Tips for choosing a physician or surgeon.

HOW TO FIND THE RIGHT SPECIALIST.

In this blog we will talk about the tools you need to select the right physician for you. We’ll start with general questions, inquiries and background information you should check on and know about all your physicians and then subsequently fine-tune some details related to certain specialties.

First for the general information:

  • Verify the physician’s credentials and that they are active, Do a Google and social media search including LinkedIn.
  • Verify that the credentials are universally active, in other words a physician may be working in a different country.
  • Verify that the credentials are universally active, in other words a physician may be working in a different country having had his license revoked in a different country or state.
  • Understand that sometimes physicians may have tainted license, malpractice suits in the past but this does not necessarily indicate that they are not good physicians, so it’s important to learn the details.
  • Find out who will be cross covering for the physician in his or her absence and the details of this position and their capacity.
  • Find out if there are physician extenders such as nurse practitioners or physician assistants that are working alongside the physician and whom you may see. It’s important to understand how often you will be interacting with this person as opposed to the physician.
  • Inquire what the process is to reach the physician specifically as opposed to a physician extender. At this time make it very clear if you are uncomfortable with seeing a physician extender and request only to see the physician – as you are paying for his for her services, they should comply with your wishes.
  • What is the process for caring for you if you have chronic medical conditions and you need medication management – who is going to do this and when will you be meeting this person before your procedure.
  • Ask your physician how many of the requested procedures has he or she performed over what period of time and inquire about the success rate.
  • Ask for references – Ask if you could speak with a former patient if you’re interested – if the physician refuses this should be a red flag.(note that privacy laws apply and the former patient will have to have previously authorized this).
  • Investigate the location (hospital or outpatient facility) where procedures and surgeries will be performed. It’s important to make sure these facilities are adequately credentialed which would indicate they comply with quality expectations amongst other requirements.
  • Ask about his or her position on pain medication prescribing and refill process.
  • Ask if the physician will provide follow-up documentation to your primary physician if you want or will they provide you with a copy of your records.

RED FLAGS

There are some red flags to know about when interviewing a physician for your procedure that you need to be aware of and alter your plans accordingly – meaning you may choose to continue with the physician or change.

  • The physician is not open to any of your questions and refers you to hey website or printed documentation. although this is helpful it is important to have the comfort of being able to speak with your physician and this indicates the amount of time and investment the physician places in the value of a patient physician relationship.
  • There are multiple malpractice lawsuits resulting in culpability of the physician.
  • The physician previously had license revoked in other places – countries or states.
  • The physician has not maintained continuing medical education or current certification.
  • The physician and or staff is not willing to review billing practices.
  • There is no internal medicine physician who will take care of your chronic medical conditions if any medical non-surgical complications should arise.
  • The physician refuses to provide information on 6 of past successful and unsuccessful cases.
  • The physician refuses to provide references or authorize you too speak with other former patience (assuming there is a patient privacy document in place, signed and authorized).
  • There are no provisions for coverage when the physician is unavailable eg. on vacation.
  • There are no subspecialty physicians on staff at the facility where the procedure or care will be provided in the event of complications, these physicians include a lung doctor (pulmonologist),heart doctor (cardiologist), or other specialties as necessary.
  • The facility/hospital where procedures are performed has not met the quality standards in the country requesting. understanding that countries outside of the United States may not qualify for the same quality certifications but there is an equivalent certification that they have indicating they have met quality expectations. (the equivalent to NCQA, JCAHO, JCI, TEMOS for example). It is OK to make decisions based on how a hospital or facility looks to you – use your gut feeling.
  • They refuse to share the infection rate, or they have an unusually high infection rate at the hospital.
  • The position does not allow for provision of pain medication. note that this is a very controversial and sticky area in health care currently, so most practices will have a very stringent, strictly regulated policy for pain medication prescription and refills which you will be required to review and sign or accept – this is OK. However, the physician office stating that they will not prescribe, or refill pain medications is not OK, as these medications may be necessary.
  • There is no post-operative process or procedure in place.
  • Make sure that you understand the pre, intra and post-surgical treatment which may include blood thinners, are there devices to prevent blood clots, therapy – physical or occupational depending on needs.

PLASTIC SURGEON

CARDIOVASCULAR (HEART) SURGEON

  • There is a cardiologist who works alongside the cardiovascular surgeon and they communicate with you to your liking giving you enough time for discussion and questions.
  • There are qualified technicians to provide related services such as echocardiogram, ultrasound, nuclear stress test, regular Bruce protocol stress test.
  • Ensure what expectations should be regarding physical activity after the procedure.
  • What adequate patient information will be provided for you to read and are diagrams provided regarding the anatomy of your heart or vessels and what operation is needed.
  • Adequate preoperative evaluation and postoperative course has been explained to you thoroughly as well as which medicine is to continue and or stop.
  • Is a cardiac rehabilitation program recommended and if so, can they refer one? If one is not readily available, can you be instructed on exercises to do or is there a video provided for this purpose?
  • https://vascular.org/patient-resources/what-vascular-surgeon

ORTHOPEDIC (Bone)  SURGEON

  • Ensure that you like the bedside manner of your physician and staff.
  • Ask questions related to the duration of surgery expected (understand that it is impossible to anticipate exactly). The type of anesthesia to be used and request to meet with the anesthesiologist prior. Find out whether a nurse anesthetist or an anesthesiologist (a physician) Will be attending your case.
  • Find out whether antibiotics will be given before the procedure.
  • Inquire about the post-operative management, specifically related to therapy required and duration.
  • Inquire about expected outcomes, expected recovery time and level of function expected after surgery and therapy and also any potential limitations after surgery.
  • https://www7.aaos.org/member/directory/definition.htm

Solo Female Travelers Shouldn’t Have to Choose Between Being Adventurous and Being Afraid

Article source: By TYLER WETHERALL at https://www.cntraveler.com/

I THOUGHT BEING A FEARLESS FEMALE TRAVELER MEANT I COULDN’T SHOW FEAR.

