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Patients who disappear


It's 11:30 am, do you know how to reach your patients? You may think you do but the reality may be quite different. The use of cell phones, combined with the recession have played havoc with many patient record files. The contact numbers are often obsolete.

It goes like this:

1) Patient suffers loss of income

2) Patient cancels land line

3) Patient uses cell

4) Patient looses cell (or can't afford the charges)

5) Patient can't be found.

Dr Perri Klass, a New York physician, noticed an unexpected jump in the head-size of a at the three-month check up. Problem was it made the observation in review the file. After reviewing the case he feared hydrocephalus and other congenital brain malfunctions. He wanted the baby to come back into for a closer look but was unable to contact the baby's mother. None of the phone numbers in her file worked. Eventually he tracked her down through a sister. The child came in and was found to be perfectly healthy. The incident gave the doctor pause.

The lesson: check phone numbers every time a patient comes in. Even then you may find yourself marking too many patient files "lost to followup."

Dr Klass's full article can be found in the April 15 issue of New England Journal of Medicine. NEJM.org

Salt in the (internal) wound


How many of your patients know how much salt is there in an Oreo cookie? Probably a lot more than you or they might think. Three cookies give you fully 11% of your daily recommend, for children the figure is a lot higher. Perhaps you'd be better to switch to low fat cottage cheese. No you wouldn't. A single serving contains one quarter of the daily adult intake.

These are some of the numbers from a US government commissioned study by the Institute of Medicine which estimates salt causes 100,000 premature deaths due to hypertension and related diseases.

“Salt is very addicting,” says Sidney Alexander, a Boston cardiologist. He sees his patients struggle. “Even though there are good salt substitutes and other spices they can use, they have a hard time giving it up."

There's very little you can do to avoid over dosing on salt unless you eat only food prepared at home. Three-quarters of the salt you consume comes from processed food and that served in restaurants. Some dishes contain three and four times the daily requirement.

For more see the New York Times report at http://nyti.ms/dDm0tP