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Tips on Doctors

The real risks of self-diagnosis

Are you suffering from something? A rash, maybe a fever or a red-eye can determine you to search on the internet for an answer. Many times people choose to search the Web to figure out what may be wrong with them, rather than to make an appointment with the doctor. With limited time and the wealth of information now available at the click of a mouse, people tend to “Google” anything. In this article we will describe when self-diagnosis is dangerous, and what you might know overtly about this danger. Here are a few truths to consider and how self-diagnosis can affect you.

What are the risks of self-diagnosis? Too often this practice leads to inaccurate, worst-case conclusions.

Getting information via the Web can also make it difficult to decide what symptoms mean in the absence of a doctor’s analysis. According to Harvard Med, Online Symptoms Checkers are wrong about 70% of the time. Similar results were found in the British Medical Journal.

While healthcare professionals acknowledge the convenience of the internet and sympathize with the struggle of some insurance plans, here are some reasons you should think twice before you search on the World Wide Web for your health problems. The risks that are associated with self-medication include:

  • The stress caused by assuming the worst about your symptoms before seeing a doctor can end up becoming an added detriment to your health.
  • The benefit of seeing a doctor is the access to trained medical experience and the personal relationship you form. The personal knowledge your doctor has about you and your medical history can’t be replaced by a website.
  • There’s also the danger of self-medicating using products with negative side effects. It’s best to consult your doctor about remedies you’d like to use because your provider will be able to inform you of the risks associated with these treatments, specific to your health and history.
  • Self-medication can be life-threatening when inaccurate dosages are taken. When you estimate your own dosage, you are at risk for taking enough to result in an accidental overdose.

When it comes to themselves, people tend to exaggerate

According to the researchers, when referring to their own symptoms people were much quicker to diagnose to a rare disease compared if they thought the symptoms were someone else’s.

Imagine the situation that you need to take a decision about someone else rather than yourself — people tend to rely more on broader information such as statistics and less on information specific to the individual, such as the symptoms he or she is having.

Consumers often fear the worst when it comes to their own health while maintaining a calm objectivity with regard to others,” said Yan Dengfeng Yan, a doctoral student at the Hong Kong University of Science and Technology. If you’ve got pain in the chest, you think heart attack. If a friend of a friend has the same symptoms, you say probably indigestion.

Think twice about self-diagnosing

While this article may sound like an internet ban when it comes to health information, it’s important to know that doctors do not intend to prohibit their patients from playing an active role in healthcare. It’s great that you can stay informed, but self-diagnosis is a bad thing for you and for your own mental and physical health.

Doctors are generally very enthusiastic to answer patients’ questions, so it would help if you actually trusted your doctor. If your doctor is someone whom you cannot trust, then think again about that and choose a person you fully trust. Your doctor should respect your opinion, but the discussion should be an active one. If you doubt the doctor’s diagnosis, tell him or her that you do and say why. This is much better than silently diagnosing your own syndrome.

In conclusion, self-diagnosis can have tremendous negative repercussions on the patient. For this reason, while reading is helpful and informative, it is always best to discuss your impressions with a doctor before you decide on the treatment you want.

For any questions that you may have about the prostate cancer, you can contact Dr. David Samadi who is more than happy to answer your questions.

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Study reveals that medical errors are third leading cause of death

An alarming study from 2016, conducted by Johns Hopkins patient safety experts, reveals that medical errors are responsible for the third leading cause of death in the U.S., with more than 250,000 deaths yearly.  The U.S.’s Center for Disease Control and Prevention’s (CDC) report on the leading causes of death doesn’t take into account situations where the death of a patient was caused by a fault of the medical system. The lack of information on this topic correlates directly with the absence of medical error as a cause of death in the coding system. The classification is valid and available since 1949, when the U.S. adopted an international form based on the International Classification of Diseases (ICD) billing codes.

doctor's office

Due to the valid coding system, yearly statistics on leading causes of death have excluded medical error. Faulty medical care, wrong diagnosis, lack of procedures or of safety nets weren’t considered a potential threat to the lives of patients. The coding system was constructed in such a way as to maximize billing for medical services, rather than to collect national health statistics.

“Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics. […] At that time (1949), it was under-recognized that diagnostic errors, medical mistakes and the absence of safety nets could result in someone’s death, and because of that, medical errors were unintentionally excluded from national health statistics,” says Martin Makary, M.D., M.P.H., professor of surgery at the Johns Hopkins University School of Medicine.

Lack of reporting on deaths caused by medical mistakes has developped into a dangerous situation

Reaching this conclusion was not an easy challenge for researchers at Johns Hopkins, especially for lack of coding of medical errors in the health information system. Their approach consisted in analyzing data from four independent studies, from 2000 to 2008. Using yearly hospitalization information and number of deaths, the researchers were able to arrive at the conclusion that about 9.5% of all deaths each year are caused by medical errors. The issue has passed unnoticed for years and plenty of research and funding were allocated by the Government to the causes of death reported by the CDC. In the list of life threatening causes, medical errors are less frequent than heart disease or cancer, but are more likely to occur than respiratory disease.

Fortunately or not, experts state that most medical errors are not due to poorly qualified doctors, but, rather to systemic problems: fragmented insurance networks, lack of procedures, protocols, safety nets, geographic variations (unwarranted variations) in the way physicians choose to treat the same conditions, that are not explainable by illness, medical need or the dictates of evidence-based medicine.

Reducing variability in physician practices by developing protocols that clearly set a standard for curing illnesses and delivering medicin,e can both improve quality of the health care system, lower costs and ensure higher success rates in dealing with life threatening illnesses. Resources should be invested in finding more manners of preventing medical errors.

How can you avoid being a victim of medical errors?

  • Finding the right doctor – Even though poorly trained doctors are not a direct cause of faulty medical treatment, knowing how to choose the right doctor is still paramount to receiving an efficient, safe and tested treatment. You should never choose to go to a physician with more bad reviews than good ones and should always verify his or her reputation from multiple sources.
  • Checking in the most adequate hospital – Secondly, checking the hospital you wish to get treatment or surgery in is mandatory. There are plenty of sites that rate hospitals based on mortality rate, success in treating certain types of diseases, specialized equipments, safety score. You can’t foresee all the issues that may appear, but being prepared and informed before choosing the hospital will take you a long way in receiving the treatment you need.
  • Choosing the right insurance – Last but not least, your medical insurance should cover the adequate treatment for your condition. If, for example, your doctor recommends a certain type of surgery that is not covered by your insurance, you should not bend your treatment to fit the insurance’s limitations, but rather try to expand it as to cover the recommended treatment. If not, try as much as possible to contract another insurance that is going to support the treatment you need.

 

 

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How to make the most out of your doctor’s appointment

There was a time that when a doctor used to see his/her patients for 20 – 25 minutes, but that’s unfortunately shrinking now. Doesn’t matter who you are and how much time you want to spend at your physician’s office. Getting the most out of your doctor’s appointment has been significantly affected by insurance companies, because the doctors aren’t financially encouraged to take time for critical thinking with their patients. Instead, they will get paid for sending them to get as much tests as possible. How can you avoid getting caught up in this?

Insurance companies make it hard for doctors to spend time with their patients

Spending time asking questions and finding more about the medical history of the patient will not be reimbursed by insurance companies, but the number of patients they put through the office will get compensated. If insurance companies and the government would pay doctors an extra couple hundred dollars for critical thinking time, instead of paying for the $1,500 test, scan, or image, the health system would get better results, have lower costs, people would have better care and the doctor-patient relationship will get significantly improved.

Doctors could have the option of getting out of insurances and adopt concierge medicine. This requires that the patient pays an annual fee or retainer to the primary care physician, in exchange for which the doctor will provide enhanced care and commitment to the patient, in an adequate time. This is not a solution, though, for every physician and should not be the norm.