After I returned from Cuba, friends asked me how it was. Amazing, I said, and I meant it. I told them about the tumbledown houses and rattle of old cars. About dancing on the streets of Baracoa or hitching a ride on the back of an ox cart through the jungle. I also told them I found it hard to travel there as a single woman. And then I told them a story about what happened to me in a cab in Havana.

I have always defined myself as an adventurous female traveler. I first went backpacking at 17 years old around Central America, and I’ve since traveled to nearly 50 countries, often alone. Men have harassed me on the street and followed me home. A hotel owner in Guatemala once let himself into my room at night. I know I am lucky that nothing worse has happened. But the experience in Havana shook me, because I didn’t know how to bridge the gap between being an adventurous—read, fearless—female traveler and being afraid.

I had been in Cuba for over a month. I knew how to navigate the streets of the capital without a map and shout back good-humoredly in Spanish at the men who heckled me. After clubbing with some Cuban friends, I hailed a taxi around 2 a.m. I sat in the front because I get motion sickness and I like to practice Spanish. The taxi driver and I were chatting about life in Cuba, when he told me I was beautiful, and I felt the familiar clench of fear in my gut. I looked out the window. He asked if I wanted to see something, and I already knew he was holding his penis. My first response was to laugh, and then I told him to stop the car. But he didn’t. He started grabbing between my legs with one hand, while masturbating with the other, all—remarkably—without crashing.

I DIDN’T KNOW HOW TO BRIDGE THE GAP BETWEEN BEING AN ADVENTUROUS—READ, FEARLESS—FEMALE TRAVELER AND BEING AFRAID.

When I told my friends this story, I told it like any other travel anecdote, emphasizing the humor in the uncomfortable situations we find ourselves in while on the road. I wanted people to laugh with me, because that would normalize it. I didn’t describe it as sexual assault. If I called it assault, I would have to confront its impact on me.

Instead, I described how the car had no door handles on the inside—common among the tin can cabs of Cuba—so I had to manually open the window, painstakingly slowly, to reach through and open the door from the outside, staving off the taxi driver’s gropes at the same time. I didn’t feel in real danger until the taxi stopped, and suddenly we were on an empty street. He stood on one side of the car, and I, on the other, ready to run. Then he asked me for the $3 fare. I was dumbfounded, but I handed over $5 and waited for my change, because there’s no way I was giving this guy a tip. See how it’s almost funny?

There has been a well-documented rise in female solo travel over the past few years, and I celebrate it. But there is another older story that when women choose to travel alone, they’re placing themselves in danger. Gender violence happens everywhere, but the conversation changes once the experience takes places abroad. When I told people what happened in Cuba, they responded first with alarm, and then with criticism. I should not have been out at night alone. I should not have sat in the front seat.

A recent New York Times article, “Adventurous. Alone. Attacked.,” itemized violence against women traveling abroad over the past four years, including the horrifying killing of Carla Stefaniak by the security guard of her AirBnb in Costa Rica. It is an important piece of journalism, but reading it made me feel uncomfortable, because it perpetuated a narrative that solo travel is too dangerous for women, a narrative I’ve resisted throughout my career. But neither can I deny the reality of traveling alone as a woman. So where is the middle ground?

TRAVEL, LIKE MUCH OF THE REST OF THE WORLD, HAS ALWAYS BEEN DEFINED THROUGH A MALE LENS THAT VALUES BOLDNESS.

We tell stories in order to make sense of the world. I talked about what happened in Cuba because I was trying to make sense of it within my idea of what it means to be a traveler. I grew up on stories of adventure. As a kid, I read Bruce Chatwin, Bill Bryson, and Jack Kerouac. I remember the thrill of discovering Mary Wollstencraft’s 18th-century travel memoir, Letters Written in Sweden, Norway, and Denmark. I reveled in her bravery to set off virtually alone (with just her maid and her infant daughter) at a time when it was near unthinkable for a woman to travel without the protection of a man.

I continue to seek out stories of female adventurers, but travel, like much of the rest of the world, has always been defined through a male lens that values boldness. I want to be brave, too. I often hear a voice in my head that says if a man can do it, dammit, so will I. I have hitchhiked at night with defiance, slept outside in a hammock in bandit-infested jungle, and knocked on the doors of private homes looking for a room to sleep when I found myself in a remote coastal village with no hostel. In order to claim the title of adventurer as my own, I have felt obliged to follow in men’s “fearless” footsteps. Perhaps that is why I struggle to make sense of experiences such as what happened to me in Cuba; it is not represented in those stories of adventure.

Media offers us two versions of solo female travel: the inspirational story as it exists on the pages of Eat, Pray, Love; or the story of women like Carla Stefaniak. As long as society’s view of female solo travel is informed by these two narratives, stories like mine, and so many others, don’t have a place in the travel world. And if that’s the case, we need to rewrite the script to recognize that these experiences might happen, but they should not hinder our right to roam the world alone. We need to create our own travel narratives, one in which we might not always be fearless, but we can certainly still be brave.

Q.- Who is the blame when ppl are ill because of socially created vulnerabilities? Is it the individual? Is it an external source ? Or is it the social & political arrangements themselves & those who benefit from them?

You are invited to answer those questions in our comments section.