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Doctor","publishDate":1532458816,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>If you're in the hospital or a doctor's office with a painful problem, you'll likely be asked to rate your pain on a \u003ca href=\"https://paindoctor.com/pain-scales/\" target=\"_blank\" rel=\"noopener\">scale\u003c/a> of 0 to 10 – with 0 meaning no pain at all and 10 indicating the worst pain you can imagine. But many doctors and nurses say this rating system isn't working and they're trying a new approach.[contextly_sidebar id=\"PzT9DEOa22PlTyV4kUDRN8kM4A2CX5Tx\"]\u003c/p>\n\u003cp>The numeric pain scale may just be too simplistic, says \u003ca href=\"https://www.urmc.rochester.edu/people/21192807-john-d-markman\" target=\"_blank\" rel=\"noopener\">Dr. John Markman\u003c/a>, director of the Translational Pain Research Program at the University of Rochester School of Medicine and Dentistry. It can lead doctors to \"treat by numbers,\" he says and as a result, patients may not be getting the most effective treatment for their pain.\u003c/p>\n\u003cp>Take the case of 33-year-old Adam Rosette, who was recently hospitalized for \u003ca href=\"https://orthoinfo.aaos.org/en/diseases--conditions/fibrous-dysplasia/\" target=\"_blank\" rel=\"noopener\">fibrous dysplasia\u003c/a>, a bone disorder that made it nearly impossible for him to chew or even speak. After brain surgery to remove benign tumors related to the disorder, he was definitely in pain. But he was reluctant to label the pain too high.\u003c/p>\n\u003cp>\"I don't think I ever answered higher than a '7' because an '8' would be, in my mind, like I'm missing half of my body or a limb,\" he recalls.\u003c/p>\n\u003cp>On the pain scale a rating of 4 to 7 is considered moderate. Mild pain is rated 1 to 3. Over 7 is considered severe.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Today, Rosette has recovered and is pain-free, but he wonders if \"low balling\" his pain level while in the hospital, meant he wasn't given adequate pain medication.[contextly_sidebar id=\"gNyBEO7kaaOOQQPLiTFHH1VcWAsQe2Bq\"]\u003c/p>\n\u003cp>\"You realize you got less medicine and it's been eight hours and they're not allowed to give you more for a while,\" Rosette says.\u003c/p>\n\u003cp>If your doctor gets the wrong idea about your pain, it's not just going to affect your comfort — it can affect your treatment. Markman says that especially after an injury, there's therapeutic value to keeping the pain tamped down, so that you can keep up with physical therapy.\u003c/p>\n\u003cp>For chronic pain, being clear can help clinicians choose the right mix of therapies or medications to allow you to stay as active as possible. And staying active can help manage chronic pain, says \u003ca href=\"https://anesthesiology.duke.edu/?page_id=834374\" target=\"_blank\" rel=\"noopener\">Dr. William Maixner\u003c/a>, with Duke University School of Medicine and current president of the American Pain Society.\u003c/p>\n\u003cp>Exercise, he says, \"causes the release of a number of anti-inflammatory substances from the muscle that can help diminish pain and pain processing and make the individual more resilient.\"\u003c/p>\n\u003cp>To find out more about how the numerical pain scale was affecting treatment, Markman and colleagues at the University of Rochester did a study, which they will present at the World Congress on Pain in Boston in September. The research analyzed data from other studies, which asked chronic pain patients to rate their pain using both numbers and words.\u003c/p>\n\u003cp>Patients were asked to rate their pain on a scale of 0 to 10, and they were also asked the question, \"Is your pain tolerable?\"\u003c/p>\n\u003cp>Surprisingly, three quarters of the patients who rated their pain between 4 and 7 on the numerical scale, a range that typically calls for higher doses of medications, also described their pain as \"tolerable\" — a description that normally means no more pain treatment is needed.[contextly_sidebar id=\"ClUbqCuoEqdLIyjzgS1I1irhMb4fhntn\"]\u003c/p>\n\u003cp>This showed the danger of relying only on a number, Markman says. \"If you were just treating by the numbers you might say, 'Well, someone has a pain that is 6 [out of]10. I feel obligated to do something about that ... to fix that number just like you might fix their blood pressure or their blood glucose,' \" he says.\u003c/p>\n\u003cp>If clinicians just look at a number, Markman says, they may be more likely to over-treat or prescribe more medication, which can be worrisome during an era of concern about opioid abuse and addiction.\u003c/p>\n\u003cp>So if today's pain scale isn't working well for patients and doctors, what's the alternative?\u003c/p>\n\u003cp>Many health care providers are trying to come up with a system that involves words, not numbers.\u003c/p>\n\u003cp>\"I never look at just the pain scale,\" says \u003ca href=\"https://www.uclahealth.org/chrystina-jeter\" target=\"_blank\" rel=\"noopener\">Dr. Chrystina Jeter\u003c/a>, an anesthesiologist and pain management specialist with UCLA Health, who was Rosette's doctor.\u003c/p>\n\u003cp>Using words to describe pain brings greater specificity to the measurement of pain, says Maixner.[contextly_sidebar id=\"jBdk15Gcdb1FQXh8PlzSvMvHZmeTdBu9\"]\u003c/p>\n\u003cp>If patients can describe their pain precisely, he says, their appointment with a health care provider will be much more focused, allowing the physician to \"come to a decision about treatment in a much more rapid and logical way.\"\u003c/p>\n\u003cp>Here's advice for the next time you need to talk to your doctor about your pain.\u003c/p>\n\u003cp>\u003cstrong>Get Descriptive\u003c/strong>\u003c/p>\n\u003cp>You can help doctors understand just how debilitating your pain is by being more descriptive.\u003c/p>\n\u003cp>\"It's perfectly OK to be a little more flowery in the description of pain,\" says Jeter. \"My pain is aching, burning. What does it feel like to you? Where is it? Does it move?\"\u003c/p>\n\u003cp>Jeter typically asks patients to compare their current pain to the worst pain they ever had, such as childbirth or kidney stones. This helps put their pain in context, she says, and may help them realize their pain may not be that bad after all.\u003c/p>\n\u003cp>\u003cstrong>Describe Your Day\u003c/strong>\u003c/p>\n\u003cp>It can be helpful to talk about how your pain waxes and wanes throughout the day, says Jeter. For example, is it mostly when you eat, walk, or do certain activities?\u003c/p>\n\u003cp>\"I look for trends over time and I look at their function,\" she says.\u003c/p>\n\u003cp>\u003cstrong>Talk About Function, Not Feeling\u003c/strong>\u003c/p>\n\u003cp>Be clear about how your pain interferes with daily activities, such as getting out of bed early, getting dressed, feeling fatigued, or no longer enjoying getting out with friends, suggests Maixner.\u003c/p>\n\u003cp>Thinking about function is key, agrees Markman. He says the most accurate measurement of pain may be what it prevents patients from doing. For example, if a patient cannot chew or talk, walk, or exercise that might be more disturbing to them than the pain. Sometimes it's more useful to seek ways to \"work around the pain\" rather than \"making it go away,\" Markman says.\u003c/p>\n\u003cp>\u003cstrong>Share Treatment History\u003c/strong>\u003c/p>\n\u003cp>Describe the history of the pain, the location, how long it's been hurting and what factors seem to aggravate it, or help it get better, suggests Maixner.\u003c/p>\n\u003cp>Share other treatments you've sought, such as acupuncture, massage and certain medications, he says. \"Let the doctor know what you've done and whether it was effective.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Family history is also important, he says, especially when you consider much of an individual's pain sensitivity is inherited. If your parents were highly sensitive to pain, chances are you will be, too, he says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Words+Matter+When+Talking+About+Pain+With+Your+Doctor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"When you go to the doctor in pain, you'll probably be asked to rate your discomfort on a scale of 0 to 10. But doctors say there may be a better way to assess pain.","status":"publish","parent":0,"modified":1532390120,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":37,"wordCount":1147},"headData":{"title":"Words Matter When Talking About Pain With Your Doctor | KQED","description":"When you go to the doctor in pain, you'll probably be asked to rate your discomfort on a scale of 0 to 10. But doctors say there may be a better way to assess pain.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Words Matter When Talking About Pain With Your Doctor","datePublished":"2018-07-24T19:00:16.000Z","dateModified":"2018-07-23T23:55:20.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"443544 https://ww2.kqed.org/futureofyou/?p=443544","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/07/24/words-matter-when-talking-about-pain-with-your-doctor/","disqusTitle":"Words Matter When Talking About Pain With Your Doctor","source":"Health","nprByline":"Patti Neighmond, NPR","nprImageAgency":"Lynn Scurfield for NPR","nprStoryId":"626202281","nprApiLink":"http://api.npr.org/query?id=626202281&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/07/23/626202281/words-matter-when-talking-about-pain-with-your-doctor?ft=nprml&f=626202281","nprRetrievedStory":"1","nprPubDate":"Mon, 23 Jul 2018 11:59:00 -0400","nprStoryDate":"Mon, 23 Jul 2018 05:01:00 -0400","nprLastModifiedDate":"Mon, 23 Jul 2018 11:59:51 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/07/20180723_me_words_matter_when_talking_about_pain_with_your_doctor.mp3?orgId=1&topicId=1066&d=236&p=3&story=626202281&ft=nprml&f=626202281","nprAudioM3u":"http://api.npr.org/m3u/1631434748-973f75.m3u?orgId=1&topicId=1066&d=236&p=3&story=626202281&ft=nprml&f=626202281","path":"/futureofyou/443544/words-matter-when-talking-about-pain-with-your-doctor","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/07/20180723_me_words_matter_when_talking_about_pain_with_your_doctor.mp3?orgId=1&topicId=1066&d=236&p=3&story=626202281&ft=nprml&f=626202281","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you're in the hospital or a doctor's office with a painful problem, you'll likely be asked to rate your pain on a \u003ca href=\"https://paindoctor.com/pain-scales/\" target=\"_blank\" rel=\"noopener\">scale\u003c/a> of 0 to 10 – with 0 meaning no pain at all and 10 indicating the worst pain you can imagine. But many doctors and nurses say this rating system isn't working and they're trying a new approach.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The numeric pain scale may just be too simplistic, says \u003ca href=\"https://www.urmc.rochester.edu/people/21192807-john-d-markman\" target=\"_blank\" rel=\"noopener\">Dr. John Markman\u003c/a>, director of the Translational Pain Research Program at the University of Rochester School of Medicine and Dentistry. It can lead doctors to \"treat by numbers,\" he says and as a result, patients may not be getting the most effective treatment for their pain.\u003c/p>\n\u003cp>Take the case of 33-year-old Adam Rosette, who was recently hospitalized for \u003ca href=\"https://orthoinfo.aaos.org/en/diseases--conditions/fibrous-dysplasia/\" target=\"_blank\" rel=\"noopener\">fibrous dysplasia\u003c/a>, a bone disorder that made it nearly impossible for him to chew or even speak. After brain surgery to remove benign tumors related to the disorder, he was definitely in pain. But he was reluctant to label the pain too high.\u003c/p>\n\u003cp>\"I don't think I ever answered higher than a '7' because an '8' would be, in my mind, like I'm missing half of my body or a limb,\" he recalls.\u003c/p>\n\u003cp>On the pain scale a rating of 4 to 7 is considered moderate. Mild pain is rated 1 to 3. Over 7 is considered severe.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Today, Rosette has recovered and is pain-free, but he wonders if \"low balling\" his pain level while in the hospital, meant he wasn't given adequate pain medication.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"You realize you got less medicine and it's been eight hours and they're not allowed to give you more for a while,\" Rosette says.\u003c/p>\n\u003cp>If your doctor gets the wrong idea about your pain, it's not just going to affect your comfort — it can affect your treatment. Markman says that especially after an injury, there's therapeutic value to keeping the pain tamped down, so that you can keep up with physical therapy.\u003c/p>\n\u003cp>For chronic pain, being clear can help clinicians choose the right mix of therapies or medications to allow you to stay as active as possible. And staying active can help manage chronic pain, says \u003ca href=\"https://anesthesiology.duke.edu/?page_id=834374\" target=\"_blank\" rel=\"noopener\">Dr. William Maixner\u003c/a>, with Duke University School of Medicine and current president of the American Pain Society.\u003c/p>\n\u003cp>Exercise, he says, \"causes the release of a number of anti-inflammatory substances from the muscle that can help diminish pain and pain processing and make the individual more resilient.\"\u003c/p>\n\u003cp>To find out more about how the numerical pain scale was affecting treatment, Markman and colleagues at the University of Rochester did a study, which they will present at the World Congress on Pain in Boston in September. The research analyzed data from other studies, which asked chronic pain patients to rate their pain using both numbers and words.\u003c/p>\n\u003cp>Patients were asked to rate their pain on a scale of 0 to 10, and they were also asked the question, \"Is your pain tolerable?\"\u003c/p>\n\u003cp>Surprisingly, three quarters of the patients who rated their pain between 4 and 7 on the numerical scale, a range that typically calls for higher doses of medications, also described their pain as \"tolerable\" — a description that normally means no more pain treatment is needed.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>This showed the danger of relying only on a number, Markman says. \"If you were just treating by the numbers you might say, 'Well, someone has a pain that is 6 [out of]10. I feel obligated to do something about that ... to fix that number just like you might fix their blood pressure or their blood glucose,' \" he says.\u003c/p>\n\u003cp>If clinicians just look at a number, Markman says, they may be more likely to over-treat or prescribe more medication, which can be worrisome during an era of concern about opioid abuse and addiction.\u003c/p>\n\u003cp>So if today's pain scale isn't working well for patients and doctors, what's the alternative?\u003c/p>\n\u003cp>Many health care providers are trying to come up with a system that involves words, not numbers.\u003c/p>\n\u003cp>\"I never look at just the pain scale,\" says \u003ca href=\"https://www.uclahealth.org/chrystina-jeter\" target=\"_blank\" rel=\"noopener\">Dr. Chrystina Jeter\u003c/a>, an anesthesiologist and pain management specialist with UCLA Health, who was Rosette's doctor.\u003c/p>\n\u003cp>Using words to describe pain brings greater specificity to the measurement of pain, says Maixner.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>If patients can describe their pain precisely, he says, their appointment with a health care provider will be much more focused, allowing the physician to \"come to a decision about treatment in a much more rapid and logical way.\"\u003c/p>\n\u003cp>Here's advice for the next time you need to talk to your doctor about your pain.\u003c/p>\n\u003cp>\u003cstrong>Get Descriptive\u003c/strong>\u003c/p>\n\u003cp>You can help doctors understand just how debilitating your pain is by being more descriptive.\u003c/p>\n\u003cp>\"It's perfectly OK to be a little more flowery in the description of pain,\" says Jeter. \"My pain is aching, burning. What does it feel like to you? Where is it? Does it move?\"\u003c/p>\n\u003cp>Jeter typically asks patients to compare their current pain to the worst pain they ever had, such as childbirth or kidney stones. This helps put their pain in context, she says, and may help them realize their pain may not be that bad after all.