When doctors don’t spend very much time, they get rushed and work with stereotypes: what age is the patient, gender, what they do for a living and make quick thoughts about what may be the cause of their illness and what tests could prove their theories. You might have heard, more than a couple of times, the phrase “let’s order this scan or these tests and see what they show”.

Doctors are not always to blame here. Every other day, something comes down the pipeline and some regulations will interfere with the best medical advices. If a doctor considers that the best course of action is an MRI or an ultrasound, but the insurance people who have to act by strict regulations, not necessarily by medical considerations, think that there aren’t enough conditions to ask for this kind of testing, then the examinations are not going to be approved and the financial and reimbursement frustrations will ensue. These types of situations drive the doctors crazy as they want to make their ends meet and take care of their patients.

Is it the doctors’ fault that they’re moving faster and jamming more patients, or is it just that the whole health care system is on the verge of collapsing and the quality of care has gone down?

Tips on making the most out of your doctors’ visit

Considering this, patients should take some extra steps for preparations when going to see a doctor: think about how to make your visit more productive, what kind of questions you should be asking, bringing all relevant test results or list of medications that you are taking.

How to get the most out of your doctor’s appointment?

  • Have a written list of all of the medications, instead of the doctor going through one of those bags, with the old bottles and look at everything. Make a list of all the allergies that you have, make a list of all the medications that you take and be very specific about the reason why you’re there.
  • Talk frankly about what’s bothering you: If you feel that your doctor is not hearing you, don’t be shy to say: “Doctor, I need your help with these symptoms. What’s the diagnosis, should I get this test?”. Just questioning the doctor can stop the whole rush and basically get them to devote time to you. Put your finger right on the issue when you sense the doctor is on automatic pilot and not really hearing you. Break them off out of that by asking the question: “doctor, I know I’m a little bit young and I know I’m not at high risk for cancer, but could this be that?” or “You know, I’ve been told I’ve had this condition for two months… they’ve been treating me, it’s not getting better, could it possibly be something else?”. Get them to use their critical thinking they got their training for and break them out of that automatic pilot.
  • See them in their early office hours. Doctors are a little more tired when you see them at 3 or 4 o’clock. Try to get an appointment with them at 7 or 8 a.m., as one of the first patients.
  • Ask for a second opinion: There are circumstances when doctors tend to send their patients to do a biopsy without sufficient risk factors. This should be each patient’s choice to decide if they feel that the statistics are in their favor and they could wait for a palpable  lump to appear or be subjected to a lot of biopsies with 90% false negatives. In these circumstances, having a second opinion could help you make a better and safer decision.

The fact is that some doctors are under pressure to meet financial quotas imposed by the hospitals and insurance companies. However, this doesn’t mean that they’ve abandoned their vocation of helping their patients and improving their lives. Knowing what to ask and how to present all the facts of your illness when going to the doctor, will create a bigger and more comprehensive picture that will help them put the puzzle together and know which course of action to recommend.

 

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Finding your balance as a doctor: Tips from David Samadi

As a very successful doctor, David Samadi has made lots of sacrifices on the road of becoming one of the leading urological oncologists, specializing in robotics and minimally invasive surgery for prostate cancer. It is a well known fact that at the age of 15 he was forced to leave his parents and little sister Heidi in Iran and flee the country with his younger brother Dan. During the eight years of living among strangers, in Belgium, the UK and, finally, the US, the only motivation for the two was the goal to succeed. After this lonely period, their parents and little sister were finally able to fly to the US and the Samadi family was reunited.

Dr. Samadi’s ambition to succeed was motivated by the sacrifices his parents were making back home in Iran. After they came to the US, his drive didn’t stop. He went on to complete his master’s degree, his training in urology and fellowships in proctology and robotic radical prostatectomy. His professional life has been on the rise ever since. He has performed over 7000 robotic prostate surgeries, pioneered the SMART technique that managed to achieve the Trifecta for most of his patients, has written many publications and held speeches internationally. More than that, he is often called a “celebrity doctor” due to his repeated appearances in Fox’s Sunday Housecall, on Fox and Friends, frequent articles in media publications, podcasts and videos on his personal sites. He even had a guest cameo on Law&Order: Criminal Intent, playing a prostate cancer doctor, raising awareness on the issue. These might appear hectic for the ordinary person, but Dr. Samadi enjoys every single facet of his professional life: “It’s a very exciting life that takes me from surgery, to broadcast news, to the Emmy Awards and then, the next day, I meet people from different countries, who I’d never meet if didn’t do what I do.”

