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[back] Attention to detail Anthony Thanasayan (The Star) - 7 April 2011

  Thursday April 7, 2011

Attention to detail

Wheel Power
by ANTHONY THANASAYAN

ONE of the important aspects of living with a disability is to have regular medical check-ups. Recently Wheel Power spoke to consultant neurologist Dr Lim Shen-Yang on the subject at Universiti Malaya Medical Centre in Kuala Lumpur.


Dr. Lim Shen-Yang, Consultant Neurologist, UMMC (Pic inserted by MPDA)

Dr Lim, a Parkinson's disease and movement disorders specialist, came up with some pertinent points for people suffering from chronic disabilities to pay attention to when seeking the help of doctors in hospitals.

His suggestions are also relevant for anyone who at some point in their lives will need medical care.

"There are ways to increase the efficiency of a consultation with your doctor, so that he/she can spend the limited time available coming up with good solutions to your problems," said Dr Lim. "Not a day goes by when I do not see patients who have no idea of what medicines they are taking. They frequently describe their medication as 'it's that small yellow tablet, doctor!'

"Patients do not take the trouble to bring the medication in for verification or provide the doctor with a written list of their medicines."

Dr Lim said precious time was wasted in trying to figure out what constitutes basic information needed for proper medical consultation.

Having a neatly written or typed list of medicines that is accurate and up-to-date can go a long way in conveying that you are interested in your health.

This, according to Dr Lim, will help to minimise the chance of being prescribed a medicine that interacts negatively with a prescription that a patient is taking.


Patients should provide accurate information to avoid misdiagnosis.

The written list should include information on the generic and/or brand name, dose and frequency of intake of the medicines, as well as a list of medicines that previously caused a patient to have a bad reaction.

For patients with multiple medical problems, it helps to have an up-to-date point-list of the diseases or conditions that he/she suffers from.

"If you have a medical chart that is six inches thick, it probably is not reasonable to expect a doctor seeing you for the first time to go through this," said Dr Lim.

In such situations, he suggests the following:

  • Bring along whatever scans or test results you have, for your doctor's visits. Whenever possible, ask to keep a copy of important medical records.

  • If there are a number of symptoms or problems to tell your doctor, write these down. If it is a long list, try to prioritise them in order of "most troublesome" to those that are less so.

  • You should come away from a consultation with at least a basic understanding of the doctor's assessment of your clinical situation and his/her rationale for recommending particular treatments. If no explanation is forthcoming, ask for one. If things are not clear, do not be shy to ask for clarification.

Often, it helps to have a family member or friend present during the consultation to listen in and jot down the important points or ask relevant questions. Providing a collateral history is useful to doctors. (For example, an accurate diagnosis of epilepsy relies heavily on a description of the events surrounding the seizures, which cannot be provided by the patient himself, as he was unconscious at that time.)

If your problem is an unusual one, consider seeking a second (or even a third) opinion. There have been cases where a wrong diagnosis was made, or incorrect treatment given. A good doctor will not be offended if his/her patient asks to consult another doctor for another opinion as long as the colleague is one with the appropriate expertise. This, however, needs to be balanced against the other extreme of "doctor-shopping"; these are patients who flit from one doctor to the next, and continuity of care inevitably suffers.

In this context, it is worth noting that there is great variability in individual responses to treatments. Thus failure of a trial of one or two medicines should not immediately indicate that the doctor is incompetent. If you trust your doctor, and provided that time is on your side, it is often best to adopt a disciplined approach and persist with the treatment recommendations, rather than bail out prematurely.

To sum up the above in one sentence: "Be interested in, and take responsibility for, your own healthcare".

Source: thestar.com.my/columnists/story.asp?file=/2011/4/7/columnists/wheelpower/8419402&sec=Wheel%20Power