\u003c/p>\n\u003cp>\u003cstrong>Describe Your Day\u003c/strong>\u003c/p>\n\u003cp>It can be helpful to talk about how your pain waxes and wanes throughout the day, says Jeter. For example, is it mostly when you eat, walk, or do certain activities?\u003c/p>\n\u003cp>\"I look for trends over time and I look at their function,\" she says.\u003c/p>\n\u003cp>\u003cstrong>Talk About Function, Not Feeling\u003c/strong>\u003c/p>\n\u003cp>Be clear about how your pain interferes with daily activities, such as getting out of bed early, getting dressed, feeling fatigued, or no longer enjoying getting out with friends, suggests Maixner.\u003c/p>\n\u003cp>Thinking about function is key, agrees Markman. He says the most accurate measurement of pain may be what it prevents patients from doing. For example, if a patient cannot chew or talk, walk, or exercise that might be more disturbing to them than the pain. Sometimes it's more useful to seek ways to \"work around the pain\" rather than \"making it go away,\" Markman says.\u003c/p>\n\u003cp>\u003cstrong>Share Treatment History\u003c/strong>\u003c/p>\n\u003cp>Describe the history of the pain, the location, how long it's been hurting and what factors seem to aggravate it, or help it get better, suggests Maixner.\u003c/p>\n\u003cp>Share other treatments you've sought, such as acupuncture, massage and certain medications, he says. \"Let the doctor know what you've done and whether it was effective.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Family history is also important, he says, especially when you consider much of an individual's pain sensitivity is inherited. If your parents were highly sensitive to pain, chances are you will be, too, he says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Words+Matter+When+Talking+About+Pain+With+Your+Doctor&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/443544/words-matter-when-talking-about-pain-with-your-doctor","authors":["byline_futureofyou_443544"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_259","futureofyou_61","futureofyou_379","futureofyou_218"],"collections":["futureofyou_1093"],"featImg":"futureofyou_443546","label":"source_futureofyou_443544"},"futureofyou_442670":{"type":"posts","id":"futureofyou_442670","meta":{"index":"posts_1591205157","site":"futureofyou","id":"442670","score":null,"sort":[1529002856000]},"guestAuthors":[],"slug":"trump-administration-to-shut-down-guidelines-database-for-doctors","title":"Trump Administration To Shut Down Guidelines Bank for Doctors","publishDate":1529002856,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Diagnostic and treatment guidelines aren’t sexy, but they play a vital role in the practice of medicine. Physician societies, government agencies, and others issue detailed recommendations for everything from who should receive cardiac stents to which antibiotics patients should get to avoid infections after knee surgery.[contextly_sidebar id=\"OZslp8wClgKtjgZF05JxjMNXhSPssdaO\"]\u003c/p>\n\u003cp>These documents are essential for the provision of evidence-based care, as opposed to seat-of-the-pants treatment that might be expedient or lucrative for doctors but less than ideal for patients.\u003c/p>\n\u003cp>Until now, the most rigorous of those guidelines have been available for doctors to peruse in a single location: the government’s Agency for Healthcare Research and Quality’s National Guidelines Clearinghouse (NGC). NGC also takes the time to summarize the more than 4,000 guidelines it maintains, an indispensible service for the physicians who come to the site seeking information.\u003c/p>\n\u003cp>It’s a niche site, but the NGC draws an average of 200,000 visitors per month, according to AHRQ.\u003c/p>\n\u003cp>After roughly a decade of budget cuts, however, AHRQ has defunded the repository, effective July 16. While the recommendations will still exist elsewhere after that date, anyone hoping to find out, say, how best to treat a teenager with asthma, or who should have a particular test, will have to work harder to locate the most current guidance. The NGC itself will disappear.[contextly_sidebar id=\"9HkdwjjGHZqkrMUudb7y4ILOnDncrFEI\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“Killing these resources to save a few hundred thousand dollars per year is a penny-wise, pound-foolish decision, and your health and mine will be poorer for it,” said Dr. Kenny Lin, a family physician in Washington, D.C., who is also on the faculty at Georgetown University’s medical school.\u003c/p>\n\u003cp>In fact, similar repositories do exist, but the NGC’s criteria for inclusion were set by the National Academy of Medicine, which established a high bar for rigor that other clearinghouses might lack. In addition to physicians, other users of the NGC include state and local governments, medical schools and other educational institutions, and health care organizations.\u003c/p>\n\u003cp>An AHRQ spokesperson acknowledged that “some clinicians and others may initially miss the NGC. But in today’s information-rich environment, they’ll have the ability to find guidelines in other places, such as with organizations that develop guidelines. Likewise, information about guidelines’ trustworthiness will be available from peer-reviewed publications and other sources.”\u003c/p>\n\u003cp>Others beg to differ. Dr. Roy Poses, a Brown University professor of medicine and president of the Foundation for Integrity and Responsibility in Medicine, said doctors “will be losing an important resource for research, education and evidence-based practice.” (It’s worth noting that some doctors are not fond of the proliferation of guidelines, which they blame for a culture of cookie-cutter care that’s bereft of art and flexibility — and that exposes them to liability if they happen to deviate from doctrine.)[contextly_sidebar id=\"uP9YVw1C4FCBYcJFLPHxKYEIBCgiiNn1\"]\u003c/p>\n\u003cp>As lamentable as the loss of the NGC would be for doctors and patients, it’s hardly surprising. Its parent agency has been suffering death by 1,000 cuts for years. Despite a modest bump in its 2018 funding, the AHRQ’s $334 million annual budget is $120 million below its 2010 level, adjusted for inflation.\u003c/p>\n\u003cp>The NGC — whose fiscal year 2017 budget was $1.2 million, down from $2.1 million the year before — didn’t survive the chopping block. “The decision to end support for the NGC was an Agency decision based on assessing how best to use our current resources, including both appropriated dollars and dollars from the Patient-Centered Outcomes Research Trust Fund,” the AHRQ spokesperson told STAT. The AHRQ budget for the 2019 fiscal year, as proposed by the Trump administration, “will re-focus support to only the highest priority research programs.” That doesn’t include the NGC — which is operated by ECRI, a health nonprofit — because it is considered a dissemination contract.\u003c/p>\n\u003cp>With the date of death for the NGG barely a month away, America’s doctors — and their patients — may, to paraphrase another clearinghouse, already be losers. Perhaps some physician group would like to ride in like a white knight and provide the funding to keep the NGC alive.\u003c/p>\n\u003cp>AHRQ “is receiving expressions of interest from stakeholders who may wish to carry on NGC’s work,” according to the AHRQ spokesperson. “If the work continues, we may be able to provide more information in the future, such as listing those potential stakeholders and opportunities for the public to comment.”\u003c/p>\n\u003cp>If that comes to pass, that funding, to borrow a phrase from politics, should be put in a lockbox.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/06/13/ahrq-practice-guidelines-clearinghouse-shutting-down/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"After roughly a decade of budget cuts, the repository has been defunded effective July 16. While the recommendations will still exist elsewhere after that date, doctors will have to work harder to locate the most current guidance.","status":"publish","parent":0,"modified":1528933102,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":17,"wordCount":828},"headData":{"title":"Trump Administration To Shut Down Guidelines Bank for Doctors | KQED","description":"After roughly a decade of budget cuts, the repository has been defunded effective July 16. While the recommendations will still exist elsewhere after that date, doctors will have to work harder to locate the most current guidance.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Trump Administration To Shut Down Guidelines Bank for Doctors","datePublished":"2018-06-14T19:00:56.000Z","dateModified":"2018-06-13T23:38:22.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"442670 https://ww2.kqed.org/futureofyou/?p=442670","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/06/14/trump-administration-to-shut-down-guidelines-database-for-doctors/","disqusTitle":"Trump Administration To Shut Down Guidelines Bank for Doctors","source":"Health","nprByline":"Ivan Oransky\u003cbr />STAT","path":"/futureofyou/442670/trump-administration-to-shut-down-guidelines-database-for-doctors","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Diagnostic and treatment guidelines aren’t sexy, but they play a vital role in the practice of medicine. Physician societies, government agencies, and others issue detailed recommendations for everything from who should receive cardiac stents to which antibiotics patients should get to avoid infections after knee surgery.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>These documents are essential for the provision of evidence-based care, as opposed to seat-of-the-pants treatment that might be expedient or lucrative for doctors but less than ideal for patients.\u003c/p>\n\u003cp>Until now, the most rigorous of those guidelines have been available for doctors to peruse in a single location: the government’s Agency for Healthcare Research and Quality’s National Guidelines Clearinghouse (NGC). NGC also takes the time to summarize the more than 4,000 guidelines it maintains, an indispensible service for the physicians who come to the site seeking information.\u003c/p>\n\u003cp>It’s a niche site, but the NGC draws an average of 200,000 visitors per month, according to AHRQ.\u003c/p>\n\u003cp>After roughly a decade of budget cuts, however, AHRQ has defunded the repository, effective July 16. While the recommendations will still exist elsewhere after that date, anyone hoping to find out, say, how best to treat a teenager with asthma, or who should have a particular test, will have to work harder to locate the most current guidance. The NGC itself will disappear.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Killing these resources to save a few hundred thousand dollars per year is a penny-wise, pound-foolish decision, and your health and mine will be poorer for it,” said Dr. Kenny Lin, a family physician in Washington, D.C., who is also on the faculty at Georgetown University’s medical school.\u003c/p>\n\u003cp>In fact, similar repositories do exist, but the NGC’s criteria for inclusion were set by the National Academy of Medicine, which established a high bar for rigor that other clearinghouses might lack. In addition to physicians, other users of the NGC include state and local governments, medical schools and other educational institutions, and health care organizations.\u003c/p>\n\u003cp>An AHRQ spokesperson acknowledged that “some clinicians and others may initially miss the NGC. But in today’s information-rich environment, they’ll have the ability to find guidelines in other places, such as with organizations that develop guidelines. Likewise, information about guidelines’ trustworthiness will be available from peer-reviewed publications and other sources.”\u003c/p>\n\u003cp>Others beg to differ. Dr. Roy Poses, a Brown University professor of medicine and president of the Foundation for Integrity and Responsibility in Medicine, said doctors “will be losing an important resource for research, education and evidence-based practice.” (It’s worth noting that some doctors are not fond of the proliferation of guidelines, which they blame for a culture of cookie-cutter care that’s bereft of art and flexibility — and that exposes them to liability if they happen to deviate from doctrine.)\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>As lamentable as the loss of the NGC would be for doctors and patients, it’s hardly surprising. Its parent agency has been suffering death by 1,000 cuts for years. Despite a modest bump in its 2018 funding, the AHRQ’s $334 million annual budget is $120 million below its 2010 level, adjusted for inflation.\u003c/p>\n\u003cp>The NGC — whose fiscal year 2017 budget was $1.2 million, down from $2.1 million the year before — didn’t survive the chopping block. “The decision to end support for the NGC was an Agency decision based on assessing how best to use our current resources, including both appropriated dollars and dollars from the Patient-Centered Outcomes Research Trust Fund,” the AHRQ spokesperson told STAT. The AHRQ budget for the 2019 fiscal year, as proposed by the Trump administration, “will re-focus support to only the highest priority research programs.” That doesn’t include the NGC — which is operated by ECRI, a health nonprofit — because it is considered a dissemination contract.\u003c/p>\n\u003cp>With the date of death for the NGG barely a month away, America’s doctors — and their patients — may, to paraphrase another clearinghouse, already be losers. Perhaps some physician group would like to ride in like a white knight and provide the funding to keep the NGC alive.\u003c/p>\n\u003cp>AHRQ “is receiving expressions of interest from stakeholders who may wish to carry on NGC’s work,” according to the AHRQ spokesperson. “If the work continues, we may be able to provide more information in the future, such as listing those potential stakeholders and opportunities for the public to comment.”\u003c/p>\n\u003cp>If that comes to pass, that funding, to borrow a phrase from politics, should be put in a lockbox.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>This\u003ca href=\"https://www.statnews.com/2018/06/13/ahrq-practice-guidelines-clearinghouse-shutting-down/\" target=\"_blank\" rel=\"noopener\"> story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/442670/trump-administration-to-shut-down-guidelines-database-for-doctors","authors":["byline_futureofyou_442670"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_259","futureofyou_1176","futureofyou_952","futureofyou_1056"],"featImg":"futureofyou_427825","label":"source_futureofyou_442670"},"futureofyou_440154":{"type":"posts","id":"futureofyou_440154","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440154","score":null,"sort":[1521061468000]},"guestAuthors":[],"slug":"how-to-get-people-to-see-a-doctor-when-they-refuse","title":"How To Get People To See A Doctor When They Refuse","publishDate":1521061468,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The Tsimane people are among the most isolated people in Bolivia. They number about 16,000 and live in 80 mostly riverbank villages of 50 to several hundred people scattered across about 3,000 square miles of Amazon jungle. They are forager-farmers who fish, hunt, cut down jungle trees with machetes and produce an \u003ca href=\"http://www.anth.ucsb.edu/people/michael-gurven\" target=\"_blank\" rel=\"noopener\">average of nine children per family,\u003c/a> says \u003ca href=\"http://www.anth.ucsb.edu/gurvenlab/\" target=\"_blank\" rel=\"noopener\">Michael Gurven\u003c/a>, chair of the Integrated Anthropological Sciences Unit at the University of California at Santa Barbara.[contextly_sidebar id=\"09DUGAe9ia3Jjr77ebYOxlbZOLjB4H3E\"]\u003c/p>\n\u003cp>Gurven has visited and studied the Tsimane people for 16 years. Last month, he and colleagues published a paper in the journal \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0277953618300170?via%3Dihub\" target=\"_blank\" rel=\"noopener\">\u003cem>Social Science & Medicine\u003c/em>\u003c/a> on why these impoverished people, who live an average of just over 50 years (compared to the \u003ca href=\"http://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends/en/\" target=\"_blank\" rel=\"noopener\">world average of 71.5\u003c/a>), often won't take advantage of medical care, even when it's free and offered by people they've come to trust.