 

David Samadi’s wife has been alongside him for 18 years now

In 2000, David Samadi met his wife, Sarah Danielpour, at Cedars Sinai Medical Center in Los Angeles, where she worked in Hospital Management. “I’m fortunate to have a wife who is a superb mom and a great partner,” Samadi says of his wife, who, like him, is from Iran. Together, they have two children, a daughter and a son. David Samadi’s family is a large and atypical one. Him, his brother, sister and 20 cousins are all doctors. He has 5 nephews only from his brother’s and sister’s side, so when the entire family comes together, Samadi and his wife have a full table.

His professional work does sometimes put a strain on his personal life: “My immediate family has paid the price. They would like to see much more of me”, Samadi says. Even though the thousands of patients he has had all these years have taken up a big part of the time spent in family, Samadi insists that all doctors must try to disconnect once in a while from their hospital lives and enjoy valuable time spent with their loved ones.

 

David Samadi’s tips for work-life balance

  • Find a favorite physical activity – Dr. Samadi was captain of the soccer team back in Iran and has always been a competitive person. He is an active person and still plays tennis, golf and other sports. Practicing sports can help reduce stress, clear the thinking, increase self-confidence. Any doctor should have a physical activity that gives him 1 or 2 hours weekly of time out from his/her medical practice.
  • Focus on your spirituality – Dr. Samadi was raised Jewish by his family and remembers how his dad taught him about Judaism on their 45 minutes drive to school. After all these years, even when apart from his parents, he maintained a close relationship to his spirituality: “I practice my religion every time I raise a scalpel. Taking care of all people regardless of religion and using my God-given talent to help others and save lives is what is imprinted on me from my faith.” David Samadi and his wife are active members of Temple Beth Shalom in Roslyn, NYC. Focusing on your religion or on whatever your inner motivation for helping people is, will give you purpose through the hard times and keep you going.
  • Go on holidays – Even though your schedule might be booked throughout the entire year, your patients won’t benefit from you if you’re tired, overworked, stressed out, on the verge of a physical or emotional breakdown from all the stress and responsibility. Try to empty your schedule at least once every six months and go on a trip with your family, for 7-10 days. When you’ll return, everything will seem more bearable.
  • Get enough sleep – This might feel like a dream to you, especially if you’re a surgeon, but the lack of sleep will, in time, lead to fatigue, daytime sleepiness, clumsiness and can affect the brain and cognitive functions. It could also affect your mood, your patience and overall well-being. Not sleeping enough will affect both your professional and personal life, so make sure you allow yourself to rest for as long as possible.
  • Delegate tasks whenever possible – Assigning some tasks, especially administrative ones, such as scheduling, filling up forms, ordering supplies and medication, to members of your team, will clean up your plate from not so important tasks. You will be able to dedicate yourself to the important issues of your patients and will be able to leave the practice once every appointment has been met.

Balancing work and personal life is a struggle for the modern man and woman, which increases in complexity, especially for those practicing medicine. Doctors are generous persons who, more often than usual, will sacrifice their personal lives for the wellbeing of their patients. Even though this shows dedication and passion towards the profession, being one-sided helps no one: not the patient, not the doctor and not his/her family. “Balance is not something you find. It’s something you create”. In other words, you need to make continuous efforts to be happy in both areas of your life.

