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Medical Forum / Diseases and Disorders / Breast Cancer / November 2003

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Need Survey Participants...Patients and Doctors

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John Cisar - 09 Nov 2003 05:18 GMT
Hello group members,

My name is John, and as a student at Champlain College, in Burlington,
VT, I am conducting two surveys for project purposes.
The first is a survey aimed at patients with the purpose of analyzing
Patient-Doctor relations, to determin the gaps within, and to improve
upon existing resources used by patients in search of Doctors and care
givers.
Your easy-access web link to this survey is:

http://www.CustomInsight.com/start/patientrelations.asp

The second survey is designed for Medical Professionals and Care givers
ONLY.
The Objective of this survey is similar: to identify gaps in patient-
doctor relations, to analyze growth among mutiply practice types, and to
determine what future services could be used by those Doctors reaching
out for patients.
You can access this survey by following this link:

http://www.CustomInsight.com/start/helpingdoctors.asp

Thanks.
Kaye301 - 09 Nov 2003 18:43 GMT
<< The first is a survey aimed at patients with the purpose of analyzing
Patient-Doctor relations, to determin the gaps within, and to improve
upon existing resources used by patients in search of Doctors and care
givers. >>

My first thoughts are the problems inherent in patient-doctor relations would
be further exacerbated by the method used to study such--surveys.  Having seen
4 surgeons, 4 plastic surgeons, and consutled with no less than 6
oncologists--the problems are individualistic combinations of
characteristics--although I suppose one might be able to better identify or get
a handle on some of them through statistical analysis...
Some of the difficulies I've seen include:
not listening to patients--presenting their own agenda whether or not in
answers the patients questions or addresses their needs at that time.  Another
is not looking at the individual characteristics of patients and trying to fit
them into a prescribed set of criteria into which their unique symptoms don't
adequately match.  A third is not admitting their own lack of understanding or
knowledge about a given situation.  A fourth is not looking at the patients
symptoms as a whole and how the symptoms may be interrelated.  In other words,
trying to separate out the symptoms as being specific to a given area of
specialty while disregarding their interrelationship.  Thus, the validity of
this practice becomes highly questionable in the long run since the individual
areas work together in a systematic fashion.  
Another difficulty (4th), not specific to oncology, is the dr. who only wants
to deal with one symptom per visit when patient waits to be seen until there
are several symptoms that warrant attention.
Then a 5th problem is that the dr's do not communicate with each other--the
patient is like the hub--and each dr. is like a separate spoke--but not all of
them reach the outter rim which reinforces the outter rim.  If they did they
would have a much clearer picture of what is going on.  In other words the
practice of medicine doesn't go far enough in dealing with many of the problems
and thus, preventing others before they co-occur.
That leads to a 6th problem, often times, which is that the patient must have
an advocate or does tie it altogether, if they are not able to do so
themselves.  If that doesn't happen the patient oftentimes does not receive the
requisite care in all areas that need to be addressed.  The pcp is supposed to
do that. However, if the pcp doesn't look at how the individual parts
inter-related, something important is often missing.
There is an 7th problem where the reported information is innacurate due to the
dr's not remembering or having heard something different than the patient
actually said. This may result in both misinterpretation or results.  Been
there/done that.
Then there is a 8th problem--where other dr's rely on results of reports (i.e.
radiology) rather than the direct information themselves.  If first dr.
(radiologist) is basing his findings on the norm for that given situation and
patient does not fit into that normative category, the interpretation may be
wrong.
That leads to the 9th problem--where the specialist doesn't have knowledge of
difficulties beyond the most common scenarion which may lead to missed
diagnoses.  (i.e. the radiologist who said that the enlarged retroperitoneal
nodes that were on my first scan were not likely associated with breast cancer.
He was 'right' for the majority of breast cancers--85%.  However, if you are
not amongst that 85% that statement may not fit.  It didn't in my case.  I was
in the minority, having the 2nd most common type for which the retroperitoneal
nodes and retroperitoneum were the 3rd most common site for metastases.  I
don't know if the interpreting radiologist at our HMO knew that--but a private
radiologist acquaintance informed us that he hadn't been aware of that.
Thus, that leads to a 9th problem--that specialist who do specialized
procedures often don't have all the critical patient history nor an
understanding of what differential symptomatology, which is out of the  norm,
may mean.
I have not experienced this with all the dr's I've seen but have seen it to
varying degrees in several.
Now that I have finished ramblings probably not of interest to most I will get
off my soap box...and apologize, because I do assume that surveys may be a
beginning of a search for a better answer (while at the same time still
maintain they often wind up 'missing the boat' or perpetuating another set of
difficulties at the same time.
Jasmine - 09 Nov 2003 23:30 GMT
Excellent post, Kaye!!!
Jasmine

> << The first is a survey aimed at patients with the purpose of analyzing
> Patient-Doctor relations, to determin the gaps within, and to improve
[quoted text clipped - 64 lines]
> maintain they often wind up 'missing the boat' or perpetuating another set of
> difficulties at the same time.
Kaye301 - 10 Nov 2003 02:30 GMT
Jasmine wrote<< Excellent post, Kaye!!!
Jasmine

Thanks, glad it sounded ok--was just kind of rambling or letting my thoughts
flow and didn't have time to proof read but it reflected my feelings about what
I think of alot or research, and I am in a field that is  heavily
research-based.  One problem with much of research is that it is next to
impossible to control all the relevant variables.  I guess that is why it is
hard to develop effective treatments for cancer patients across the board.  Not
only do  breast cancers differ between people but tumor characteristics can be
differrent in one given person--which is why the med may work for some tumors
but not others...
Jasmine - 10 Nov 2003 03:24 GMT
> Jasmine wrote<< Excellent post, Kaye!!!
> Jasmine
[quoted text clipped - 9 lines]
> differrent in one given person--which is why the med may work for some tumors
> but not others...

What do you think about this: http://www.dadamo.com/ ?  Could our blood type
having something to do with our health and how susceptible we are to the
environment, medicines, the foods we eat, etc?
Jasmine
Kaye301 - 10 Nov 2003 15:48 GMT
Jasmine wrote << What do you think about this: http://www.dadamo.com/ ?  Could
our blood type
having something to do with our health and how susceptible we are to the
environment, medicines, the foods we eat, etc?

I had heard about that previously but really don't know anything about it.
Supposedly the type of blood I have (A+) is more associated with b.c. risk than
other types although am not sure if that has been conclusively proven.  I have
no clue if diet would have anything to do with that.  I do believe that diet
may help and influence who gets b.c.  Then there is my aunt, who by the way has
a fast metabolism, who got b.c. at the age of 45.    She hasn't changed her
diet and continues to eat whatever she wants, when she wants.  She remains tall
and slender.  She was dx'd 22 years ago.  She started chemo which was never
finished because she was badly burnt in a fire while undergoing chemo.  She
could never have radiation.  She then got a b.c. recurrence in the other breast
and had a mastectomy.  She had, at the least a couple of positive nodes.   She
has not had a further recurrence of b.c. although did have 3 separate lung
cancers (due to either the fire and/or her past hx of smoking).  She is now 67
and the only one of my mother's several relatives with b.c. to have survived...
 
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