\u003c/p>\n\u003cp>What the researchers found offers some clues about why many of us resist going to the doctor when things like rashes, coughs and pains make it pretty clear that we should. \u003ca href=\"https://www.jhsph.edu/faculty/directory/profile/1450/lisa-a-cooper\" target=\"_blank\" rel=\"noopener\">Dr. Lisa Cooper\u003c/a>, professor of medicine at Johns Hopkins University School of Medicine, is not connected with the social science study, but she studies medical adherence and preventive care in the U.S. She says the study shows that while providing medical services is important, it's not enough to ensure good health.[contextly_sidebar id=\"3WXNkyKOIWInX4REHuJ8jcJx7knSTAAA\"]\u003c/p>\n\u003cp>\"We also have to deal with belief systems, with world view, with spiritual beliefs,\" she says. \"We've got to take a much broader view of health.\"\u003c/p>\n\u003cp>When Gurven and his team made trips to Bolivia over the years, they brought medical teams to the most remote villages. \"We'd set up a camp and provide health care,\" he says. \"If there were 100 people in the village, maybe 70 would come. And every time, it would be the same people. I wondered: Were they the sickest? Why didn't others come? We didn't charge them, so money wasn't the reason. We were right there, so they didn't have to travel anywhere.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Fatalism\u003c/strong>\u003cbr>\nIn less remote villages closer to bigger towns, health clinics existed. But in these villages as well, a lot of sick people didn't go for health care.\u003c/p>\n\u003cp>To find out why, researchers asked 690 people, ages 40 to 89, about their priorities, their perceptions about health, their knowledge of medical care. But they also probed deeper, looking into people's beliefs about the extent to which their actions mattered.\u003c/p>\n\u003cp>\"We tried to get at what they think,\" says Gurven. \"If they think they're in charge of what happens to them, that what they put into their body or what they do effects what happens, they're more likely to go to the doctor. With that feeling of control, they're likely to believe that medical treatment will help heal them, or that they might be able to prevent getting sick in the first place.[contextly_sidebar id=\"OQgAwOmNgvR0qCTeiOSMMaCmMZzhxqD5\"]\u003c/p>\n\u003cp>But people who think outside forces are in charge — fate or chance — are less likely to seek out care. They believe that nothing they do will matter, or matters far less than the forces of nature or the whims of others, so why bother, says Sarah Alami, a graduate student in anthropology at UC Santa Barbara and lead author of the study. It turned out that the Tsimane people largely believed that forces outside their control — like a mosquito bite that results in a deadly fever or a neighbor who puts a curse on them — mattered more than things within their control.\u003c/p>\n\u003cp>Alami has spent eight months in Bolivia, working with the Tsimane people. She's seen active people in good health: men felling tall trees, children using the jungle as a playground, women juggling a couple of kids while breastfeeding and fishing.\u003c/p>\n\u003cp>But she's also seen their ill health. A villager she met a few weeks ago might be gone on her next visit, having succumbed to dengue fever. \"You can see they're heavily burdened by parasites,\" she says. \"You see open sores that are infected, and they might not go for help. For something they know will kill them, like a snake bite, they'll try to go for help.\" But where it gets trickier, she says, is a less immediately urgent problem, like a cough that might be tuberculosis.[contextly_sidebar id=\"cdlKRlLfAt4DKi3kH575qPWqNDUsVBiC\"]\u003c/p>\n\u003cp>The researchers concluded that, from the point of view of a Tsimane villager, not taking advantage of medical care might be a rational decision. They know, Gurven says, that while they might get relief from a parasitic infection by going to a clinic, they also know that they're quite likely to get reinfected right away. Or maybe they'll be bitten by a snake on the way home, so they shouldn't risk venturing as far away as a health clinic.\u003c/p>\n\u003cp>The same kind of thinking in the U.S. keeps people from medical care, Cooper says. \"I liken it to what I see in disadvantaged communities where things are chaotic and people believe their circumstances are controlled by chance,\" she says. \"You go in for care, and the doctor tells you to eat better and exercise.\" But you can't afford to join a fitness center, and you live miles from any store that sells fresh fruits and vegetables. \"People living in chaotic environments might think that they don't have control over what's happening today, so why worry about what might happen in the future,\" she says.[contextly_sidebar id=\"KANLlW97Nqu1xraacTt3S4hyzVXssZqH\"]\u003c/p>\n\u003cp>Like the Tsimane, poor people in the U.S. might decide to skip medical care, she says. And from their point of view, it's a rational decision.\u003c/p>\n\u003cp>Even among middle-class people in the developed world, fears of losing control can lead people avoid medical care. \"People are afraid they're going to be diagnosed with something that will limit their employment, or that their disease is so serious, treatment won't work,\" Cooper says. So again, why bother.\u003c/p>\n\u003cp>Avoiding trips to the doctor happens all over the world. But a couple of things have worked to get the indigenous Bolivians to the clinic. \"We don't just explain the illness, and how a treatment will have an effect. Medical knowledge isn't the answer,\" Gurven says. \"We try to get them thinking that it matters to their family that they get treated. We get them thinking about their lives in the future. We ask them about their children's lives five years from now.\"\u003c/p>\n\u003cp>It's the line spouses all over the world use, Gurven says, to get their mates to the doctor: If you won't do it for yourself, think of the kids.\u003c/p>\n\u003chr>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Susan Brink is a freelance writer who covers health and medicine. She is the author of \u003c/em>The Fourth Trimester\u003cem> and co-author of \u003c/em>A Change of Heart.\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+To+Get+People+To+See+A+Doctor+When+They+Don%27t+Want+To&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"A new study looks at why the Tsimane people often avoid seeing doctors and what might change their minds.","status":"publish","parent":0,"modified":1521074538,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":1178},"headData":{"title":"How To Get People To See A Doctor When They Refuse | KQED","description":"A new study looks at why the Tsimane people often avoid seeing doctors and what might change their minds.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"How To Get People To See A Doctor When They Refuse","datePublished":"2018-03-14T21:04:28.000Z","dateModified":"2018-03-15T00:42:18.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440154 https://ww2.kqed.org/futureofyou/?p=440154","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/14/how-to-get-people-to-see-a-doctor-when-they-refuse/","disqusTitle":"How To Get People To See A Doctor When They Refuse","source":"DYI Health","nprImageCredit":"Michael Gurven","nprByline":"Susan Brink\u003cbr />NPR Goats & Soda","nprImageAgency":"The UC Santa Barbara Current","nprStoryId":"591274115","nprApiLink":"http://api.npr.org/query?id=591274115&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/goatsandsoda/2018/03/11/591274115/how-to-get-people-to-see-a-doctor-when-they-dont-want-to?ft=nprml&f=591274115","nprRetrievedStory":"1","nprPubDate":"Mon, 12 Mar 2018 09:34:00 -0400","nprStoryDate":"Sun, 11 Mar 2018 07:00:00 -0400","nprLastModifiedDate":"Mon, 12 Mar 2018 09:34:16 -0400","path":"/futureofyou/440154/how-to-get-people-to-see-a-doctor-when-they-refuse","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The Tsimane people are among the most isolated people in Bolivia. They number about 16,000 and live in 80 mostly riverbank villages of 50 to several hundred people scattered across about 3,000 square miles of Amazon jungle. They are forager-farmers who fish, hunt, cut down jungle trees with machetes and produce an \u003ca href=\"http://www.anth.ucsb.edu/people/michael-gurven\" target=\"_blank\" rel=\"noopener\">average of nine children per family,\u003c/a> says \u003ca href=\"http://www.anth.ucsb.edu/gurvenlab/\" target=\"_blank\" rel=\"noopener\">Michael Gurven\u003c/a>, chair of the Integrated Anthropological Sciences Unit at the University of California at Santa Barbara.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Gurven has visited and studied the Tsimane people for 16 years. Last month, he and colleagues published a paper in the journal \u003ca href=\"https://www.sciencedirect.com/science/article/pii/S0277953618300170?via%3Dihub\" target=\"_blank\" rel=\"noopener\">\u003cem>Social Science & Medicine\u003c/em>\u003c/a> on why these impoverished people, who live an average of just over 50 years (compared to the \u003ca href=\"http://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends/en/\" target=\"_blank\" rel=\"noopener\">world average of 71.5\u003c/a>), often won't take advantage of medical care, even when it's free and offered by people they've come to trust.\u003c/p>\n\u003cp>What the researchers found offers some clues about why many of us resist going to the doctor when things like rashes, coughs and pains make it pretty clear that we should. \u003ca href=\"https://www.jhsph.edu/faculty/directory/profile/1450/lisa-a-cooper\" target=\"_blank\" rel=\"noopener\">Dr. Lisa Cooper\u003c/a>, professor of medicine at Johns Hopkins University School of Medicine, is not connected with the social science study, but she studies medical adherence and preventive care in the U.S. She says the study shows that while providing medical services is important, it's not enough to ensure good health.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"We also have to deal with belief systems, with world view, with spiritual beliefs,\" she says. \"We've got to take a much broader view of health.\"\u003c/p>\n\u003cp>When Gurven and his team made trips to Bolivia over the years, they brought medical teams to the most remote villages. \"We'd set up a camp and provide health care,\" he says. \"If there were 100 people in the village, maybe 70 would come. And every time, it would be the same people. I wondered: Were they the sickest? Why didn't others come? We didn't charge them, so money wasn't the reason. We were right there, so they didn't have to travel anywhere.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Fatalism\u003c/strong>\u003cbr>\nIn less remote villages closer to bigger towns, health clinics existed. But in these villages as well, a lot of sick people didn't go for health care.\u003c/p>\n\u003cp>To find out why, researchers asked 690 people, ages 40 to 89, about their priorities, their perceptions about health, their knowledge of medical care. But they also probed deeper, looking into people's beliefs about the extent to which their actions mattered.\u003c/p>\n\u003cp>\"We tried to get at what they think,\" says Gurven. \"If they think they're in charge of what happens to them, that what they put into their body or what they do effects what happens, they're more likely to go to the doctor. With that feeling of control, they're likely to believe that medical treatment will help heal them, or that they might be able to prevent getting sick in the first place.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But people who think outside forces are in charge — fate or chance — are less likely to seek out care. They believe that nothing they do will matter, or matters far less than the forces of nature or the whims of others, so why bother, says Sarah Alami, a graduate student in anthropology at UC Santa Barbara and lead author of the study. It turned out that the Tsimane people largely believed that forces outside their control — like a mosquito bite that results in a deadly fever or a neighbor who puts a curse on them — mattered more than things within their control.\u003c/p>\n\u003cp>Alami has spent eight months in Bolivia, working with the Tsimane people. She's seen active people in good health: men felling tall trees, children using the jungle as a playground, women juggling a couple of kids while breastfeeding and fishing.\u003c/p>\n\u003cp>But she's also seen their ill health. A villager she met a few weeks ago might be gone on her next visit, having succumbed to dengue fever. \"You can see they're heavily burdened by parasites,\" she says. \"You see open sores that are infected, and they might not go for help. For something they know will kill them, like a snake bite, they'll try to go for help.\" But where it gets trickier, she says, is a less immediately urgent problem, like a cough that might be tuberculosis.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The researchers concluded that, from the point of view of a Tsimane villager, not taking advantage of medical care might be a rational decision. They know, Gurven says, that while they might get relief from a parasitic infection by going to a clinic, they also know that they're quite likely to get reinfected right away. Or maybe they'll be bitten by a snake on the way home, so they shouldn't risk venturing as far away as a health clinic.\u003c/p>\n\u003cp>The same kind of thinking in the U.S. keeps people from medical care, Cooper says. \"I liken it to what I see in disadvantaged communities where things are chaotic and people believe their circumstances are controlled by chance,\" she says. \"You go in for care, and the doctor tells you to eat better and exercise.\" But you can't afford to join a fitness center, and you live miles from any store that sells fresh fruits and vegetables. \"People living in chaotic environments might think that they don't have control over what's happening today, so why worry about what might happen in the future,\" she says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Like the Tsimane, poor people in the U.S. might decide to skip medical care, she says. And from their point of view, it's a rational decision.\u003c/p>\n\u003cp>Even among middle-class people in the developed world, fears of losing control can lead people avoid medical care. \"People are afraid they're going to be diagnosed with something that will limit their employment, or that their disease is so serious, treatment won't work,\" Cooper says. So again, why bother.\u003c/p>\n\u003cp>Avoiding trips to the doctor happens all over the world. But a couple of things have worked to get the indigenous Bolivians to the clinic. \"We don't just explain the illness, and how a treatment will have an effect. Medical knowledge isn't the answer,\" Gurven says. \"We try to get them thinking that it matters to their family that they get treated. We get them thinking about their lives in the future. We ask them about their children's lives five years from now.\"\u003c/p>\n\u003cp>It's the line spouses all over the world use, Gurven says, to get their mates to the doctor: If you won't do it for yourself, think of the kids.\u003c/p>\n\u003chr>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Susan Brink is a freelance writer who covers health and medicine. She is the author of \u003c/em>The Fourth Trimester\u003cem> and co-author of \u003c/em>A Change of Heart.\u003c/p>\n\u003chr>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=How+To+Get+People+To+See+A+Doctor+When+They+Don%27t+Want+To&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440154/how-to-get-people-to-see-a-doctor-when-they-refuse","authors":["byline_futureofyou_440154"],"categories":["futureofyou_1060","futureofyou_1"],"tags":["futureofyou_259","futureofyou_61","futureofyou_1056","futureofyou_1224"],"collections":["futureofyou_1093"],"featImg":"futureofyou_440155","label":"source_futureofyou_440154"},"futureofyou_440080":{"type":"posts","id":"futureofyou_440080","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440080","score":null,"sort":[1520899794000]},"guestAuthors":[],"slug":"hearts-get-younger-even-at-middle-age-with-exercise","title":"Hearts Get 'Younger,' Even At Middle Age, With Exercise","publishDate":1520899794,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Eventually it happens to everyone. As we age, even if we're healthy, the heart becomes less flexible, more stiff and just isn't as efficient in processing oxygen as it used to be. In most people the first signs \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.2011.218271/full\" target=\"_blank\" rel=\"noopener\">show up\u003c/a> in the 50s or early 60s. And among people who don't exercise, the underlying changes can start even sooner.