Sunday, August 29, 2010
Injury Recovery Principles: Crossing from Sickness into Health
This scene reminds me of the journey we all take during an illness or injury to regain our health. The Crossing from Sickness to Health needs a boat load of people at times to help us. For the normal sports medicine injury that I see, there may only be a few on that boat--patient, doctor, physical therapist, family and friends, shoe store personnel, internet resources, and referring source (like Yelp, Tribe, primary care physician, etc). For more complicated cases, that boat can be pretty full. Yet, sometimes with a full boat in these severe conditions, the patient can still feel very alone since they lose sight of the primary care provider steering the ship. In the crowd of people on that boat, no one is actually calling their name when the time comes to disembark, or change course. Perhaps that person in charge of steering has never been established in the first place, and the boat may not be able to be docked on the other side at the best end point.
I imagine sometimes that my patients feel alone in turbulent waters when they do not have good direction, or attempt to do it alone. In a world of super specialities, whom is looking out for that patient as the primary care giver. Every specialist, whether podiatrist, orthopedist, neurologist, etc, tends to look at the patient through some tunnel vision. The medical world needs to see the dilemma facing these patients when no one is truly guiding them. Patients are routinely told when they see a specialist to come back if they want surgery, come back if they want orthotics, come back if they want more physical therapy, etc, but how does the patient make these decisions. And when symptoms get worse, no wonder some patients choose some course of action, only because they do not know what else to do.
As health care providers, we need to prevent our patients from going it alone, and feeling that way. As patients, if your injury seems difficult or challenging, and the symptoms are lingering or worsening, we need to identify one person who will oversee the problem. One person who may steer that boat to the right landing dock. Podiatrists as a group tend to be generalists, as I am, or super specialists in surgery. When you see a health care provider, find out if they are the one to manage your injury, or only deal with one part. I love to manage my patient's foot problems from start to finish, get second opinions when I am stuck, get one of our MDs to treat their other problems, get the primary care doctor involved when necessary, and work with the physical therapists helping them. I believe email is working well for complicated patients keeping the communication flowing. I am looking into a computer program that patients can keep track of their symptoms, and then email when appropriate. Through this blog I am trying to engage my patients more to understand the complexities of medicine and where it may apply to them. There are no rigid answers, but patients need to find the right person for their injury, be it MD, Podiatrist, PT, Chiropractor, or other allied health professional, to help steer the course from illness to health. Good luck!