Handling the big gulp patient...
Often patients have lifestyle habits that are detrimental to their overall health...the pace with which you handle these issues is critical to the doctor-patient relationship.
So this week a patient came in with a "super gulp" or whatever they are called, cup of soda. (Not too out of the ordinary) The thing that gets me scratching my head is this is my financial hardship patient, with Hx of cancer, fibromyalgia, and enough stress for both of us. She left the office and 5 minutes came back and had a look of relief as she held up her cup and said "almost forgot it."
Now- am I over the top...maybe. But it gets me thinking- How many of my patients are going to be coming to me for headaches and never tell me they drink a 6 pack a day of coke? or worse, those "energy drinks" that have 5 times the caffeine. Or whatever the scenario.
Anyway, I have attempted to create a general survey that a person will feel comfortable answering honestly and yet asks the questions that are pertinent. if there are more you can think of or if you think they are too vague or whatever, please feel free to fill me in.
I like the concept of going beyond the norm it is in keeping with being more like Sherlock Holmes than Dr. Watson...
"Never trust to general impressions, my boy, but concentrate yourself upon details. My first glance is always at a woman's sleeve. In a man, it is perhaps better to take the knee of the trouser."
A Case of Identity
Sherlock Holmes to Dr. Watson
"By a man's finger-nails, by his coat-sleeve, by his boots, by his trouser-knees, by the callosities of his forefinger and thumb, by his expression, by his shirt-cuff - By each of these things a man's calling is plainly revealed. That all united should fail to enlighten the competent inquirer in any case is almost inconceivable."
A Study in Scarlet
Sherlock Holmes to Dr. Watson
I used to have patients keep track of everything they put in their mouths, or smoked, snorted or injected (I think this about coveres it...) The reason for the injected and snorted is that I neglected these questions until I had a 35 year heroin addict tell me I should ask about injecting junk...I broadened my viewpoint from that point on, and of course added the snorting part too...;-)
Don't forget though, if you asked this woman if she cared about her health, she would say OF COURSE!
Patient ignorance...not stupidity. Everyone makes choices...be sure never to prejudice your patient care by judging...a variation of the proverbial chip...
How to handle/implement your form.
Health and Wellness Survey
How many glasses of water do you drink a day? 1 2 3 4 5 6 7 8 9 10 10+
How many cans of soda do you drink a day/week (circle one)? 0 1 2 3 4 5 6 6+
What else do you drink in an “average day”? _________________________________
How many fresh fruits do you eat a day/week (circle one) (ex. apple, banana, orange)? 1 2 3 4 5 5+
How many fresh vegetables do you eat a day/week (circle one) (ex. carrot, broccoli florets, corn on the cob)? 1 2 3 4 5 5+
For you, what is your “average” breakfast? ___________________________________________
How many hours do you sleep a night? 4 5 6 7 8 9 9+
On an “average day” how long do you go without getting up from a seated position? 1 2 3 4 5 5+
How many days out of an “average” week do you feel “stressed” 1 2 3 4 5 6 7
What do you do to relieve stress? Eat Drink (what?)________ Exercise (what?)_______
other__________________________
What part of the day do you most look forward to? __________________________________
What part of the week do you most look forward to? _________________________________
How would you describe your general state of health? ________________________________
Remember you must first give them what they want in order to create the opportunity to provide them with what they need. Therefore, do not complicate things by overloading people with too much up front...allow the reservoir of trust to build up a bit. Changing someone's health paradigm takes time...
Have the patient fill out this form at the first re-evaluation rather than on the first visit...
Review the results with the patient during their visits...how does their lifestyle impact their condition? Nothing generic, all of it should be direct and focused, and personally relevant.
Do not feed patients with a firehose...as the doctor patient relationship builds, you can do more and more, and truely have a positive impact upon the life and health of each patient you serve...
So this week a patient came in with a "super gulp" or whatever they are called, cup of soda. (Not too out of the ordinary) The thing that gets me scratching my head is this is my financial hardship patient, with Hx of cancer, fibromyalgia, and enough stress for both of us. She left the office and 5 minutes came back and had a look of relief as she held up her cup and said "almost forgot it."
Now- am I over the top...maybe. But it gets me thinking- How many of my patients are going to be coming to me for headaches and never tell me they drink a 6 pack a day of coke? or worse, those "energy drinks" that have 5 times the caffeine. Or whatever the scenario.
Anyway, I have attempted to create a general survey that a person will feel comfortable answering honestly and yet asks the questions that are pertinent. if there are more you can think of or if you think they are too vague or whatever, please feel free to fill me in.
I like the concept of going beyond the norm it is in keeping with being more like Sherlock Holmes than Dr. Watson...
"Never trust to general impressions, my boy, but concentrate yourself upon details. My first glance is always at a woman's sleeve. In a man, it is perhaps better to take the knee of the trouser."
A Case of Identity
Sherlock Holmes to Dr. Watson
"By a man's finger-nails, by his coat-sleeve, by his boots, by his trouser-knees, by the callosities of his forefinger and thumb, by his expression, by his shirt-cuff - By each of these things a man's calling is plainly revealed. That all united should fail to enlighten the competent inquirer in any case is almost inconceivable."
A Study in Scarlet
Sherlock Holmes to Dr. Watson
I used to have patients keep track of everything they put in their mouths, or smoked, snorted or injected (I think this about coveres it...) The reason for the injected and snorted is that I neglected these questions until I had a 35 year heroin addict tell me I should ask about injecting junk...I broadened my viewpoint from that point on, and of course added the snorting part too...;-)
Don't forget though, if you asked this woman if she cared about her health, she would say OF COURSE!
Patient ignorance...not stupidity. Everyone makes choices...be sure never to prejudice your patient care by judging...a variation of the proverbial chip...
How to handle/implement your form.
Health and Wellness Survey
How many glasses of water do you drink a day? 1 2 3 4 5 6 7 8 9 10 10+
How many cans of soda do you drink a day/week (circle one)? 0 1 2 3 4 5 6 6+
What else do you drink in an “average day”? _________________________________
How many fresh fruits do you eat a day/week (circle one) (ex. apple, banana, orange)? 1 2 3 4 5 5+
How many fresh vegetables do you eat a day/week (circle one) (ex. carrot, broccoli florets, corn on the cob)? 1 2 3 4 5 5+
For you, what is your “average” breakfast? ___________________________________________
How many hours do you sleep a night? 4 5 6 7 8 9 9+
On an “average day” how long do you go without getting up from a seated position? 1 2 3 4 5 5+
How many days out of an “average” week do you feel “stressed” 1 2 3 4 5 6 7
What do you do to relieve stress? Eat Drink (what?)________ Exercise (what?)_______
other__________________________
What part of the day do you most look forward to? __________________________________
What part of the week do you most look forward to? _________________________________
How would you describe your general state of health? ________________________________
Remember you must first give them what they want in order to create the opportunity to provide them with what they need. Therefore, do not complicate things by overloading people with too much up front...allow the reservoir of trust to build up a bit. Changing someone's health paradigm takes time...
Have the patient fill out this form at the first re-evaluation rather than on the first visit...
Review the results with the patient during their visits...how does their lifestyle impact their condition? Nothing generic, all of it should be direct and focused, and personally relevant.
Do not feed patients with a firehose...as the doctor patient relationship builds, you can do more and more, and truely have a positive impact upon the life and health of each patient you serve...
posted by Dr. Scott J. Heun at
9:21 AM