\u003c/p>\n\u003cp>\"The heart gets smaller — stiffer,\" says \u003ca href=\"http://profiles.utsouthwestern.edu/profile/14262/benjamin-levine.html\" target=\"_blank\" rel=\"noopener\">Dr. Ben Levine\u003c/a>, a sports cardiologist at University of Texas Southwestern Medical Center and director of the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital, in Dallas.[contextly_sidebar id=\"UJp77wAYFxSsTskHzbjUfLZVQstMILpG\"]\u003c/p>\n\u003cp>Think of the heart muscle as a rubber band, Levine says. In the beginning, the rubber band is flexible and pliable. But put it in a drawer for 20 years and it will emerge dry and brittle.\u003c/p>\n\u003cp>\"That's what happens to the heart and blood vessels,\" he says. And down the road, that sort of stiffness can get worse, he notes, leading to the breathlessness and other symptoms of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022300/\" target=\"_blank\" rel=\"noopener\">heart failure\u003c/a>, an inability of the heart to effectively pump blood to the lungs or throughout the body.\u003c/p>\n\u003cp>Fortunately for those in midlife, Levine is finding that even if you haven't been an avid exerciser, getting in shape now may head off that decline and help restore your aging heart. He and his colleagues \u003ca href=\"http://circ.ahajournals.org/content/early/2018/01/03/CIRCULATIONAHA.117.030617\" target=\"_blank\" rel=\"noopener\">published\u003c/a> their recent findings in the American Heart Association's journal, \u003cem>Circulation\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We took these 50-year-old hearts and turned the clock back to 30- or 35-year-old hearts.'\u003ccite>Dr. Ben Levine\u003c/cite>\u003c/aside>\n\u003cp>The research team recruited individuals between the ages of 45 and 64 who were mostly sedentary but otherwise healthy.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Dallas resident Mae Onsry, an accounts payable manager, was 62 at the time. Raising two children and working full time, she says, she never had the flexibility to fit in exercise, although she knew it was important for her health.\u003c/p>\n\u003cp>\"I have my hobbies,\" says Onsry, including ballroom dancing and gardening. But it was nothing routine, nothing \"disciplined,\" she says.\u003c/p>\n\u003cp>So when she saw a flyer about Levine's study, she signed up — along with 52 other volunteers — for a two-year study.\u003c/p>\n\u003cp>\u003cstrong>Heart Health\u003c/strong>\u003cbr>\nParticipants were randomly assigned to one of two groups. The first group engaged in a program of nonaerobic exercise — basic yoga, balance training and weight training — three times a week. The other group, which Onsry was in, was assigned a trainer and did moderate- to high-intensity aerobic exercise for four or more days a week.\u003c/p>\n\u003cp>After two years, the group doing the higher-intensity exercise saw dramatic improvements in heart health.\u003c/p>\n\u003cp>\"We took these 50-year-old hearts and turned the clock back to 30- or 35-year-old hearts,\" says Levine. Their hearts processed oxygen more efficiently and were notably less stiff.\u003c/p>\n\u003cp>\"And the reason they got so much stronger and fitter,\" he says, \"was because their hearts could now fill a lot better and pump a lot more blood during exercise.\"\u003c/p>\n\u003cp>The hearts of those engaged in less intense routines didn't change, he says.\u003c/p>\n\u003cp>A key part of the effective exercise regimen was interval training, Levine says — short bursts of high-intensity exercise followed by a few minutes of rest. The study incorporated what are often referred to as \u003ca href=\"https://www.ntnu.edu/cerg/advice\" target=\"_blank\" rel=\"noopener\">4x4 intervals\u003c/a>.\u003c/p>\n\u003cp>\"It's an old Norwegian ski team workout,\" Levine explains. \"It means four minutes at 95 percent of your maximal ability, followed by three minutes of active recovery, repeated four times.\"\u003c/p>\n\u003cp>\u003cimg class=\" wp-image-341841 alignleft\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-800x450.jpg\" alt=\"\" width=\"520\" height=\"293\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-1020x574.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-1920x1080.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-520x293.jpg 520w\" sizes=\"(max-width: 520px) 100vw, 520px\">Pushing as hard as you can for four minutes stresses the heart, he explains, and forces it to function more efficiently. Repeating the intervals helps strengthen both the heart and the circulatory system.\u003c/p>\n\u003cp>\"The sweet spot in life to get off the couch and start exercising [if you haven't already] is in late middle age when the heart still has plasticity,\" Levine says. You may not be able to reverse the aging of the vessels if you wait.\u003c/p>\n\u003cp>\"We put healthy 70-year-olds through a yearlong exercise training program, and nothing happened to them at all,\" Levine says. \"We could not change the structure of their heart and blood vessels.\"\u003c/p>\n\u003cp>Anyone considering beginning this, or a similarly strenuous exercise program, Levine says, should check with a doctor first and ask about individual health issues that might warrant a less intense program initially.\u003c/p>\n\u003cp>\u003cstrong>Mental Health\u003c/strong>\u003cbr>\nFor Onsry, who is now 65, the study was life changing. Today she exercises every day of the week, walking and jogging at least 5 miles around the lake near her home.\u003c/p>\n\u003cp>If she misses a day, she says, she just doesn't feel as good physically. And the regimen has helped her mental health, too.\u003c/p>\n\u003cp>\"I'm not moody,\" she says. \"I mean — I'm happy.\"\u003c/p>\n\u003cp>\u003ca href=\"https://nyulangone.org/doctors/1912084062/nieca-goldberg\" target=\"_blank\" rel=\"noopener\">Dr. Nieca Goldberg\u003c/a>, a cardiologist and medical director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center, and a spokeswoman for the American Heart Association, says Levine's research is important.\u003c/p>\n\u003cp>\"Many studies that are done that look at [cardiovascular] health look at improvements in risk factors like high blood pressure, cholesterol and diabetes,\" Goldberg says. \"But this study specifically looked at heart function — and how heart function can improve with exercise.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Goldberg says the findings are a great start. But the study was small and needs to be repeated with far larger groups of people to determine exactly which aspects of an exercise routine make the biggest difference.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hearts+Get+%27Younger%2C%27+Even+At+Middle+Age%2C+With+Exercise&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"For those in midlife, getting in shape now may head off decline and help restore an aging heart.","status":"publish","parent":0,"modified":1547069061,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":929},"headData":{"title":"Hearts Get 'Younger,' Even At Middle Age, With Exercise | KQED","description":"For those in midlife, getting in shape now may head off decline and help restore an aging heart.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hearts Get 'Younger,' Even At Middle Age, With Exercise","datePublished":"2018-03-13T00:09:54.000Z","dateModified":"2019-01-09T21:24:21.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440080 https://ww2.kqed.org/futureofyou/?p=440080","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/12/hearts-get-younger-even-at-middle-age-with-exercise/","disqusTitle":"Hearts Get 'Younger,' Even At Middle Age, With Exercise","source":"DIY Health","nprByline":"Patti Neighmond, NPR","nprImageAgency":"Maria Fabrizio for NPR","nprStoryId":"591513777","nprApiLink":"http://api.npr.org/query?id=591513777&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/03/12/591513777/hearts-get-younger-even-at-middle-age-with-exercise?ft=nprml&f=591513777","nprRetrievedStory":"1","nprPubDate":"Mon, 12 Mar 2018 16:06:00 -0400","nprStoryDate":"Mon, 12 Mar 2018 05:00:00 -0400","nprLastModifiedDate":"Mon, 12 Mar 2018 16:06:17 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/03/20180312_me_hearts_gets_younger_even_at_middle_age_with_exercise.mp3?orgId=1&topicId=1128&d=216&p=3&story=591513777&ft=nprml&f=591513777","nprAudioM3u":"http://api.npr.org/m3u/1592823667-03c52f.m3u?orgId=1&topicId=1128&d=216&p=3&story=591513777&ft=nprml&f=591513777","audioTrackLength":217,"path":"/futureofyou/440080/hearts-get-younger-even-at-middle-age-with-exercise","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/03/20180312_me_hearts_gets_younger_even_at_middle_age_with_exercise.mp3?orgId=1&topicId=1128&d=216&p=3&story=591513777&ft=nprml&f=591513777","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Eventually it happens to everyone. As we age, even if we're healthy, the heart becomes less flexible, more stiff and just isn't as efficient in processing oxygen as it used to be. In most people the first signs \u003ca href=\"http://onlinelibrary.wiley.com/doi/10.1113/jphysiol.2011.218271/full\" target=\"_blank\" rel=\"noopener\">show up\u003c/a> in the 50s or early 60s. And among people who don't exercise, the underlying changes can start even sooner.\u003c/p>\n\u003cp>\"The heart gets smaller — stiffer,\" says \u003ca href=\"http://profiles.utsouthwestern.edu/profile/14262/benjamin-levine.html\" target=\"_blank\" rel=\"noopener\">Dr. Ben Levine\u003c/a>, a sports cardiologist at University of Texas Southwestern Medical Center and director of the Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital, in Dallas.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Think of the heart muscle as a rubber band, Levine says. In the beginning, the rubber band is flexible and pliable. But put it in a drawer for 20 years and it will emerge dry and brittle.\u003c/p>\n\u003cp>\"That's what happens to the heart and blood vessels,\" he says. And down the road, that sort of stiffness can get worse, he notes, leading to the breathlessness and other symptoms of \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022300/\" target=\"_blank\" rel=\"noopener\">heart failure\u003c/a>, an inability of the heart to effectively pump blood to the lungs or throughout the body.\u003c/p>\n\u003cp>Fortunately for those in midlife, Levine is finding that even if you haven't been an avid exerciser, getting in shape now may head off that decline and help restore your aging heart. He and his colleagues \u003ca href=\"http://circ.ahajournals.org/content/early/2018/01/03/CIRCULATIONAHA.117.030617\" target=\"_blank\" rel=\"noopener\">published\u003c/a> their recent findings in the American Heart Association's journal, \u003cem>Circulation\u003c/em>.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We took these 50-year-old hearts and turned the clock back to 30- or 35-year-old hearts.'\u003ccite>Dr. Ben Levine\u003c/cite>\u003c/aside>\n\u003cp>The research team recruited individuals between the ages of 45 and 64 who were mostly sedentary but otherwise healthy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Dallas resident Mae Onsry, an accounts payable manager, was 62 at the time. Raising two children and working full time, she says, she never had the flexibility to fit in exercise, although she knew it was important for her health.\u003c/p>\n\u003cp>\"I have my hobbies,\" says Onsry, including ballroom dancing and gardening. But it was nothing routine, nothing \"disciplined,\" she says.\u003c/p>\n\u003cp>So when she saw a flyer about Levine's study, she signed up — along with 52 other volunteers — for a two-year study.\u003c/p>\n\u003cp>\u003cstrong>Heart Health\u003c/strong>\u003cbr>\nParticipants were randomly assigned to one of two groups. The first group engaged in a program of nonaerobic exercise — basic yoga, balance training and weight training — three times a week. The other group, which Onsry was in, was assigned a trainer and did moderate- to high-intensity aerobic exercise for four or more days a week.\u003c/p>\n\u003cp>After two years, the group doing the higher-intensity exercise saw dramatic improvements in heart health.\u003c/p>\n\u003cp>\"We took these 50-year-old hearts and turned the clock back to 30- or 35-year-old hearts,\" says Levine. Their hearts processed oxygen more efficiently and were notably less stiff.\u003c/p>\n\u003cp>\"And the reason they got so much stronger and fitter,\" he says, \"was because their hearts could now fill a lot better and pump a lot more blood during exercise.\"\u003c/p>\n\u003cp>The hearts of those engaged in less intense routines didn't change, he says.\u003c/p>\n\u003cp>A key part of the effective exercise regimen was interval training, Levine says — short bursts of high-intensity exercise followed by a few minutes of rest. The study incorporated what are often referred to as \u003ca href=\"https://www.ntnu.edu/cerg/advice\" target=\"_blank\" rel=\"noopener\">4x4 intervals\u003c/a>.\u003c/p>\n\u003cp>\"It's an old Norwegian ski team workout,\" Levine explains. \"It means four minutes at 95 percent of your maximal ability, followed by three minutes of active recovery, repeated four times.\"\u003c/p>\n\u003cp>\u003cimg class=\" wp-image-341841 alignleft\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-800x450.jpg\" alt=\"\" width=\"520\" height=\"293\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-800x450.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-160x90.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-768x432.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-1020x574.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-1920x1080.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-1180x664.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-960x540.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-240x135.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-375x211.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/02/heart-health_wide-0fa361079eb45d51ec02f0d7448db4e125b1bd9b-1-520x293.jpg 520w\" sizes=\"(max-width: 520px) 100vw, 520px\">Pushing as hard as you can for four minutes stresses the heart, he explains, and forces it to function more efficiently. Repeating the intervals helps strengthen both the heart and the circulatory system.\u003c/p>\n\u003cp>\"The sweet spot in life to get off the couch and start exercising [if you haven't already] is in late middle age when the heart still has plasticity,\" Levine says. You may not be able to reverse the aging of the vessels if you wait.\u003c/p>\n\u003cp>\"We put healthy 70-year-olds through a yearlong exercise training program, and nothing happened to them at all,\" Levine says. \"We could not change the structure of their heart and blood vessels.\"\u003c/p>\n\u003cp>Anyone considering beginning this, or a similarly strenuous exercise program, Levine says, should check with a doctor first and ask about individual health issues that might warrant a less intense program initially.\u003c/p>\n\u003cp>\u003cstrong>Mental Health\u003c/strong>\u003cbr>\nFor Onsry, who is now 65, the study was life changing. Today she exercises every day of the week, walking and jogging at least 5 miles around the lake near her home.\u003c/p>\n\u003cp>If she misses a day, she says, she just doesn't feel as good physically. And the regimen has helped her mental health, too.\u003c/p>\n\u003cp>\"I'm not moody,\" she says. \"I mean — I'm happy.\"\u003c/p>\n\u003cp>\u003ca href=\"https://nyulangone.org/doctors/1912084062/nieca-goldberg\" target=\"_blank\" rel=\"noopener\">Dr. Nieca Goldberg\u003c/a>, a cardiologist and medical director of the Joan H. Tisch Center for Women's Health at NYU Langone Medical Center, and a spokeswoman for the American Heart Association, says Levine's research is important.\u003c/p>\n\u003cp>\"Many studies that are done that look at [cardiovascular] health look at improvements in risk factors like high blood pressure, cholesterol and diabetes,\" Goldberg says. \"But this study specifically looked at heart function — and how heart function can improve with exercise.