active on Facebook and Pinterest, but you can also find my blog posts at Twitter and LinkedIn.

with my thanks

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.

You will find links to the Timely Topics on the Home page and on the right sidebar on every post (you may need to scroll down to find them on a mobile or tablet)

Here are some affiliate links you may find helpful. Thanks for considering.

                              Dr. Aletha 

Free Babsy Board Books! Spring Promotion – $5 off $45 @ eBooks.com. Use Code: springebookscp. Valid until June 20.

Expert advice to sleep well every night

Most of us have trouble sleeping occasionally, but if you persistently have difficulty with sleep, you may have a medical condition associated with sleep disturbances such as sleep apnea, restless legs syndrome, depression, or PTSD.

If you live somewhere that observes Daylight Savings Time, you get an “extra” hour of sleep the first Sunday in November when you revert to standard time; unfortunately you lose that hour in the spring when DST starts.

But just like the jet lag from travel, these time changes can interrupt our sleep schedule for a few days. And if you already have trouble sleeping, it’s even more of a problem.

Here’s a review of what sleep professionals recommend to help. But for persistent or severe problems, see your own doctor to get started.

 

person sleeping on a couch
Sometimes getting a good night’s sleep can be a challenge.

 

(Affiliate links are used in this post.It costs nothing extra to shop through these links and this blog may earn a small commission, which funds its existence. )

What is Chronic Insomnia ?

Most of us have trouble sleeping occasionally, but if you persistently have difficulty with sleep, you may have a medical condition associated with sleep disturbances. These include

  • sleep apnea
  • restless legs syndrome
  • depression and/or anxiety
  • post-traumatic stress disorder

Some people have true chronic insomnia, meaning persistent sleep difficulty alone. There are various criteria to diagnose chronic insomnia but in general include

  • difficulty falling or staying asleep
  • at least 3 nights per week for at least 1-3 months
  • with impairment of daytime function, such as fatigue/sleepiness, poor concentration, irritability, school or work dysfunction
EXPERT ADVICE TO SLEEP WELL EVERY NIGHT

How is chronic insomnia managed ? 

First step in treatment of chronic insomnia as well as occasional difficulty sleeping  is identifying and treating any underlying medical issues that might contribute to poor sleep. In addition to the ones mentioned above these include

  • pain, of all kinds
  • heartburn (gastroesophageal reflux)
  • congestive heart failure
  • lung diseases like asthma  causes nighttime breathing difficulty
  • menopausal night sweats

Sleep specialists recommend non-drug management of chronic insomnia and reserve sleep medications for more resistant cases. 

Sleep meds were one of the 7 drugs that are overused in my previous post.

a bed with ornate headboard
photo by Dr. Aletha- at the Hemingway house, Key West, Florida

(Read more about Ernest Hemingway’s preserved Florida home at this previous post)

Hemingway’s study- chaos and creativity

 

 

 

Sleep hygiene management

Experts recommend sleep hygiene , basically lifestyle changes, as the initial treatment. Some people have developed bad habits in regards to sleep that need to be unlearned and new behaviors put in place.

For optimal sleep you should

  • Engage in regular exercise- moderate intensity , tai chi , yoga and low-impact aerobic exercise
  • Avoid evening large meals
  • Limit caffeine, tobacco and alcohol
  • Use the bedroom only to sleep and for sex
  • Maintain a regular bedtime-awake schedule
  • Avoid daytime naps
  • Avoid distracting stimuli at bedtime-watching television, using electronic devices, talking on the phone
  • Stay in bed only while sleep

How to dim the lights

The light from electronic devices- clocks, thermostats, televisions, monitors-can disturb your sleep even after you turn off  your phone and tablets. This light can be blocked by stick on light blocking covers than can block out the majority of it.

Light from my clock made it hard for me to fall asleep before I discovered these products. With them I fall asleep easier, and can fall back asleep if I wake up.

Maintaining a regular schedule helps to set or reset your  sleep/wake cycle. So go to bed at the same time every night and wake up at the same time every morning.

