Friday, January 30, 2015

Striving to spend more time with cardiac patients



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For Dr. Adolfo Bellosillo, president and founder of the Foundation for Lay Education on Heart Diseases (FLEHD), doctors should spend a significant percentage of their time talking to and examining each of their patients. If it could be helped, they should even talk to their family members.


He said: “There is just no substitute for time in doctor-patient relationships. While efficiency is important, it is not the end of the story. From recorded notes and scribbles taken, doctors would clue themselves in to a lot of information—about the severity of a patient’s condition, change in the patient’s behavior, about recent family tragedies and so on.”


According to Bellosillo, spending more time with their patients will not only improve patient satisfaction and outcomes as inappropriate prescribing or poor clinical decisions based on the wrong prognosis may also be prevented if not minimized.


He said: “Doctors now have too little time and too many patients as well as too much focus on the lab results and too little on the patient. Because observation of heart diseases and their myriad manifestations is critical to building a doctors’ clinical skills, some worry that today’s doctors no longer have had enough interactions with patients to be able to recognize the more subtle signs and symptoms of heart disease or of impending emergencies.”


To address this concern, FLEHD several years ago started sponsoring free series of lectures on preventive cardiology for doctors. Now on its 15th edition, this year’s convention adopted the theme “Preventing cardiac catastrophe through better understanding of cardiovascular pathophysiology.” The convention happened last Thursday and Friday at the Tower 2 auditorium of the Makati Medical Center.


Two issues


Bellosillo explained: “This year’s theme zeroed in on two issues: the heart’s pathology and physiology, two basic subjects taught during the early part of one’s medical schooling. The former deals with the study of diseases affecting the heart and blood vessels while the latter deals with the workings of the heart and blood vessels. Given a particular cardiovascular disease, a thorough knowledge of the workings of the heart and vascular system would help a doctor comprehend what functional changes may be observed in the organs and tissues involved. Likewise, if faced with certain changes in functions of the heart or vascular system, a doctor may be able to know what sort of ailment may be expected.”


This is why the two-day convention also addressed special issues that include if the choice of antihigh-blood medicine is a guessing game, the need for hemodynamic (physical factors that govern blood flow) monitoring in patients suffering from low-blood pressure/shock, and nuances and pitfalls in electrocardiographic (ECG) interpretation. These talks were presided over by FLEHD faculty members, who include Bellosillo, Doctors Mariano Lopez, Enrique del Fuerte and Michael Rome.


Presentations


Just like any FLEHD event, the 15th national annual convention on preventive cardiology for physicians has also included presentations from the University of the Philippines Concert Chorus (under the baton of Prof. Jai Sabas with Prof. Augusto Espino at the piano). For the first time, participants were able to enjoy the Filipino version of the “How to Retain Young at Heart” musical presentation.


Bellosillo said: “With heart disease among the most widespread and costly health problems facing the nation today, cardiologists must be able to practice more efficiently, [so that] he or she will be able to deliver care to more patients. Thus, one important component of our effort is to assure patients that our cardiologists are continuously updating themselves and even taking refresher courses that would enable them to go back to the basics of common cardiovascular diseases and problems, understanding the structures and functions of the heart and major blood vessels, and the development of specific pathology and their clinical manifestations and presentations.”



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