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Goldberg says the findings are a great start. But the study was small and needs to be repeated with far larger groups of people to determine exactly which aspects of an exercise routine make the biggest difference.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit \u003ca href=\"http://www.npr.org/\" target=\"_blank\" rel=\"noopener\">http://www.npr.org/\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Hearts+Get+%27Younger%2C%27+Even+At+Middle+Age%2C+With+Exercise&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440080/hearts-get-younger-even-at-middle-age-with-exercise","authors":["byline_futureofyou_440080"],"categories":["futureofyou_1060","futureofyou_1"],"tags":["futureofyou_532","futureofyou_259","futureofyou_743","futureofyou_61","futureofyou_279","futureofyou_1640"],"collections":["futureofyou_1093"],"featImg":"futureofyou_440081","label":"source_futureofyou_440080"},"futureofyou_21516":{"type":"posts","id":"futureofyou_21516","meta":{"index":"posts_1591205157","site":"futureofyou","id":"21516","score":null,"sort":[1438793823000]},"guestAuthors":[],"slug":"frustrated-looking-for-a-doctor-these-websites-aim-to-help","title":"Frustrated Looking for a Doctor? These Websites Aim to Help","publishDate":1438793823,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>\u003cem>\u003ca href=\"http://www.scpr.org/blogs/health/2015/07/29/18052/looking-for-a-doctor-word-of-mouth-data-both-helpf/\">This post originally appeared on KPCC's consumer health blog, Impatient.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>My friend Sarah Rothbard recently started a new job. That meant switching insurance plans and finding a primary care doctor in her network that she liked.\u003c/p>\n\u003cp>And that proved to be a challenging task, even though she took a textbook approach to finding a doctor:\u003c/p>\n\u003cul>\n\u003cli>She tried asking friends for recommendations.\u003c/li>\n\u003cli>When that didn't work, she went to the website of her insurance company, Aetna, and searched for in-network doctors near her home or work.\u003c/li>\n\u003cli>She checked out where the doctors went to medical school and when they graduated, and cross-referenced this information with online reviews.\u003c/li>\n\u003c/ul>\n\u003cp>\"I'm a pretty meticulous planner, so when I plan a vacation, I'll Google it, then I'll ask friends and I'll also go to TripAdvisor,\" Rothbard, 31, says. \"I thought I would do this kind of thing for finding a doctor and it didn't really work out that way.\"\u003c/p>\n\u003cfigure id=\"attachment_21572\" class=\"wp-caption aligncenter\" style=\"max-width: 736px\">\u003cimg class=\"size-medium wp-image-21572\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/109389-full-736x600.jpg\" alt=\"Looking for the right doctor can be a frustrating procces\" width=\"736\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/109389-full-736x600.jpg 736w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/109389-full-400x326.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/109389-full-960x783.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/109389-full.jpg 1024w\" sizes=\"(max-width: 736px) 100vw, 736px\">\u003cfigcaption class=\"wp-caption-text\">Looking for the right doctor can be a frustrating process \u003ccite>(Sybren Stüvel via Flickr Creative Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>She eventually selected a doctor based on her research, but after visiting his office, she decided he was not the right fit for her.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Data \"Inadequate\" \u003c/strong>\u003c/p>\n\u003cp>Finding a high-quality primary care doctor that you like and is covered by your insurance is a challenge. That's even true for other doctors, admits Dr. Bob Wachter, professor and interim chairman of the UC San Francisco Department of Medicine.\u003c/p>\n\u003cp>\"I think the data that are available to patients to help them make these decisions are really inadequate,\" Wachter says. He adds that he runs a department of some 700 doctors and \"even in my position, I don't have any great way of figuring out who's really good at what they do.\"\u003c/p>\n\u003cp>That being said, Wachter says there are some basic things to do when searching for a high-quality doctor:\u003c/p>\n\u003cul>\n\u003cli>Check whether the doctor went through reputable training programs\u003c/li>\n\u003cli>Ensure the doctor is board-certified in his or her specialty\u003c/li>\n\u003cli>Check online review sites, but take the feedback with a grain of salt.\u003c/li>\n\u003c/ul>\n\u003cp>\"There are doctors who have wonderful bedside manner and get terrific reviews and yet are dangerous,\" Wachter cautions. \"And there are other doctors who are a little bit grumpy, who are really terrific technically at surgery or cognitively.\"\u003c/p>\n\u003cp>\"When you're looking at the online reviews, chances are you're really getting a snapshot into their bedside manner, which is clearly important but not the only thing you care about.\"\u003c/p>\n\u003cp>Consumer Reports also offers \u003ca href=\"http://www.consumerreports.org/cro/2014/09/how-to-choose-a-doctor/index.htm\">these tips\u003c/a> for finding a doctor.\u003c/p>\n\u003cp>\u003cstrong>Some Websites Offer More Data \u003c/strong>\u003c/p>\n\u003cp>Rothbard and Wachter are not alone in this struggle. In fact, it's spurred the development of at least two startup companies that aim to empower patients to connect with high quality, in-network doctors that they like and trust.\u003c/p>\n\u003cp>Through \u003ca href=\"https://www.zocdoc.com/\">ZocDoc\u003c/a>, you can search for a type of doctor, filtered by zip code and your insurance carrier. A list of doctors pops up; you can then click on their individual profiles to get information about their medical education, hospital affiliations, board certifications and which insurance plans they accept. You can also see how other ZocDoc users reviewed the doctor.\u003c/p>\n\u003cp>Another cool thing about ZocDoc: You can book an appointment with a doctor through the site.\u003c/p>\n\u003cp>With \u003ca href=\"https://betterdoctor.com/\">BetterDoctor\u003c/a>, you can search for doctors by specialty and location. Again, a list of doctors pops up; you can check out their individual profiles to learn about their medical education and specialties, as well as patients' Yelp reviews.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Why should it be that I get more information about buying a car or a refrigerator than trying to find a doctor for my cancer or my heart disease?\"\u003cbr>\n\u003ccite>Bob Wachter, professor and interim chairman of the UC San Francisco Department of Medicine.\u003c/cite>\u003c/aside>\n\u003cp>The site also integrates data from the \u003ca href=\"http://www.cms.gov/\">Centers for Medicare and Medicaid Services\u003c/a> regarding how often other physicians refer patients to this particular doctor and how often the doctor performs certain procedures.\u003c/p>\n\u003cp>I asked Wachter to look at both sites and he liked what he saw. He called the emergence of sites like these a \"healthy trend\" toward making quality and safety data more accessible to patients.\u003c/p>\n\u003cp>\"Why should it be that I get more information about buying a car or a refrigerator than trying to find a doctor for my cancer or my heart disease,\" Wachter says. \"It's crazy but it's changing very, very quickly.\"\u003c/p>\n\u003cp>\u003cstrong>'Word-of-Mouth Trumps All'\u003c/strong>\u003c/p>\n\u003cp>Back to my friend Sarah Rothbard: Not satisfied with the doctor she had selected, she went back to the drawing board. This time, she got a recommendation from one of her new colleagues.\u003c/p>\n\u003cp>\"When you're overwhelmed, word-of-mouth trumps all,\" says Rothbard, noting that she hasn't yet visited the new physician. \"I think when it comes to finding a doctor, it pretty quickly becomes overwhelming.\"\u003c/p>\n\u003cp>I ran this idea by Ari Tulla, co-founder and CEO of BetterDoctor. He says his site provides a sort of second opinion during the doctor search.\u003c/p>\n\u003cp>\"I'm a huge believer of peer recommendations and word-of-mouth,\" Tulla says. \"I think BetterDoctor and other tools are good at augmenting it.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Have you had trouble finding a doctor or specialist that you like? What strategies have you used to find a doctor? Tell me all about it in the comments section below or e-mail me at Impatient@scpr.org.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Finding a high-quality doctor that you like and is covered by your insurance can be a challenge. At least two sites are offering data to help you make a choice.","status":"publish","parent":0,"modified":1477280100,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":28,"wordCount":915},"headData":{"title":"Frustrated Looking for a Doctor? These Websites Aim to Help | KQED","description":"Finding a high-quality doctor that you like and is covered by your insurance can be a challenge. At least two sites are offering data to help you make a choice.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Frustrated Looking for a Doctor? These Websites Aim to Help","datePublished":"2015-08-05T16:57:03.000Z","dateModified":"2016-10-24T03:35:00.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"21516 http://ww2.kqed.org/futureofyou/?p=21516","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/08/05/frustrated-looking-for-a-doctor-these-websites-aim-to-help/","disqusTitle":"Frustrated Looking for a Doctor? These Websites Aim to Help","nprByline":"Rebecca Plevin","path":"/futureofyou/21516/frustrated-looking-for-a-doctor-these-websites-aim-to-help","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>\u003ca href=\"http://www.scpr.org/blogs/health/2015/07/29/18052/looking-for-a-doctor-word-of-mouth-data-both-helpf/\">This post originally appeared on KPCC's consumer health blog, Impatient.\u003c/a>\u003c/em>\u003c/p>\n\u003cp>My friend Sarah Rothbard recently started a new job. That meant switching insurance plans and finding a primary care doctor in her network that she liked.\u003c/p>\n\u003cp>And that proved to be a challenging task, even though she took a textbook approach to finding a doctor:\u003c/p>\n\u003cul>\n\u003cli>She tried asking friends for recommendations.\u003c/li>\n\u003cli>When that didn't work, she went to the website of her insurance company, Aetna, and searched for in-network doctors near her home or work.\u003c/li>\n\u003cli>She checked out where the doctors went to medical school and when they graduated, and cross-referenced this information with online reviews.\u003c/li>\n\u003c/ul>\n\u003cp>\"I'm a pretty meticulous planner, so when I plan a vacation, I'll Google it, then I'll ask friends and I'll also go to TripAdvisor,\" Rothbard, 31, says. \"I thought I would do this kind of thing for finding a doctor and it didn't really work out that way.\"\u003c/p>\n\u003cfigure id=\"attachment_21572\" class=\"wp-caption aligncenter\" style=\"max-width: 736px\">\u003cimg class=\"size-medium wp-image-21572\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/08/109389-full-736x600.jpg\" alt=\"Looking for the right doctor can be a frustrating procces\" width=\"736\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/08/109389-full-736x600.jpg 736w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/109389-full-400x326.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/109389-full-960x783.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/08/109389-full.jpg 1024w\" sizes=\"(max-width: 736px) 100vw, 736px\">\u003cfigcaption class=\"wp-caption-text\">Looking for the right doctor can be a frustrating process \u003ccite>(Sybren Stüvel via Flickr Creative Commons)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>She eventually selected a doctor based on her research, but after visiting his office, she decided he was not the right fit for her.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Data \"Inadequate\" \u003c/strong>\u003c/p>\n\u003cp>Finding a high-quality primary care doctor that you like and is covered by your insurance is a challenge. That's even true for other doctors, admits Dr. Bob Wachter, professor and interim chairman of the UC San Francisco Department of Medicine.\u003c/p>\n\u003cp>\"I think the data that are available to patients to help them make these decisions are really inadequate,\" Wachter says. He adds that he runs a department of some 700 doctors and \"even in my position, I don't have any great way of figuring out who's really good at what they do.\"\u003c/p>\n\u003cp>That being said, Wachter says there are some basic things to do when searching for a high-quality doctor:\u003c/p>\n\u003cul>\n\u003cli>Check whether the doctor went through reputable training programs\u003c/li>\n\u003cli>Ensure the doctor is board-certified in his or her specialty\u003c/li>\n\u003cli>Check online review sites, but take the feedback with a grain of salt.\u003c/li>\n\u003c/ul>\n\u003cp>\"There are doctors who have wonderful bedside manner and get terrific reviews and yet are dangerous,\" Wachter cautions. \"And there are other doctors who are a little bit grumpy, who are really terrific technically at surgery or cognitively.\"\u003c/p>\n\u003cp>\"When you're looking at the online reviews, chances are you're really getting a snapshot into their bedside manner, which is clearly important but not the only thing you care about.\"\u003c/p>\n\u003cp>Consumer Reports also offers \u003ca href=\"http://www.consumerreports.org/cro/2014/09/how-to-choose-a-doctor/index.htm\">these tips\u003c/a> for finding a doctor.\u003c/p>\n\u003cp>\u003cstrong>Some Websites Offer More Data \u003c/strong>\u003c/p>\n\u003cp>Rothbard and Wachter are not alone in this struggle. In fact, it's spurred the development of at least two startup companies that aim to empower patients to connect with high quality, in-network doctors that they like and trust.\u003c/p>\n\u003cp>Through \u003ca href=\"https://www.zocdoc.com/\">ZocDoc\u003c/a>, you can search for a type of doctor, filtered by zip code and your insurance carrier. A list of doctors pops up; you can then click on their individual profiles to get information about their medical education, hospital affiliations, board certifications and which insurance plans they accept. You can also see how other ZocDoc users reviewed the doctor.\u003c/p>\n\u003cp>Another cool thing about ZocDoc: You can book an appointment with a doctor through the site.\u003c/p>\n\u003cp>With \u003ca href=\"https://betterdoctor.com/\">BetterDoctor\u003c/a>, you can search for doctors by specialty and location. Again, a list of doctors pops up; you can check out their individual profiles to learn about their medical education and specialties, as well as patients' Yelp reviews.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Why should it be that I get more information about buying a car or a refrigerator than trying to find a doctor for my cancer or my heart disease?\"\u003cbr>\n\u003ccite>Bob Wachter, professor and interim chairman of the UC San Francisco Department of Medicine.\u003c/cite>\u003c/aside>\n\u003cp>The site also integrates data from the \u003ca href=\"http://www.cms.gov/\">Centers for Medicare and Medicaid Services\u003c/a> regarding how often other physicians refer patients to this particular doctor and how often the doctor performs certain procedures.\u003c/p>\n\u003cp>I asked Wachter to look at both sites and he liked what he saw. He called the emergence of sites like these a \"healthy trend\" toward making quality and safety data more accessible to patients.\u003c/p>\n\u003cp>\"Why should it be that I get more information about buying a car or a refrigerator than trying to find a doctor for my cancer or my heart disease,\" Wachter says. \"It's crazy but it's changing very, very quickly.\"\u003c/p>\n\u003cp>\u003cstrong>'Word-of-Mouth Trumps All'\u003c/strong>\u003c/p>\n\u003cp>Back to my friend Sarah Rothbard: Not satisfied with the doctor she had selected, she went back to the drawing board. This time, she got a recommendation from one of her new colleagues.\u003c/p>\n\u003cp>\"When you're overwhelmed, word-of-mouth trumps all,\" says Rothbard, noting that she hasn't yet visited the new physician. \"I think when it comes to finding a doctor, it pretty quickly becomes overwhelming.\"\u003c/p>\n\u003cp>I ran this idea by Ari Tulla, co-founder and CEO of BetterDoctor. He says his site provides a sort of second opinion during the doctor search.