Hope Alexander MPH

Posts Tagged ‘doctor’

Hope is attending the Anaesthetists Expert Working Party meeting.

Date
Thursday 15th April 2010

Agenda

10.00  Welcome and overview of meeting objectives – Linda MacPherson

10.10  Summary of results Kirsten Armstrong

10.30  Facilitated discussion:

• Feedback on report

• Identification of recommendations – Lorraine Acheson

12.15  Next steps and close – Linda Macpherson

Hope will be attending the following Clinical Senate meeting on 26 March 2010 in Perth, Western Australia.

Event: 26 March 2010 - Pre-Hospital Assessment - Avoiding the Revolving Door

For Debate

Vertebroplasty for painful acute osteoporotic vertebral fractures: recent Medical Journal of Australia editorial is not relevant to the patient group that we treat with vertebroplasty

William A Clark, Terrence H Diamond, H Patrick McNeil, Peter N Gonski, Glen P Schlaphoff and John C Rouse MJA 2010; 192 (6): 334-337(see link below)

Abstract

We use vertebroplasty for patients with the most severe pain caused by osteoporotic vertebral fractures less than 6 weeks old, and have observed dramatic pain relief in this acute setting.

A recent editorial in the Journal, written by the authors of two recent vertebroplasty trials, suggested that vertebroplasty is not an effective therapy for acute osteoporotic vertebral fractures.

The trials described in the editorial sampled a very different patient cohort to the one that we treat with vertebroplasty.

Our clinical experience and most of the published literature relating to the benefits of vertebroplasty are in striking contrast to the opinions presented in that editorial.

©The Medical Journal of Australia 2010 www.mja.com.au

Vertebroplasty for painful acute osteoporotic vertebral fractures: recent Medical Journal of Australia editorial is not relevant to the patient group that we treat with vertebroplasty
William A Clark, Terrence H Diamond, H Patrick McNeil, Peter N Gonski, Glen P Schlaphoff and John C Rouse.
Med J Aust 2010; 192 (6): 334-337.
http://www.mja.com.au/public/issues/192_06_150310/cla11439_fm.html

Invited editorial presents an accurate summary of the results of two randomised placebo-controlled trials of vertebroplasty
Rachelle Buchbinder, Richard H Osborne and David Kallmes.
Med J Aust 2010; 192 (6): 338-341.
http://www.mja.com.au/public/issues/192_06_150310/buc10020_fm.html

I am continually attending “Patient Safety and Quality” meetings yet the matter of hand hygiene is not raised, or even on the agenda till I bring it up.

1. “Can we wipe out … “  is about research in the UK and comes from the virtualmedicalcentre.com web site
2. MRSA consumers’ document is a WA Health Department document which can be accessed here http://www.public.health.wa.gov.au/cproot/1760/2/MRSA%20Consumers.pdf
3. “Doctors should be “horrified” by their hand hygiene-studies … is an article on research in NSW from HealthAlerts website and can be accessed via this link http://www.healthalerts.com.au/news/news.php?action=fullnews&id=541
4. Ignaz Semmelweis… discovered the importance of hand-washing hygiene by medical care-givers in 1847 …

Only after Dr. Semmelweiss’ death, was the germ theory of disease developed, and he is now recognized as a pioneer of antiseptic policy and prevention of nosocomial disease.

The below article is a guest column written by Hope, that was published in the “Medical Forum WA”  magazine, Western Australia’s Independent Monthly for Health Professionals December, 2009 edition. Her article is on Page 17 and the orginal article can be accessed at http://www.medicalhub.com.au/component/option,com_docman/task,doc_download/gid,174/Itemid,228/

The GP-patient relationship is an imperfect science, with many GPs finding it hard to diagnose properly if information is not articulated correctly or withheld. Conversely, some seniors believe GPs need to take a different approach when dealing with this growing demographic in WA.

So what do seniors want from their GP? To be listened to, taken seriously and to be able to enjoy a partnership with their health provider. I believe this leads to more productive consultations and a positive outcome for both doctor and patient.

Many seniors (like me) have at least one chronic condition, some have more. This does not necessarily mean we are ill or incapacitated. Seniors need support and information, including access to resources so that we are better able to ‘self manage’ our condition in partnership with our health providers.

