My role as physician is changing. Fortunately, we doctors have been through this many times, and you patients have always led us in the right direction. In this TEDx Penn Quarter video I’ll tell you the story of doctors and patients. I’ll show you where we’re going and where we’ve been. It might surprise you.
I’ve been on a whirlwind tour these last few weeks. I’d like to thank my brilliant and beautiful wife (and PR agent) @FoodBlogga, my colleagues and staff at Kaiser Permanente in San Diego, Chris Mahoney (@cpmahoney) and Cynergy Solutions (who graciously invited me to speak) and two inspiring physicians with whom I spent some time recently, Dr. Joe Kvedar (@jkvedar) and Dr. Atul Gawande (@Atul_Gawande).
So tell me, do you see your doctor reinventing himself or herself yet? Why or why not?
Is the milk you drink rBST-free? Is your physician board certified?
Many people take the time to buy hormone free milk, but they don’t make an effort to choose a physician who is board certified. That’s a shame.
Asking a friend or family member might be a good way to choose a hairdresser, but it is not a good way to choose a physician. Medicine is difficult. The same way that you want the pilot of your next flight to be maintaining his or her skills and knowledge of flying, you also want your physician to maintain his or her skills in medicine. The truth is, you are much more likely to die from your doctor’s mistake than from a pilot’s mistake.
Being board certified is no guarantee that your physician is good (or nice!), but it does assure you that your physician is committed to continuing education and is learning advances in medicine. It also assures you that your physician has completed the necessary training and passed a certification exam for the field of medicine he or she is practicing. Having a license means only that they completed the minimal requirement to practice medicine. Maintaining active board certification means that your physician has undergone yearly continuing education and has passed a re-certification exam every few years.
Certainly there is more to being a good physician than completing residency and passing written and oral examinations. But studies show that high exam scores do correlate with practicing better medicine.
There are 24 board specialties. You can check to see if your physician is board certified by going to the American Board of Medical Specialties site at ABMS.org, registering, and putting in your physician’s name. It is a free and confidential service. You can have a nice glass of rBST-free milk in the meantime.
In a recent dermatology study, a mere 50% of adults and 30% of children were still using their medications 8 weeks after they were prescribed.
But what if I sent you a text to remind you? Would you be more likely to take your meds or use your creams?
Taking medications or applying creams takes effort and discipline. Unless you form a new habit and apply your medication or take your pills at the same time everyday, it is unlikely you will persist. It is similar to exercising — if you exercise at different times and different days, then it is much more difficult to stay exercising than if you developed a habit and did it as part of your daily routine.
There might be a new way to help encourage people to get into a habit of taking their medication everyday: text them.
A recent study presented at a Society for Investigative Dermatology meeting showed that texting patients actually improves compliance (that is, the likelihood that they will take their medication). In the study, 70 cell phone users were randomized to receive a text message reminder to apply sunscreen everyday or to not receive the text reminder.
At the end of 6 weeks those who received the text reminder were more likely to apply their sunscreen as compared to those who did not receive the text. In the text group, people used the sunscreen 56% of the time while in the control group they used it only 30% of the time.
The researchers cleverly attached the weather forecast to the text message to make the message more useful and to encourage people to open the message and read it. The act of opening and reading the message everyday helped them get into the habit of applying the sunscreen everyday, improving their compliance.
In my practice more and more patients use email to communicate with me. Texting might be another way to communicate with patients to help them be more compliant with their therapy.
You can’t text me, but you can twit me if you like.