\u003c/p>\n\u003cp>\"I'm a huge believer of peer recommendations and word-of-mouth,\" Tulla says. \"I think BetterDoctor and other tools are good at augmenting it.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Have you had trouble finding a doctor or specialist that you like? What strategies have you used to find a doctor? Tell me all about it in the comments section below or e-mail me at Impatient@scpr.org.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/21516/frustrated-looking-for-a-doctor-these-websites-aim-to-help","authors":["byline_futureofyou_21516"],"categories":["futureofyou_1060","futureofyou_452"],"tags":["futureofyou_259","futureofyou_270","futureofyou_80"],"featImg":"futureofyou_22071","label":"futureofyou"},"futureofyou_3845":{"type":"posts","id":"futureofyou_3845","meta":{"index":"posts_1591205157","site":"futureofyou","id":"3845","score":null,"sort":[1433351077000]},"guestAuthors":[],"slug":"should-you-read-your-doctors-notes-online","title":"Should You Read Your Doctor's Notes Online?","publishDate":1433351077,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>During a recent physical, Jeff Gordon’s doctor told him he may be pre-diabetic. It was a quick mention, mixed in with a review of blood pressure numbers, other vital statistics like his heart rate, height and weight, and details about his prescription for cholesterol medication. Normally, Gordon, 70, a food broker who lives in Washington, D.C., would have paid it little attention.\u003c/p>\n\u003cp>But his physician, who recently joined MedStar Health, uses the system’s Web portal that allows him to share his office notes with patients. For Gordon, seeing the word “pre-diabetic” in writing made it difficult to ignore, and he took action.\u003c/p>\n\u003cp>He contacted MedStar about joining a pre-diabetes clinical study. In the course of taking the tests required to participate, the otherwise healthy septuagenarian found out his blood sugar wasn’t elevated enough to qualify.\u003c/p>\n\u003cp>Still, the experience of seeing the term in his doctor’s notes was a “wake-up call,” inspiring him to pay more attention to his diet and exercise. “It’s harder to ignore when it’s in your face,” he said.\u003c/p>\n\u003cp>This kind of note-sharing got a kick-start five years ago when researchers from Harvard Medical School joined forces with the Pennsylvania-based Geisinger Health System and Harborview Medical Center in Seattle to launch a high-profile pilot program called Open Notes. The initiative focused on encouraging health care providers to give patients access to doctors’ office notes and then tracked what happened when patients read them. Even before the project, some providers had independently shared notes, but since the organized effort began, interest has grown.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Now, \u003ca href=\"http://www.myopennotes.org/\" target=\"_blank\">Open Notes\u003c/a> estimates about 5 million people see physicians who share notes as part of the initiative, said Tom Delbanco, a professor at Harvard Medical School who has been with the project since it launched. That includes doctors from more than 20 institutions across the country, consisting of major academic medical centers and health systems ranging from the Cleveland Clinic to the Veterans Health Administration to Wellspan, in Maryland and Pennsylvania. And even beyond the project’s participants, there is a trend among physicians — such as Gordon’s doctor — to move in this direction, too.\u003c/p>\n\u003cp>It’s part of the health system’s growing focus on patient engagement – the idea that more informed people will take better care of themselves, improving their health while lowering costs. This emphasis is driven in part by the federal health law, which links Medicare payments to how well hospitals and doctors do at getting and keeping patients healthy.\u003c/p>\n\u003cp>The trend is also fueled, experts suggest, by components in the health law and the earlier financial stimulus law that set out financial incentives for doctors to use electronic health records and better connect with patients online.\u003c/p>\n\u003cp>Advocates say open notes could fundamentally shift the doctor-patient relationship by making it less paternalistic, putting patients in a position to catch mistakes and have more informed conversations with their physicians. But others worry the practice could curb honesty in what doctors write about their patients, or cause confusion if patients misinterpret what’s written.\u003c/p>\n\u003cp>What doctors write is hardly the stuff of state secrets. Some portions are technical to the point of dullness. Other portions offer clear, valuable advice.\u003c/p>\n\u003cp>In one note, shared by a patient who requested his name be withheld due to privacy reasons, a doctor wrote, in the context of a potential diagnosis of a hand deformity condition called Dupuytren’s contracture, that the patient’s “sensation is intact in the medial, ulnar and radial nerve distribution.” Hard to understand, yes, but still helpful to the patient for tracking the condition. Even more helpful, perhaps, is the physician’s summary of the condition: “It is very early, so we just need to monitor it.”\u003c/p>\n\u003cp>Some health care providers, though, worry patients might misuse the information – attempting to diagnose themselves or declining beneficial treatment because they misunderstand what’s written. That isn’t out of the question, said Jan Walker, an assistant professor of medicine at Harvard Medical School, who also worked on the Open Notes project. “We certainly believe so far, the good far outweighs the bad,” she said.\u003c/p>\n\u003cp>Kenneth Burman, director of endocrinology at MedStar Washington Hospital Center, said he independently began sharing his notes with patients years ago, mailing them a private copy. When patients read their notes, he said, they can actually “understand the diagnosis and the recommendations.” Patients will look things up, he added, and occasionally correct references to things like family history, or add relevant details he might have missed.\u003c/p>\n\u003cp>Though he can’t document it, he said patients are generally better about following through with treatment if they get to read their notes. “It helps the patient understand the disease process and what the course of action should be,” Burman said.\u003c/p>\n\u003cp>How patients respond to this disclosure varies. Some use notes as helpful reminders while others use the information to challenge a physician’s recommendation and help rule out a diagnoses.\u003c/p>\n\u003cp>For Kent Snyder, 63, a lawyer from Portland, Ore., note-sharing was particularly helpful when he developed arthritis-like symptoms and vision trouble – part of an autoimmune condition doctors still haven’t been able to figure out.\u003c/p>\n\u003cp>Reading what his doctors had written, Snyder said, helped him focus conversations on “key salient issues” – for instance, correcting physicians about symptoms he’d actually experienced, which in turn allowed them to rule out potential diagnoses.\u003c/p>\n\u003cp>Looking at his notes, Snyder added, meant he better understood why doctors ordered certain procedures or treatments.\u003c/p>\n\u003cp>“It’s not just money – I don’t want to take an antibiotic unless I absolutely have to,” he said. “I don’t want to have a test if I don’t need it.”\u003c/p>\n\u003cp>Patients’ abilities to fix errors in their records could encourage providers to adopt note-sharing, especially if it could reduce the odds of doctor mistakes, said Steven Weinberger, CEO of the American College of Physicians, which represents internal medicine doctors.\u003c/p>\n\u003cp>But while doctors and patients said they knew anecdotally of patients finding and fixing mistakes when looking at their notes, Walker said there’s no research measuring how common it is and what effect it could have on patient outcomes or satisfaction.\u003c/p>\n\u003cp>Some physicians worry sharing notes could require them to change what they write so it’s easier for patients to understand, Weinberger said. Peter Elias, an Auburn, Maine-based doctor, said colleagues often worry they might have to omit things for fear of confusing or upsetting patients. But, he added, sharing notes makes him have important conversations he might otherwise have skipped.\u003c/p>\n\u003cp>When patients see what doctors write, he said, “it makes the difficult conversations essential. You can’t skip them anymore.”\u003c/p>\n\u003cp>\u003cem>Corrected, June 2 – An earlier version of this story misidentified Jan Walker. She is an an assistant professor of medicine at Harvard Medical School.\u003c/em>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cstrong>This story originally appeared on \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN), a nonprofit national health policy news service. \u003c/strong>\u003c/p>\n\n","blocks":[],"excerpt":"What doctors write is hardly the stuff of state secrets. Some portions are technical to the point of dullness. Other portions offer clear, valuable advice. ","status":"publish","parent":0,"modified":1434047783,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":27,"wordCount":1232},"headData":{"title":"Should You Read Your Doctor's Notes Online? | KQED","description":"What doctors write is hardly the stuff of state secrets. Some portions are technical to the point of dullness. Other portions offer clear, valuable advice. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Should You Read Your Doctor's Notes Online?","datePublished":"2015-06-03T17:04:37.000Z","dateModified":"2015-06-11T18:36:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"3845 http://ww2.kqed.org/futureofyou/?p=3845","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/06/03/should-you-read-your-doctors-notes-online/","disqusTitle":"Should You Read Your Doctor's Notes Online?","nprByline":"Shefali Luthra, Kaiser Health News ","path":"/futureofyou/3845/should-you-read-your-doctors-notes-online","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>During a recent physical, Jeff Gordon’s doctor told him he may be pre-diabetic. It was a quick mention, mixed in with a review of blood pressure numbers, other vital statistics like his heart rate, height and weight, and details about his prescription for cholesterol medication. Normally, Gordon, 70, a food broker who lives in Washington, D.C., would have paid it little attention.\u003c/p>\n\u003cp>But his physician, who recently joined MedStar Health, uses the system’s Web portal that allows him to share his office notes with patients. For Gordon, seeing the word “pre-diabetic” in writing made it difficult to ignore, and he took action.\u003c/p>\n\u003cp>He contacted MedStar about joining a pre-diabetes clinical study. In the course of taking the tests required to participate, the otherwise healthy septuagenarian found out his blood sugar wasn’t elevated enough to qualify.\u003c/p>\n\u003cp>Still, the experience of seeing the term in his doctor’s notes was a “wake-up call,” inspiring him to pay more attention to his diet and exercise. “It’s harder to ignore when it’s in your face,” he said.\u003c/p>\n\u003cp>This kind of note-sharing got a kick-start five years ago when researchers from Harvard Medical School joined forces with the Pennsylvania-based Geisinger Health System and Harborview Medical Center in Seattle to launch a high-profile pilot program called Open Notes. The initiative focused on encouraging health care providers to give patients access to doctors’ office notes and then tracked what happened when patients read them. Even before the project, some providers had independently shared notes, but since the organized effort began, interest has grown.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Now, \u003ca href=\"http://www.myopennotes.org/\" target=\"_blank\">Open Notes\u003c/a> estimates about 5 million people see physicians who share notes as part of the initiative, said Tom Delbanco, a professor at Harvard Medical School who has been with the project since it launched. That includes doctors from more than 20 institutions across the country, consisting of major academic medical centers and health systems ranging from the Cleveland Clinic to the Veterans Health Administration to Wellspan, in Maryland and Pennsylvania. And even beyond the project’s participants, there is a trend among physicians — such as Gordon’s doctor — to move in this direction, too.\u003c/p>\n\u003cp>It’s part of the health system’s growing focus on patient engagement – the idea that more informed people will take better care of themselves, improving their health while lowering costs. This emphasis is driven in part by the federal health law, which links Medicare payments to how well hospitals and doctors do at getting and keeping patients healthy.\u003c/p>\n\u003cp>The trend is also fueled, experts suggest, by components in the health law and the earlier financial stimulus law that set out financial incentives for doctors to use electronic health records and better connect with patients online.\u003c/p>\n\u003cp>Advocates say open notes could fundamentally shift the doctor-patient relationship by making it less paternalistic, putting patients in a position to catch mistakes and have more informed conversations with their physicians. But others worry the practice could curb honesty in what doctors write about their patients, or cause confusion if patients misinterpret what’s written.\u003c/p>\n\u003cp>What doctors write is hardly the stuff of state secrets. Some portions are technical to the point of dullness. Other portions offer clear, valuable advice.\u003c/p>\n\u003cp>In one note, shared by a patient who requested his name be withheld due to privacy reasons, a doctor wrote, in the context of a potential diagnosis of a hand deformity condition called Dupuytren’s contracture, that the patient’s “sensation is intact in the medial, ulnar and radial nerve distribution.” Hard to understand, yes, but still helpful to the patient for tracking the condition. Even more helpful, perhaps, is the physician’s summary of the condition: “It is very early, so we just need to monitor it.”\u003c/p>\n\u003cp>Some health care providers, though, worry patients might misuse the information – attempting to diagnose themselves or declining beneficial treatment because they misunderstand what’s written. That isn’t out of the question, said Jan Walker, an assistant professor of medicine at Harvard Medical School, who also worked on the Open Notes project. “We certainly believe so far, the good far outweighs the bad,” she said.\u003c/p>\n\u003cp>Kenneth Burman, director of endocrinology at MedStar Washington Hospital Center, said he independently began sharing his notes with patients years ago, mailing them a private copy. When patients read their notes, he said, they can actually “understand the diagnosis and the recommendations.” Patients will look things up, he added, and occasionally correct references to things like family history, or add relevant details he might have missed.\u003c/p>\n\u003cp>Though he can’t document it, he said patients are generally better about following through with treatment if they get to read their notes. “It helps the patient understand the disease process and what the course of action should be,” Burman said.\u003c/p>\n\u003cp>How patients respond to this disclosure varies. Some use notes as helpful reminders while others use the information to challenge a physician’s recommendation and help rule out a diagnoses.\u003c/p>\n\u003cp>For Kent Snyder, 63, a lawyer from Portland, Ore., note-sharing was particularly helpful when he developed arthritis-like symptoms and vision trouble – part of an autoimmune condition doctors still haven’t been able to figure out.\u003c/p>\n\u003cp>Reading what his doctors had written, Snyder said, helped him focus conversations on “key salient issues” – for instance, correcting physicians about symptoms he’d actually experienced, which in turn allowed them to rule out potential diagnoses.\u003c/p>\n\u003cp>Looking at his notes, Snyder added, meant he better understood why doctors ordered certain procedures or treatments.\u003c/p>\n\u003cp>“It’s not just money – I don’t want to take an antibiotic unless I absolutely have to,” he said. “I don’t want to have a test if I don’t need it.”