Having gained weight and body fat after cancer treatment I do not want to be told “it is because you are menopausal”, “because you have had children”, “it is in your family”, or worse still “go to Jenny Craig”. It is more useful to be referred to a dietician and an exercise physiologist. In this way a plan can be drawn up to achieve my goal, that is, to manage my weight, to keep fit, to reduce the risk of other medical conditions, and reduce the risk of the cancer recurring.

With the help of my GP I can set my health goals, draft an action plan, and take responsibility for my continuing wellness.

What doctors can do to make the journey easier:

1. Suggest the patient brings all medication they are taking to the consultation. An on-going review can minimise errors such as a patient taking the same drug by another name, continuing to take medication if no longer required and confusion.
2. Ask the patient to write down a list of questions to ask the doctor, and copy the answers given by the doctor.
3. Offer the patient a print-out of all medications they are taking, the reason for taking it and dosage – including any known drug reactions. Seniors often put this list on their fridge, so in an emergency ambulance officers have access to this vital information.
4. If a doctor is uncomfortable discussing a particular issue, e.g. sexuality, refer the patient to someone who is not. Many patients have difficulties in this area because of surgery, chemotherapy and other procedures.
5. Suggest the patient request a long consultation if there are several issues to be discussed, or else make two consultations. If these are bulk-billed (for pensioners) this could perhaps save time for both doctor and patient.

And what will the doctors stand to gain? Patients who are using the knowledge and support offered to better manage their health and such conditions they may have. This may result in fewer and shorter visits, more time spent achieving positive outcomes than having to listen to the same old sad story. Many seniors are ‘experts on their own condition’ and do have a wealth of experience in coping – but we do need the relevant up-to-date information the doctor can provide.

Hope Alexander

December 2009

© Copyright Hope Alexander

10 Best Questions for parents to ask a child obesity expert – Focus Group

Below are Hope’s notes from the Focus Group.

I did query the title – my suggestion would be a consult the family doctor BEFORE going to see a “childhood obesity expert”, whoever that may be.

All present agreed on the first question “is my child too fat?”

In the un-ranked questions I asked “Does my child need a medical assessment?”. The reason being that a GP can rule out any underling medical condition.

A child may be fat for reasons other than poor diet, lack of nutrition/exercise etc. I was the only person who saw this as an important step. I did this in real life, taking one of my girls to the GP because she was too chubby and chunky at 8 years old.

I was advised to give her smaller portions and later as a teenager she took up swimming and at 14, I got her enrolled in a women’s basketball team. She ended up as an adult with a beautiful figure.

10 Best Questions for Parents to ask a child obesity expert

1. Is my child too fat?
2. What can I do as a parent to help my child have a healthy weight?
3. What can I do to prevent my child becoming obese?
4. What food should I be giving my child and how much?
5. How do I provide a nutritional diet on a budget?
6. Why is my child fat?
7. How could I motivate myself and my child to do more physical activity and make healthy food choices?
8. How much exercise should my child get?
9. Where can I get appropriate programs?How can I lobby the government or food companies to limit the availability of unhealthy food choices?

Other questions not ranked in the top ten

1. Where can I get information about obesity?
2. Do I need to get a medical assessment by a GP?
3. How can I make my child more comfortable about their weight?
4. How can I limit my child’s exposure to unhealthy food advertising?
5. What are the effects of childhood obesity?

Norman Swan on The Health Report on ABC Radio National, 10 August 2009, interviewed Anne McKenzie who is a consumer advocate in the School of Population Health at the University of Western Australia, Hope Alexander, a consumer member of their Research Advisory Panel, and Kos Sclavos, president of the Pharmacy Guild of Australia. The topic of discussion was “Labelling of medications dispensed by pharmacists”.

Labelling of medications dispensed by pharmacists

“Health consumer advocates have uncovered what they feel might be an unacceptable level of pharmacists dispensing medications with ‘use as directed’ or equivalent on the label. They argue that this is dangerous and should not happen.”

The Health Report transcript can be read here:
http://www.abc.net.au/rn/healthreport/stories/2009/2647591.htm

The Health Report transcript can be listened to here:
http://mpegmedia.abc.net.au/rn/podcast/2009/08/hrt_20090810_0841.mp3