However, if you can’t  sleep, rather than lie in bed awake, you should get up, do a non-stimulating activity, then return to bed when sleepy.

woman typing on a laptop keyboard.
Using a computer, laptop, or tablet before going to bed can impair sleep.

If you have persistent sleep loss, consider more intensive therapy by a professional.

Cognitive behavior therapy for insomnia , CBT-I , significantly improves chronic insomnia and daytime functioning and is recommended as first line therapy.

CBT-I combines cognitive therapy with sleep restriction, relaxation training and stimulus control.

Treatment typically requires 5-8 sessions conducted by a health professional trained in its use. Patients need to participate by keeping a sleep diary and writing down daily thoughts in a journal, while continuing with the sleep hygiene practices mentioned above.

person writing in a spiral notebook
Writing thoughts in a journal is often encouraged in cognitive behavioral therapy. (photo from the Lightstock.com collection)

Insomnia sufferers can also get help from an online web-based CBT-I, Sleep Healthy Using the Internet , SHUTi.

One study found 70% of those participating improved their sleep, compared with 43% who received education only.  If you  can’t find a trained therapist or don’t have time for office based therapy, this may be a good option.

 

 

 

SleepPhone by Acoustic Sheep

A physician, Dr. Wei-Shin Lai had trouble falling asleep after being awakened at night by calls from the ER. Her husband suggested listening to relaxing music to help her fall asleep.

She designed a comfortable headphone for her own use, and eventually started a company to make and sell them . You can try her SleepPhone  made by her company AcousticSheep.

Manage stress, learn to relax

If you have  occasional trouble sleeping due to stress,  relaxation techniques can help you.  Techniques include  meditation, yoga, imagery, abdominal breathing and muscle relaxation techniques . These can reduce tension and anxious thoughts that inhibit sleep onset and maintenance.

You may find these ideas from a previous post helpful .

5 steps to manage stress and strain

man with hands folded over a book

 

 

Expert advice from physicians

Think alcohol will help you sleep better ? Read this advice from a psychiatrist, Dr. Melissa Welby.

The truth about alcohol and sleep

Curious about sleep apnea? Dr. Deborah Burton offers this review of another common sleep problem.

EVERYTHING YOU NEED TO KNOW ABOUT DIFFERENT SLEEP APNEA TYPES

exploring the HEART of healthy sleep

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.

My goal is to bring health and wholeness to everyone who seeks it and hope you will join me.  Please visit my resources page.

Dr. Aletha 
26952564_10213093560871954_4239554644472378905_o

This post was featured at Thursday Favorite Things Link Up

Expert advice to sleep well every night

What medical experts recommend to sleep well without drugs

 

 Almost everyone has trouble sleeping occasionally, but for some it is a frequent or persistent problem. Here is information that may help.

person sleeping on a couch
Sometimes getting a good night’s sleep can be a challenge.

(Affiliate links are used in this post.It costs nothing extra to shop through these links and this blog may earn a small commission, which funds its existence. )

What is Chronic Insomnia ?

Most of us have trouble sleeping occasionally, but if you persistently have difficulty with sleep, you may have a medical condition associated with sleep disturbances. These include

  • sleep apnea
  • restless legs syndrome
  • depression and/or anxiety
  • post-traumatic stress disorder

Some people have true chronic insomnia, meaning persistent sleep difficulty alone. There are various criteria to diagnose chronic insomnia but in general include

  • difficulty falling or staying asleep
  • at least 3 nights per week for at least 1-3 months
  • with impairment of daytime function, such as fatigue/sleepiness, poor concentration, irritability, school or work dysfunction

How is chronic insomnia managed ? 

First step in treatment of chronic insomnia as well as occasional difficulty sleeping  is identifying and treating any underlying medical issues that might contribute to poor sleep. In addition to the ones mentioned above these include

  • pain, of all kinds
  • heartburn (gastroesophageal reflux)
  • congestive heart failure
  • lung diseases like asthma  causes nighttime breathing difficulty
  • menopausal night sweats

Sleep specialists recommend non-drug management of chronic insomnia and reserve sleep medications for more resistant cases. 