 

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A second opinion for cancer can save your life. This is how you ask for it.

second opinion from doctors

Asking for a second opinion from a doctor can be intimidating, but that doesn’t mean you shouldn’t do it anyway. There may be several factors that refrain you from doing so, such as: the fear of seeming demanding, of being impolite by not granting him/her full confidence, feeling scared and wanting to commence treatment as soon as possible, not wanting to go through the hassle of finding another experienced doctor. Although these might feel legitimate to you, we believe that the reasons you should proceed with asking for a second opinion from a doctor, especially in the case of a life-threatening or serious disease, are much more compelling:

  • if you feel your doctor isn’t really listening to you or was hasted in making a decision;
  • if the treatment proposed is especially risky or toxic;
  • if you feel you’re being rushed inexplicably into making a decision;
  • if the procedure that is recommended involves the use of experimental instruments or devices;
  • if the recovery process for the initial procedure is especially long;
  • if you feel like your doctor isn’t interested in your case;
  • if he explains your disease using only medical terms which you don’t fully understand and refuses to be more explanatory;
  • if you’re in line for receiving experimental or trial drugs;
  • if the medical analysis or diagnosis isn’t 100% clear or accurate;
  • if the FDA hasn’t established a consensus or an approved treatment for your disease.

Doctor David B. Samadi says: “As a rule of thumb with most diagnosis, it’s always recommended to seek out a second opinion. This is especially true when you are diagnosed with prostate cancer, specifically before you have decided on a course of treatment. Seeking a second opinion is an invaluable way for a patient to verify certain facts about prostate cancer, such as the stage of cancer or location of the cancerous growth. Patients generally look for a second opinion because they feel an inability to communicate effectively with their current doctor. Some patients are also confused as to what is the best treatment and course of action for their scenario.”

If you decide on getting a second opinion, make sure to write down any question you want to ask or that you feel weren’t answered in your initial consultation. Regardless of your choice, just be sure not to take too long for deciding. While your disease can be slow growing, in most cases you don’t want to delay any treatment you may require, to prevent future  complications.

What’s the best way to ask doctors for a second opinion?

Even tough it might seem awkward, you should tell your first doctor you intend on looking for a second opinion. Doctors don’t need to feel threatened by this and they should encourage you to follow all the steps that might make you feel more comfortable with your diagnosis. A doctor who doesn’t support your need for a second opinion will lose your confidence. Telling him/her that you are interested in looking for a different opinion is an act of exercising your right to be in control of your body and your treatment and the first step in building a relationship with your doctor, based on respect, honesty and trust.

How to reach out for a second opinion?

One of the easiest ways of finding a new doctor is asking your current one for a referral. Most physicians located in the same area know each other from university, conferences or other sorts of gatherings, so they should have a broad reach in the field. However, if for some reason he/she refuses to provide some referrals, there are multiple sites you can access in order to find reputable experts in your ailment, near your location.

It is preferable that your first doctor will be on board with you asking for a 2nd opinion for one simple reason: you need to provide medical records from the moment you started making appointments to your first doctor, all test results, scans, treatments and medication you might have taken up until that moment. Cooperating with your first doctor will make it a lot easier for you to have access to these.

How should you approach the doctor giving the second opinion?

As in the case of the first doctor, honesty is at the essence. Being fair with your doctor, letting him know what your first diagnosis was and the specific steps you had to go through up until that moment, will be very useful and will save you a lot of time. Just be frank: “These are my test results, I have been diagnosed with X and given this medication. What is your opinion about this course of action?”.

Key to the conversation is trying to be as objective as possible when presenting your case: exhibit the battery of tests you’ve taken until then, all your medical history and your current diagnosis and treatment, without expressing doubt or overconfidence in your initial physician, or your expectancy to hear a certain answer. This way, his judgement won’t be influenced by the first opinion and he’ll be able to decide unbiased what will the next steps for uncovering your diagnosis be.

Find out if your insurance covers second opinions

Insurance companies handle second opinions in different manners. Before deciding who you should get a second opinion from, find out who your plan covers in terms of medical professionals and institutions you can approach free of charge. You may have to advocate for yourself quite loudly if there are better opportunities for your treatment at other facilities, outside your healthcare network.

 

Doctors are human too and sometimes they can make mistakes. You don’t want to go through with excessively long treatment or invasive surgery if you’re not 100% sure it’s the right way to go. Better safe than sorry!

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