\u003c/p>\n\u003cp>Patients’ abilities to fix errors in their records could encourage providers to adopt note-sharing, especially if it could reduce the odds of doctor mistakes, said Steven Weinberger, CEO of the American College of Physicians, which represents internal medicine doctors.\u003c/p>\n\u003cp>But while doctors and patients said they knew anecdotally of patients finding and fixing mistakes when looking at their notes, Walker said there’s no research measuring how common it is and what effect it could have on patient outcomes or satisfaction.\u003c/p>\n\u003cp>Some physicians worry sharing notes could require them to change what they write so it’s easier for patients to understand, Weinberger said. Peter Elias, an Auburn, Maine-based doctor, said colleagues often worry they might have to omit things for fear of confusing or upsetting patients. But, he added, sharing notes makes him have important conversations he might otherwise have skipped.\u003c/p>\n\u003cp>When patients see what doctors write, he said, “it makes the difficult conversations essential. You can’t skip them anymore.”\u003c/p>\n\u003cp>\u003cem>Corrected, June 2 – An earlier version of this story misidentified Jan Walker. She is an an assistant professor of medicine at Harvard Medical School.\u003c/em>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>This story originally appeared on \u003ca href=\"http://www.kaiserhealthnews.org/\">Kaiser Health News\u003c/a> (KHN), a nonprofit national health policy news service. \u003c/strong>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/3845/should-you-read-your-doctors-notes-online","authors":["byline_futureofyou_3845"],"categories":["futureofyou_1"],"tags":["futureofyou_259","futureofyou_138","futureofyou_270","futureofyou_80","futureofyou_405","futureofyou_406","futureofyou_404"],"featImg":"futureofyou_3846","label":"futureofyou"},"futureofyou_2581":{"type":"posts","id":"futureofyou_2581","meta":{"index":"posts_1591205157","site":"futureofyou","id":"2581","score":null,"sort":[1430496002000]},"guestAuthors":[],"slug":"the-doctor-will-video-chat-with-you-now-insurer-covers-virtual-visits","title":"The Doctor Will Video Chat With You Now: Insurer Covers Virtual Visits","publishDate":1430496002,"format":"standard","headTitle":"Contributor | KQED Future of You | KQED Science","labelTerm":{"term":172,"site":"futureofyou"},"content":"\u003cp>If you can live stream movies, why not live stream medical care?\u003c/p>\n\u003cp>Insurance company \u003ca href=\"http://www.uhc.com/\">UnitedHealthcare\u003c/a> will start covering visits to the doctor's office — via video chat. Patients and physicians talk live online — on smartphones, tablets or home computer — to get to a clinical diagnosis. This move to cybermedicine could save insurers a ton of money — or have unintended consequences.\u003c/p>\n\u003cp>Cybermedicine has been \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761771/\">long-discussed\u003c/a> by the experts. Now, Eric Neiman, father to a little girl in San Francisco, can explain how it works — from personal experience.\u003c/p>\n\u003cp>\"So I'd gotten a text from my wife earlier in the day,\" he says. \"One of our daughter's eyes was a little bit red and she was rubbing it.\"\u003c/p>\n\u003cp>A few hours passed and it got more red and started oozing. \"Well, unfortunately that sounds like it could be pinkeye. So we would look at it together when I got home,\" Neiman says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Which was close to 8 p.m. — too late to see their regular pediatrician. And kind of late to see any doctor. If they went to the local urgent care center, they'd get back home at 10 p.m. or 11 p.m.\u003c/p>\n\u003cp>Then, Neiman remembered something, from his Instagram account, a post for an app called \u003ca href=\"http://www.doctorondemand.com/\">Doctor On Demand\u003c/a>. It pairs users up with doctors who are licensed in their state for a video screening.\u003c/p>\n\u003cp>Neiman decided to log in. \"The pediatrician came on, introduced himself, and then asked to see our daughter, asked to hold the iPhone up to her eye, checked her throat, everything that he could see via the phone.\"\u003c/p>\n\u003cp>Within minutes, the doctor called in a prescription for pinkeye. The visit cost Neiman $40.\u003c/p>\n\u003cp>Neiman was so impressed, he says, he used the app just a few days later for himself. He thought he was getting a sinus infection, and logged in \u003cem>from his car\u003c/em>.\u003c/p>\n\u003cp>\"I was sitting on the side of the street. It's not the first time I pulled over to use my phone,\" he says. \"But to actually go to the doctor — I was just hopeful nobody was watching!\"\u003c/p>\n\u003cp>\u003cstrong>Save On Cost Or Break \u003c/strong>\u003cstrong>The Bank?\u003c/strong>\u003c/p>\n\u003cp>UnitedHealthcare's move to cover all or part of the cost of these e-visits — for up to 20 million customers by 2016 — is big. A major company is putting its stamp of approval on a process that, until now, has been largely experimental.\u003c/p>\n\u003cp>Three mobile-doc startups – Doctor on Demand, \u003ca href=\"https://nowclinic.com/landing.htm\">NowClinic\u003c/a> and \u003ca href=\"https://www.americanwell.com/\">Amwell\u003c/a> – are the initial providers.\u003c/p>\n\u003cp>Karen Scott, who directs innovation initiatives at UnitedHealthcare, says the company is studying cost: \"What happens if somebody is more likely to use virtual care? Maybe they would have gone in to urgent care. How many of them will choose the virtual visit instead?\"\u003c/p>\n\u003cp>It could be that people grab a doctor online for skin rashes, colds and coughs — and by getting care early on, they prevent an expensive catastrophe. Or maybe people wait too long when they really just need to see a doctor in person. Or it could be this service brings out the inner hypochondriac in us and leaves the insurer with a bigger bill to co-pay.\u003c/p>\n\u003cp>\"Those are the sorts of health care economics and actuarial questions that our experts will be watching,\" Scott says.\u003c/p>\n\u003cp>\u003cstrong>Convenience For Doctors\u003c/strong>\u003c/p>\n\u003cp>This move has big implications for physicians, too.\u003c/p>\n\u003cp>Dr. Tania Elliott, an allergist with Doctor on Demand, says that through the app, patients with a rash show her their symptoms in the moment — not a week later. She takes virtual tours of people's homes to search dust mite sources. Instead of tedious planning, she gives patients a ballpark of when to do a follow up visit.\u003c/p>\n\u003cp>\"They have access to essentially my schedule. And so when they log into the app they can see when I'm online,\" she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The doctor has even gotten to work remotely — from a hotel room in Hawaii.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=The+Doctor+Will+Video+Chat+With+You+Now%3A+Insurer+Covers+Virtual+Visits&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n","blocks":[],"excerpt":"Medical consultation via video is going mainstream. UnitedHealthcare says it will cover doctors' visits by live video on smartphones, tablets and computers. Will people overuse it and boost costs?","status":"publish","parent":0,"modified":1434048989,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":681},"headData":{"title":"The Doctor Will Video Chat With You Now: Insurer Covers Virtual Visits | KQED","description":"Medical consultation via video is going mainstream. UnitedHealthcare says it will cover doctors' visits by live video on smartphones, tablets and computers. Will people overuse it and boost costs?","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"The Doctor Will Video Chat With You Now: Insurer Covers Virtual Visits","datePublished":"2015-05-01T16:00:02.000Z","dateModified":"2015-06-11T18:56:29.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"2581 http://ww2.kqed.org/futureofyou/?p=2581","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/05/01/the-doctor-will-video-chat-with-you-now-insurer-covers-virtual-visits/","disqusTitle":"The Doctor Will Video Chat With You Now: Insurer Covers Virtual Visits","nprByline":"Aarti Shahani","nprStoryId":"403346731","nprApiLink":"http://api.npr.org/query?id=403346731&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/blogs/alltechconsidered/2015/04/30/403346731/the-doctor-will-video-chat-with-you-now-insurer-covers-virtual-visits?ft=nprml&f=403346731","nprRetrievedStory":"1","nprPubDate":"Thu, 30 Apr 2015 19:05:00 -0400","nprStoryDate":"Thu, 30 Apr 2015 16:27:00 -0400","nprLastModifiedDate":"Thu, 30 Apr 2015 17:18:52 -0400","nprAudio":"http://pd.npr.org/anon.npr-mp3/npr/atc/2015/04/20150430_atc_united_healthcare_to_cover_virtual_doctors_visits_for_20_million_customers.mp3?orgId=1&topicId=1019&d=200&p=2&story=403346731&t=progseg&e=403362523&seg=10&ft=nprml&f=403346731","nprAudioM3u":"http://api.npr.org/m3u/1403362692-bab9a0.m3u?orgId=1&topicId=1019&d=200&p=2&story=403346731&t=progseg&e=403362523&seg=10&ft=nprml&f=403346731","path":"/futureofyou/2581/the-doctor-will-video-chat-with-you-now-insurer-covers-virtual-visits","audioUrl":"http://pd.npr.org/anon.npr-mp3/npr/atc/2015/04/20150430_atc_united_healthcare_to_cover_virtual_doctors_visits_for_20_million_customers.mp3?orgId=1&topicId=1019&d=200&p=2&story=403346731&t=progseg&e=403362523&seg=10&ft=nprml&f=403346731","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you can live stream movies, why not live stream medical care?\u003c/p>\n\u003cp>Insurance company \u003ca href=\"http://www.uhc.com/\">UnitedHealthcare\u003c/a> will start covering visits to the doctor's office — via video chat. Patients and physicians talk live online — on smartphones, tablets or home computer — to get to a clinical diagnosis. This move to cybermedicine could save insurers a ton of money — or have unintended consequences.\u003c/p>\n\u003cp>Cybermedicine has been \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1761771/\">long-discussed\u003c/a> by the experts. Now, Eric Neiman, father to a little girl in San Francisco, can explain how it works — from personal experience.\u003c/p>\n\u003cp>\"So I'd gotten a text from my wife earlier in the day,\" he says. \"One of our daughter's eyes was a little bit red and she was rubbing it.\"\u003c/p>\n\u003cp>A few hours passed and it got more red and started oozing. \"Well, unfortunately that sounds like it could be pinkeye. So we would look at it together when I got home,\" Neiman says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Which was close to 8 p.m. — too late to see their regular pediatrician. And kind of late to see any doctor. If they went to the local urgent care center, they'd get back home at 10 p.m. or 11 p.m.\u003c/p>\n\u003cp>Then, Neiman remembered something, from his Instagram account, a post for an app called \u003ca href=\"http://www.doctorondemand.com/\">Doctor On Demand\u003c/a>. It pairs users up with doctors who are licensed in their state for a video screening.\u003c/p>\n\u003cp>Neiman decided to log in. \"The pediatrician came on, introduced himself, and then asked to see our daughter, asked to hold the iPhone up to her eye, checked her throat, everything that he could see via the phone.\"\u003c/p>\n\u003cp>Within minutes, the doctor called in a prescription for pinkeye. The visit cost Neiman $40.\u003c/p>\n\u003cp>Neiman was so impressed, he says, he used the app just a few days later for himself. He thought he was getting a sinus infection, and logged in \u003cem>from his car\u003c/em>.\u003c/p>\n\u003cp>\"I was sitting on the side of the street. It's not the first time I pulled over to use my phone,\" he says. \"But to actually go to the doctor — I was just hopeful nobody was watching!\"\u003c/p>\n\u003cp>\u003cstrong>Save On Cost Or Break \u003c/strong>\u003cstrong>The Bank?\u003c/strong>\u003c/p>\n\u003cp>UnitedHealthcare's move to cover all or part of the cost of these e-visits — for up to 20 million customers by 2016 — is big. A major company is putting its stamp of approval on a process that, until now, has been largely experimental.\u003c/p>\n\u003cp>Three mobile-doc startups – Doctor on Demand, \u003ca href=\"https://nowclinic.com/landing.htm\">NowClinic\u003c/a> and \u003ca href=\"https://www.americanwell.com/\">Amwell\u003c/a> – are the initial providers.\u003c/p>\n\u003cp>Karen Scott, who directs innovation initiatives at UnitedHealthcare, says the company is studying cost: \"What happens if somebody is more likely to use virtual care? Maybe they would have gone in to urgent care. How many of them will choose the virtual visit instead?\"\u003c/p>\n\u003cp>It could be that people grab a doctor online for skin rashes, colds and coughs — and by getting care early on, they prevent an expensive catastrophe. Or maybe people wait too long when they really just need to see a doctor in person. Or it could be this service brings out the inner hypochondriac in us and leaves the insurer with a bigger bill to co-pay.\u003c/p>\n\u003cp>\"Those are the sorts of health care economics and actuarial questions that our experts will be watching,\" Scott says.\u003c/p>\n\u003cp>\u003cstrong>Convenience For Doctors\u003c/strong>\u003c/p>\n\u003cp>This move has big implications for physicians, too.\u003c/p>\n\u003cp>Dr. Tania Elliott, an allergist with Doctor on Demand, says that through the app, patients with a rash show her their symptoms in the moment — not a week later. She takes virtual tours of people's homes to search dust mite sources. Instead of tedious planning, she gives patients a ballpark of when to do a follow up visit.\u003c/p>\n\u003cp>\"They have access to essentially my schedule. And so when they log into the app they can see when I'm online,\" she says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The doctor has even gotten to work remotely — from a hotel room in Hawaii.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=The+Doctor+Will+Video+Chat+With+You+Now%3A+Insurer+Covers+Virtual+Visits&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/2581/the-doctor-will-video-chat-with-you-now-insurer-covers-virtual-visits","authors":["byline_futureofyou_2581"],"series":["futureofyou_172"],"categories":["futureofyou_1"],"tags":["futureofyou_259","futureofyou_34","futureofyou_138","futureofyou_80","futureofyou_173","futureofyou_125","futureofyou_267"],"featImg":"futureofyou_2582","label":"futureofyou_172"},"futureofyou_2509":{"type":"posts","id":"futureofyou_2509","meta":{"index":"posts_1591205157","site":"futureofyou","id":"2509","score":null,"sort":[1430330721000]},"guestAuthors":[],"slug":"hospitals-increasingly-turn-to-patients-for-advice","title":"Hospitals Increasingly Turn to Patients for Advice","publishDate":1430330721,"format":"standard","headTitle":"Contributor | KQED Future of You | KQED Science","labelTerm":{"term":172,"site":"futureofyou"},"content":"\u003cp>Jane Maier was one of a select group of patients invited in early 2012 to help \u003ca href=\"http://www.partners.org/\">Partners HealthCare\u003c/a>, Massachusetts’ largest health system, pick its new electronic health record system – a critical investment of close to $700 million.\u003c/p>\n\u003cp>The system, which is now being phased in, will help coordinate services and reshape how patients and doctors find and read medical information. The fact that Partners sought the perspective of patients highlights how hospitals increasingly care about what their customers think.\u003c/p>\n\u003cp>“It’s such a great experience,” Maier said. “They treat us as a member – a partner – in their review process.”\u003c/p>\n\u003cp>Patient advisory councils, like the one Maier belongs to, often serve as sounding boards for hospital leaders – offering advice on a range of issues. Members are usually patients and relatives who had bad hospital experiences and want to change how things work, or who liked their stay and want to remain involved.\u003c/p>\n\u003cp>For Maier, it all started in 2009 when she had surgery at\u003ca href=\"http://www.brighamandwomens.org/\"> Brigham and Women’s Faulkner Hospital\u003c/a>, a Partners facility. Her husband wrote to the hospital’s CEO, praising her experience. The couple was then invited to speak at a hospital leadership retreat, sharing with top executives both the good and the not-so-good, and Maier was recruited to serve on a new patient advisory panel.