Dr. Gary Oberlender spent many years on the staff of the federal Veterans Administration Medical Center in Salem. When he retired a decade ago, he opened his own practice as a consultant in geriatric medicine.
In that role, he often speaks at such facilities as the Harrogate retirement complex off Wildwood Road in West Salem. There I heard him earlier this month speak and lead a 90-minute program “Improving Communications with Your Health Care Provider.”
Older people usually have to deal with “medical providers” more often than those younger. Their physical problems most commonly fall into one or more of these changes: joint aches and pains, bladder and sexual dysfunction difficulties, memory issues and depression/anxiety. None of these, the doctor said, are caused by old age, and no doctor should treat a patient in physical or mental pain as though nothing can be done or the discomfort doesn’t matter.
But many of the speaker’s observations apply to anyone old enough to consult a medical provider for “today medicine is practiced on a production model.” Oberlender said that doctors in big centers like those in the Roanoke Valley expect to give about 12 minutes to listening to, diagnosing and offering advice and/or a drug per patient. Increasingly too, drugs themselves can become a major problem. Many patients don’t know why they’re taking so many.
One might ask on a visit, “Do you think I need all these drugs?” the speaker suggested. Herbal supplements count too. A full list needs to be with the patient.
The very term “medical provider” is deliberately general, Oberlender pointed out, for well-qualified people may hold the traditional Doctor of Medicine degree while others are physician’s assistants, nurse practitioners or thoroughly conversant in an alternative healing program.
In surveys, patients have complained their provider talks too fast, has an accent they can’t understand or uses medical terms such as “prognosis” for “outcome”. Oberlender, who also works with medical professionals to help them be more at ease with sick people, provided for us elders at the seminar a list of translated medical terms.
Basically, patients want from their doctor’s affability, availability and ability. Those needing a surgeon to remove a cancerous growth or repair a heart or brain clearly must be assured of her ability. For less life or death needs the “bedside manner” of the family physician of memory is vital, and ease and confidence in the doctor may even hasten recovery, Oberlender noted.
When seeing a doctor, patients do well to plan their questions in advance so they won’t forget; it may work to give these typed to the provider. Many older people need someone to accompany them, but this person must be registered with the hospital or clinic as qualified to receive information about the patient’s condition because of privacy laws.
{I might add, from what I read in church newsletters, that an authorized family member must also notify the patient’s religious community, if it’s important to the hospitalized, so that the pastor may visit.}
The speaker was firm about the need of a patient to ask the doctor questions about any symptoms or worries. “You appeal to his intellect,” Oberlender said, smiling. “And he or she may certainly miss an important change if you don’t speak up.”
Though medical providers become highly skilled at looking for clues to a patient’s condition – only about seven percent of what is learned comes by words, it’s been found – it appears to help greatly if advance planning is in place to save those valuable minutes.
At the retirement home lecture, several mentioned adjustments necessary when a new doctor enters the picture. I personally have had to adjust since 2000 to the retirements of four doctors I had come to like and trust. Two young female physicians moved away to marry. I long for the days when a patient could count on her physician for 20 years or more. Part of this frustration is my own advancing years, but the fast-moving medical scene as personnel seek escape from their own stresses is also contributing to the sense of confusion about their health care which many increasingly feel.
‘Remember, what you say and show makes up 50 percent of the outcome of your treatment,” Oberlender advised.