Sleep meds were one of the 7 drugs that are overused in my previous post.

a bed with ornate headboard
photo by Dr. Aletha- at the Hemingway house, Key West, Florida

(Read more about Ernest Hemingway’s preserved Florida home at this previous post)

Hemingway’s study- chaos and creativity

Sleep hygiene management

Experts recommend sleep hygiene , basically lifestyle changes, as the initial treatment.

For optimal sleep you should

  • Engage in regular exercise- moderate intensity , tai chi , yoga and low-impact aerobic exercise
  • Avoid evening large meals
  • Limit caffeine, tobacco and alcohol
  • Use the bedroom only to sleep and for sex
  • Maintain a regular bedtime-awake schedule
  • Avoid daytime naps
  • Avoid distracting stimuli at bedtime-watching television, using electronic devices, talking on the phone
  • Stay in bed only while sleep

 

 

How to dim the lights

The light from electronic devices- clocks, thermostats, televisions, monitors-can disturb your sleep even after you turn off  your phone and tablets. This light can be blocked by stick on light blocking covers than can block out the majority of it.

affiliate link

Light from my clock made it hard for me to fall asleep before I discovered these products. With them I fall asleep easier, and can fall back asleep if I wake up.

 

 

 

Maintaining a regular schedule helps to set or reset your  sleep/wake cycle. So go to bed at the same time every night and wake up at the same time every morning.

However, if you can’t  sleep, rather than lie in bed awake, you should get up, do a non-stimulating activity, then return to bed when sleepy.

woman typing on a laptop keyboard.
Using a computer, laptop, or tablet before going to bed can impair sleep.

 

 

 

If you have persistent sleep loss, consider more intensive therapy by a professional.

Cognitive behavior therapy for insomnia , CBT-I , significantly improves chronic insomnia and daytime functioning and is recommended as first line therapy.

CBT-I combines cognitive therapy with sleep restriction, relaxation training and stimulus control.

Treatment typically requires 5-8 sessions conducted by a health professional trained in its use. Patients need to participate by keeping a sleep diary and writing down daily thoughts in a journal, while continuing with the sleep hygiene practices mentioned above.

person writing in a spiral notebook
Writing thoughts in a journal is often encouraged in cognitive behavioral therapy. (photo from the Lightstock.com collection)

 

 

Insomnia sufferers can also get help from an online web-based CBT-I, Sleep Healthy Using the Internet , SHUTi.

One study found 70% of those participating improved their sleep, compared with 43% who received education only.  If you  can’t find a trained therapist or don’t have time for office based therapy, this may be a good option.

SleepPhone by Acoustic Sheep

A physician, Dr. Wei-Shin Lai had trouble falling asleep after being awakened at night by calls from the ER. Her husband suggested listening to relaxing music to help her fall asleep.

She designed a comfortable headphone for her own use, and eventually started a company to make and sell them . You can try her SleepPhone  made by her company AcousticSheep.

SleepPhones

 

 

Manage stress, learn to relax

If you have  occasional trouble sleeping due to stress,  relaxation techniques can help you.  Techniques include  meditation, yoga, imagery, abdominal breathing and muscle relaxation techniques . These can reduce tension and anxious thoughts that inhibit sleep onset and maintenance.

You may find these ideas from a previous post helpful .

5 steps to manage stress and strain

 

man with hands folded over a book

Expert advice from physicians

Think alcohol will help you sleep better ? Read this advice from a psychiatrist, Dr. Melissa Welby.

The truth about alcohol and sleep

Curious about sleep apnea? Dr. Deborah Burton offers this review of another common sleep problem.

EVERYTHING YOU NEED TO KNOW ABOUT DIFFERENT SLEEP APNEA TYPES

 

 

 

 

Please share on your social media sites and follow Watercress Words as we continue to explore the heart of health. My goal is to bring health and wholeness to everyone who seeks it and hope you will join me.  Please visit my resources page.

Dr. Aletha 26952564_10213093560871954_4239554644472378905_o