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>This hunt for patient perspective, which is becoming more and more common, is fueled in part by the health law’s quality-improvement provisions and other federal financial incentives, such as the link between Medicare payments and patient satisfaction scores.\u003c/p>\n\u003cp>“It’s a change in culture,” said Jayne Hart Chambers, senior vice president for quality at the \u003ca href=\"http://fah.org/\">Federation of American Hospitals\u003c/a>, which represents for-profit hospitals.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Data from 2013 suggested that 40 percent of hospitals had some kind of patient council, said Mary Minniti, a program and resource specialist at the\u003ca href=\"http://www.ipfcc.org/\"> Institute for Patient and Family Centered Care\u003c/a>, a Maryland-based nonprofit organization. Though councils appear to have become more common in the past few years, experts say it’s too early to know whether they typically improve hospital practices.\u003c/span>\u003c/p>\n\u003cp>“A lot of hospitals right now are very concerned because of the direction of [Medicare] payments,” said Carol Cronin, executive director of the nonprofit Informed \u003ca href=\"http://www.patientinstitute.org/\">Patient Institute\u003c/a>, an advocacy group. “They’re very concerned about patient experience and patient satisfaction.”\u003c/p>\n\u003cp>But it’s not just federal incentives. Patients have greater expectations as they shoulder larger shares of health care costs, said Richard Evans, chief experience officer at \u003ca href=\"http://www.massgeneral.org/\">Massachusetts General Hospital\u003c/a>, another Partners facility. This, he added, leads hospitals to focus on customer service.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Initially, nobody knew who we were and we had to sell ourselves\"\u003cbr>\n\u003ccite>Andy DeVries, patient advisory council at Spectrum Health \u003c/cite>\u003c/aside>\n\u003cp>Cronin, who has had a relative stay for an extended time in the hospital, volunteers on the patient advisory council at Johns Hopkins Hospital in Baltimore.\u003c/p>\n\u003cp>She was struck, she said, by the “meaty” topics the group addresses. Hopkins’ medical researchers have even pitched their projects to the council to find out what patients and families think are worthy of scientific investigation.\u003c/p>\n\u003cp>To have an impact, though, these groups can’t operate in isolation.\u003c/p>\n\u003cp>Patient and family advisory councils are useful if they have the ear of hospital leaders, Minniti said. But the groups also have to be integrated into decision making.\u003c/p>\n\u003cp>Andy DeVries joined the first patient advisory council at Michigan’s Spectrum Health about 10 years ago, after he was hospitalized with life-threatening injuries from a motorcycle accident.\u003c/p>\n\u003cp>“Initially, nobody knew who we were and we had to sell ourselves,” said DeVries, who now serves on one of Spectrum Health’s 13 patient groups.\u003c/p>\n\u003cp>Now, by contrast, his group offers input “any time there’s something new that involves patient or family care,” adding that the panel of patient advisers has tackled issues ranging from beefing up the facility’s security to how the hospital should give patients billing information. He’s even worked with the human resources department on what to look for when hiring doctors and nurses.\u003c/p>\n\u003cp>Such feedback led to marked increases in patient satisfaction scores, said Deborah Sprague, Spectrum Health’s program manager for patient and family services.\u003c/p>\n\u003cp>For instance, she said, a member of the orthopedics and neuroscience patient council noticed slow responses when he pushed the call button in his hospital room, a problem staff hadn’t noticed. The council worked with hospital employees to speed up response times. After the fix, positive patient assessments of the hospital jumped.\u003c/p>\n\u003cp>Maier, from the Faulkner council, recalled a time when hospital executives asked for help with patient complaints regarding nighttime noise levels. Late-night talking by staff was keeping patients awake.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Council members are often “middle-aged and older, white and English-speaking, and a lot of women.\"\u003cbr>\n\u003ccite>Deb Wachenheim, health quality manager at Health Care For Ally\u003c/cite>\u003c/aside>\n\u003cp>The group discussed potential nighttime “quiet times” and other strategies to minimize noise without keeping doctors from doing their jobs.\u003c/p>\n\u003cp>Once changes were made, patient satisfaction scores went up, Maier said — and a council member noticed a definite improvement the next time he was a patient.\u003c/p>\n\u003cp>Meanwhile, \u003ca href=\"http://www.medstarhealth.org/\">MedStar Health\u003c/a>, which serves the District of Columbia and Maryland, has targeted advisory panels’ efforts to improve both the quality and safety of its care. The system has emerged as a model for finding ways to incorporate patients’ opinions, which was noted in a report from the American Hospital Association.\u003c/p>\n\u003cp>In one recent case, said David Mayer, MedStar’s vice president of quality and safety, patient advisers helped brainstorm ways to soothe the confusion and stress that often sets in when people have been in the ICU for more than a day. When implemented, the ideas led to reduced instances of patient confusion – known as delirium – which is linked to more destructive behavior, like patients trying to leave the room or bed before they should.\u003c/p>\n\u003cp>But even as the role of patient advisory committees grows, recruiting members continues to be a challenge. Finding people from diverse backgrounds with both the inclination and time to serve can be tricky, Cronin said.\u003c/p>\n\u003cp>As a result, council members are often “middle-aged and older, white and English-speaking, and a lot of women,” said Deb Wachenheim, health quality manager at the Massachusetts-based advocacy group Health Care For All.\u003c/p>\n\u003cp>For some hospitals and health systems, though, these panels are just the beginning. Massachusetts General puts patients on various policy setting committees, and Faulkner has a non-voting patient board member.\u003c/p>\n\u003cp>“As we continue to evolve,” Maier said, “the hospital looks to us more and more.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Copyright 2015 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">http://www.kaiserhealthnews.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Digital+Tools+For+Health+Come+With+%27Hope%2C+Hype+And+Harm%27&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Patients have greater expectations for their medical treatment and care as they now shoulder larger shares of health care costs. ","status":"publish","parent":0,"modified":1434048952,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":30,"wordCount":1169},"headData":{"title":"Hospitals Increasingly Turn to Patients for Advice | KQED","description":"Patients have greater expectations for their medical treatment and care as they now shoulder larger shares of health care costs. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Hospitals Increasingly Turn to Patients for Advice","datePublished":"2015-04-29T18:05:21.000Z","dateModified":"2015-06-11T18:55:52.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"2509 http://ww2.kqed.org/futureofyou/?p=2509","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/04/29/hospitals-increasingly-turn-to-patients-for-advice/","disqusTitle":"Hospitals Increasingly Turn to Patients for Advice","nprByline":"Shefali Luthra, Kaiser Health News ","path":"/futureofyou/2509/hospitals-increasingly-turn-to-patients-for-advice","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Jane Maier was one of a select group of patients invited in early 2012 to help \u003ca href=\"http://www.partners.org/\">Partners HealthCare\u003c/a>, Massachusetts’ largest health system, pick its new electronic health record system – a critical investment of close to $700 million.\u003c/p>\n\u003cp>The system, which is now being phased in, will help coordinate services and reshape how patients and doctors find and read medical information. The fact that Partners sought the perspective of patients highlights how hospitals increasingly care about what their customers think.\u003c/p>\n\u003cp>“It’s such a great experience,” Maier said. “They treat us as a member – a partner – in their review process.”\u003c/p>\n\u003cp>Patient advisory councils, like the one Maier belongs to, often serve as sounding boards for hospital leaders – offering advice on a range of issues. Members are usually patients and relatives who had bad hospital experiences and want to change how things work, or who liked their stay and want to remain involved.\u003c/p>\n\u003cp>For Maier, it all started in 2009 when she had surgery at\u003ca href=\"http://www.brighamandwomens.org/\"> Brigham and Women’s Faulkner Hospital\u003c/a>, a Partners facility. Her husband wrote to the hospital’s CEO, praising her experience. The couple was then invited to speak at a hospital leadership retreat, sharing with top executives both the good and the not-so-good, and Maier was recruited to serve on a new patient advisory panel.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This hunt for patient perspective, which is becoming more and more common, is fueled in part by the health law’s quality-improvement provisions and other federal financial incentives, such as the link between Medicare payments and patient satisfaction scores.\u003c/p>\n\u003cp>“It’s a change in culture,” said Jayne Hart Chambers, senior vice president for quality at the \u003ca href=\"http://fah.org/\">Federation of American Hospitals\u003c/a>, which represents for-profit hospitals.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Data from 2013 suggested that 40 percent of hospitals had some kind of patient council, said Mary Minniti, a program and resource specialist at the\u003ca href=\"http://www.ipfcc.org/\"> Institute for Patient and Family Centered Care\u003c/a>, a Maryland-based nonprofit organization. Though councils appear to have become more common in the past few years, experts say it’s too early to know whether they typically improve hospital practices.\u003c/span>\u003c/p>\n\u003cp>“A lot of hospitals right now are very concerned because of the direction of [Medicare] payments,” said Carol Cronin, executive director of the nonprofit Informed \u003ca href=\"http://www.patientinstitute.org/\">Patient Institute\u003c/a>, an advocacy group. “They’re very concerned about patient experience and patient satisfaction.”\u003c/p>\n\u003cp>But it’s not just federal incentives. Patients have greater expectations as they shoulder larger shares of health care costs, said Richard Evans, chief experience officer at \u003ca href=\"http://www.massgeneral.org/\">Massachusetts General Hospital\u003c/a>, another Partners facility. This, he added, leads hospitals to focus on customer service.\u003c/p>\n\u003caside class=\"pullquote alignright\">“Initially, nobody knew who we were and we had to sell ourselves\"\u003cbr>\n\u003ccite>Andy DeVries, patient advisory council at Spectrum Health \u003c/cite>\u003c/aside>\n\u003cp>Cronin, who has had a relative stay for an extended time in the hospital, volunteers on the patient advisory council at Johns Hopkins Hospital in Baltimore.\u003c/p>\n\u003cp>She was struck, she said, by the “meaty” topics the group addresses. Hopkins’ medical researchers have even pitched their projects to the council to find out what patients and families think are worthy of scientific investigation.\u003c/p>\n\u003cp>To have an impact, though, these groups can’t operate in isolation.\u003c/p>\n\u003cp>Patient and family advisory councils are useful if they have the ear of hospital leaders, Minniti said. But the groups also have to be integrated into decision making.\u003c/p>\n\u003cp>Andy DeVries joined the first patient advisory council at Michigan’s Spectrum Health about 10 years ago, after he was hospitalized with life-threatening injuries from a motorcycle accident.\u003c/p>\n\u003cp>“Initially, nobody knew who we were and we had to sell ourselves,” said DeVries, who now serves on one of Spectrum Health’s 13 patient groups.\u003c/p>\n\u003cp>Now, by contrast, his group offers input “any time there’s something new that involves patient or family care,” adding that the panel of patient advisers has tackled issues ranging from beefing up the facility’s security to how the hospital should give patients billing information. He’s even worked with the human resources department on what to look for when hiring doctors and nurses.\u003c/p>\n\u003cp>Such feedback led to marked increases in patient satisfaction scores, said Deborah Sprague, Spectrum Health’s program manager for patient and family services.\u003c/p>\n\u003cp>For instance, she said, a member of the orthopedics and neuroscience patient council noticed slow responses when he pushed the call button in his hospital room, a problem staff hadn’t noticed. The council worked with hospital employees to speed up response times. After the fix, positive patient assessments of the hospital jumped.\u003c/p>\n\u003cp>Maier, from the Faulkner council, recalled a time when hospital executives asked for help with patient complaints regarding nighttime noise levels. Late-night talking by staff was keeping patients awake.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Council members are often “middle-aged and older, white and English-speaking, and a lot of women.\"\u003cbr>\n\u003ccite>Deb Wachenheim, health quality manager at Health Care For Ally\u003c/cite>\u003c/aside>\n\u003cp>The group discussed potential nighttime “quiet times” and other strategies to minimize noise without keeping doctors from doing their jobs.\u003c/p>\n\u003cp>Once changes were made, patient satisfaction scores went up, Maier said — and a council member noticed a definite improvement the next time he was a patient.\u003c/p>\n\u003cp>Meanwhile, \u003ca href=\"http://www.medstarhealth.org/\">MedStar Health\u003c/a>, which serves the District of Columbia and Maryland, has targeted advisory panels’ efforts to improve both the quality and safety of its care. The system has emerged as a model for finding ways to incorporate patients’ opinions, which was noted in a report from the American Hospital Association.\u003c/p>\n\u003cp>In one recent case, said David Mayer, MedStar’s vice president of quality and safety, patient advisers helped brainstorm ways to soothe the confusion and stress that often sets in when people have been in the ICU for more than a day. When implemented, the ideas led to reduced instances of patient confusion – known as delirium – which is linked to more destructive behavior, like patients trying to leave the room or bed before they should.\u003c/p>\n\u003cp>But even as the role of patient advisory committees grows, recruiting members continues to be a challenge. Finding people from diverse backgrounds with both the inclination and time to serve can be tricky, Cronin said.\u003c/p>\n\u003cp>As a result, council members are often “middle-aged and older, white and English-speaking, and a lot of women,” said Deb Wachenheim, health quality manager at the Massachusetts-based advocacy group Health Care For All.\u003c/p>\n\u003cp>For some hospitals and health systems, though, these panels are just the beginning. Massachusetts General puts patients on various policy setting committees, and Faulkner has a non-voting patient board member.\u003c/p>\n\u003cp>“As we continue to evolve,” Maier said, “the hospital looks to us more and more.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Copyright 2015 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\">http://www.kaiserhealthnews.org/\u003c/a>.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Digital+Tools+For+Health+Come+With+%27Hope%2C+Hype+And+Harm%27&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/2509/hospitals-increasingly-turn-to-patients-for-advice","authors":["byline_futureofyou_2509"],"series":["futureofyou_172"],"categories":["futureofyou_1"],"tags":["futureofyou_261","futureofyou_259","futureofyou_34","futureofyou_138","futureofyou_80","futureofyou_260","futureofyou_257","futureofyou_262","futureofyou_258"],"featImg":"futureofyou_2510","label":"futureofyou_172"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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