Conversations key to health care


Illustration by Bryan Nielsen/Standard-Examiner
Story by Jamie Lampros
(Standard-Examiner correspondent)
Tue, Dec 27, 2011
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People living in the Western part of the country are among the most health-conscious, active Americans.

However, like many people across the nation, the biggest risk facing them is the fact that when they feel good, they neglect wellness visits. What’s more, they aren’t very obedient when it comes to following doctor’s orders.

The findings, reported in “A Fragile Nation in Poor Health,” were released last month by TeleVox, a Mobile, Ala., software company that uses technology to connect patients and health-care providers. The company is encouraging people to take their health care seriously.

The report shows that people in the West believe they could better follow their prescribed plans — and would be more likely to do so — if they received encouragement and reminders from their doctors between visits. The study also found that many people living in the West don’t visit their doctor until something is wrong.

Dr. Christine Nefcy, chief medical officer at McKay-Dee Hospital in Ogden, said health care is multifaceted and often complex, and good communication and trust between doctor and patient are essential. However, she says, the reasons for poor compliance and accessing care are also complicated.

“The cost of health care is one barrier to not only accessing care, but following through on recommendations,” Nefcy said. “Prescriptions can be expensive, even seeing a physician can be too much for some patients.”

According to the study, the high unemployment rate and lack of jobs are taking a toll on the health of Americans. Three in five people who are out of work reported that their overall personal health went downhill as well. Being out of work causes stress. Stress causes illness. No job means they can’t afford health care.

Patient responsibility

Dr. Brent Williams, a family physician in South Ogden, said his patients are fairly responsive at following his orders. However, he said, he would like to see people be more proactive when it comes to preventive care.

“I think people do pretty much what I ask them to do,” he said. “I’m sure cost is an issue, but I would like to see people focus on trying to prevent disease instead of waiting until things get serious.”

Williams said although it’s important for doctors to be interactive with patients and keep patients on track, he would like to see people take more responsibility for their health as well.

“The patient needs to be responsible for their diabetes or heart disease or obesity,” he said. “Sometimes people think it’s their doctor’s responsibility instead of theirs, but as physicians we can only diagnose, treat and remind them. We can’t force the patient to take their insulin or change their eating habits. They’ve got to do that themselves.”

Williams also said physicians don’t have as much control over what is happening in medicine.

“When I came through medical school, the doctors were the ones setting the standard of care. They felt an obligation. If they had a patient in the ER, they went over there and admitted them to the hospital or consulted with the ER physician,” he said. “Now the corporations are setting the standard of care — and I’m not saying that’s a bad thing, but we just don’t have as much skin in the game anymore.”

Confusion & mistrust

Misunderstanding directions and suffering side effects after taking medications are also cited in the study as reasons people stop treatment. Nefcy said both of these can be addressed by establishing good communication with health-care providers.

“Your doctor wants to know if you can’t afford or tolerate the medicine she or he prescribed,” she said. “Likewise, they want to know if you don’t understand why or when you are supposed to take something, but they won’t know unless you, the patient, tells them.”

Nefcy also said mistrust of the health-care system is a barrier to care. Patients now have access to a vast amount of information on the Internet, and that information is not always accurate.

“An example ... is the British physician who published an article suggesting a link between the MMR (measels, mumps, rubella) vaccine and autism,” she said. “There was a huge media outcry, parents were terrified, vaccination rates dropped, measles cases surged and children in England unfortunately died as a result.”

Despite numerous studies showing no scientific evidence for any link whatsoever between MMR and autism, Nefcy said, the fear still persists and still causes some families to avoid vaccinations.

“Ten children died in California last year from whooping cough, clearly illustrating why we recommend routine vaccinations and the consequences of not immunizing,” she said. “Patients can’t always tell what website is a valid one, and often the voice of science and medicine is overshadowed by the voice of fear and distrust.”

Providers’ efforts

Cheri Bursell, marketing and communications coordinator at Ogden Regional Medical Center, said MountainStar launched a comprehensive referral service in 2008 to help patients navigate the complex network of health-care providers in the community.

“In particular, it serves those who might not otherwise follow through with recommended treatment referrals or tests,” she said. “Patients can conveniently call our service from their primary care physician’s office or from home. Our patient advocates will not only help them to schedule an appointment with a specialist, often while they remain on the phone, but also authorize insurance coverage and preauthorizations as required.”

Chris Dallin, public relations director at McKay-Dee Hospital, said Intermountain Healthcare has a pilot program that attempts to coordinate care between the hospital, doctor and health insurance so they all know what is going on with a patient.

“Find a physician you trust,” Nefcy said. “Lastly, your health starts at home. Your health-care team is available for education, treatment, follow-up and encouragement, but eating right, exercising, turning off the TV, avoiding drugs, tobacco and excessive alcohol are your responsibilities. We’re here to help you in any way we can, but it’s a team effort.”

Doctor, Health
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