Unnecessary Medical Care

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How many times have you had blood work, x-rays, or EKG’s done before a simple surgery? Have you had procedures, tests, or screenings suggested by your doctor or dentist, and wondered if they’re really necessary?

Turns out, unnecessary medical care is more common than thought! It can also be thought of as overuse of care. If you Google the words “unnecessary medical care” your search results will bring you many pages about the subject.

A study published in 2017 in PLOS One found that physicians reported more than 20% of overall medical care was not needed. When questioned, the most common reason was for fear of being sued for malpractice. This is known as defensive medicine.

I know most of us have been involved in this practice in some way, and I am no different. I’ve heard countless stories, from patients and peers! This overuse negatively impacts us emotionally, financially, and physically.  Not to mention driving up the overall costs of healthcare.

Advocating for Advocates

So how do you know what tests, procedures, or screenings are necessary? Do you seek treatment for something just for the sake of being “treated”?

There are some groups who are working toward eliminating, or at least, improving our needless healthcare. Choosing Wisely, The Do No Harm Project, and Costs of Care are some of these groups. They each have a slightly different approach. Ultimately, though, they are advocating for a conversation between healthcare provider and patient to eliminate overuse.

Choosing Wisely is an initiative from the American Board of Internal Medicine Foundation. The Patient Resources tab on their website has some great information to get started.

This contributes to the healthcare “spiral” I mentioned in my first post. I believe that we all need to be advocates for our own healthcare. And this means educating ourselves as best as possible.

What are your thoughts? Have you had recommendations for screenings and such that you thought were questionable?

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Happy First Day of Spring! 💐🐣

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Today is the first day of one of my favorite seasons (fall is my other favorite)! I love the new life in nature. Flowers and trees start budding, temperatures are getting warmer, birds are chirping, not to mention the longer daylight hours.  I can actually see the sun when I get off work in the evenings!

Most people associate sunlight with skin cancer, but there are many benefits to getting a little bit of sun!  Some of these include:

  • Improve brain function and mental health
  • Lower blood pressure
  • Improve inflammation
  • Build strong bones
  • Treating skin conditions
  • Cancer prevention

Mental Health

Sunlight exposure increases the release of serotonin from the brain.  It is a natural mood stabilizer and helps with sleeping, eating, and digesting.  When serotonin levels are low, we can suffer from depression or seasonal affective disorder (SAD).

Skin Conditions and Cancer

According to the World Health Organization (WHO),  skin conditions like acne, jaundice, eczema, and psoriasis can benefit from UV radiation exposure.  Although excess sunlight can lead to cancer, research shows that people who live in areas with little sunlight are at greater risk for certain types of cancer such as colon cancer, Hodgkin’s lymphoma, prostate cancer, ovarian cancer, and pancreatic cancer.  

Building Strong Bones

Exposure to UVB from the sun causes our skin to produce Vitamin D, a big part of bone health.  Low levels of Vitamin D can cause rickets in children, and bone wasting diseases like osteoporosis and osteomalacia.  The WHO recommends 5-15 minutes of direct sunlight two to three times per week is sufficient to get the levels of Vitamin D needed.  

All things in moderation……

The UV radiation from the sun can damage cell DNA, which leads to skin cancer.  Although there is no exact measurement as to how much sunlight to get to reap the benefits, it’s important to know your skin type and the direct rays of the sun affect this.  The sun is more powerful between 10am and 4pm so this is when the potential for sunburn is greatest.  Also, people with fairer skin will burn more quickly.

I plan to soak up the sun as much as possible this spring!  We’ve had such a grey and wet winter, I’m hoping things dry out and I can enjoy a favorite season.  😊

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Healthcare Declarations

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In my years as an RN, I’ve seen way too many patients and families left with difficult end of life issues. It’s not a topic most people like to discuss, because let’s face it, nobody likes to talk about death or loosing a loved one. But I do believe it is so very important! This goes along with my last post on aging parents (check it out).


Healthcare declarations are not just for the elderly and sick, either! Legally, 18 year olds are adults when it comes to medical decision making. And only 7% of those 18 to 29 have any sort of advance directive. Most people assume that family members will make decisions on your behalf in the event of illness or injury. Too many times this ends in heartache, confusion, and possibly even in court if members are in disagreement over your care.


Types of Advanced Directives

Advance directives are usually referred to as the combination of living wills and healthcare proxy documents, including durable power of attorney for healthcare.

Living Wills: A living will is your health care declaration, not to be confused with a conventional will or living trust used to leave property at death. A living will states what type of medical treatment you do or do not wish to receive if you are too ill or injured to direct your own care. Ideally, these should be as specific as possible. Directives as to artificial hydration and nutrition, treatments like dialysis and chemotherapy/radiation, and surgeries should be addressed here.

DNR, or Do Not Resuscitate, Order: A DNR order is written and signed by a doctor, instructing healthcare providers not to do CPR if your breathing or heart stops. These are usually done near the end of life or if you have a life-limiting illness. A DNR order does not address other treatments.

Physician Orders for Life-Sustaining Treatment (POLST): A POLST form is like a DNR, but they cover much more. They must be signed by a medical doctor and usually in life-limiting situations (near end of life, or a life threatening illness). They include a DNR order as well as addressing other medical treatments like breathing and feeding tubes and antibiotics. POLST forms are available in most states, although they might have different names (MOST form in NC).

A lawyer is not needed to create these specific documents. It is important, however, to know about laws in your specific state. For example, in Florida, a DNR order must be printed on yellow paper for it to be legally valid. Also, Florida does not have its own form for a POLST yet.

Resources

Here are some books I came across, too, that might be of interest and helpful.





Like I said before, I’ve seen more than enough end of life heartache and despair throughout my career. I’ve seen families ripped apart by decisions and opinions regarding a loved ones final days. I feel like a lot of these situations could have been a tad easier had there been advanced care planning in some form. Or at the very least, some sort of conversation.

Let me know your thoughts on this difficult topic! ❤️

Aging Parents

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I keep hearing more and more stories of frustration when it comes to caring for aging parents, and it breaks my heart! Nobody likes to think about their parents getting to the point of not being able to care for themselves. Or even worse, when an event such as a fall, broken bone, or illness causes them to suddenly not be able to care for themselves.

Interestingly enough, I came across an article as I was doing some research on this topic that completely piqued my interest. After reading this article, I actually paused and had to rethink, therefore even erase parts of this post! It made me think about the other side to the coin. How are our “aging parents” actually feeling about this stage in their lives? Is loss of independence a big issue?

Although my original intention for this post was going to be resources and tips, I’ve actually been consumed with looking at this from a different angle. I could get lost in the psychology of aging, but I’ll spare you the details! The bottom line for me is that studies have shown that some older adults fear losing their independence more than death. Knowing this means learning that patience and planning are the keywords.

Planning and Patience

Coping with the loss of independence can take time. There may be loss of mobility, social isolation, memory impairment, hearing and vision loss, not to mention the death of loved ones and friends. Helping older adults come to terms with these changes is key.

That being said, patience is not always easy and that’s where planning comes in. I’ve found multiple articles, blogs, and websites that talk about how important planning for the future is. And that doesn’t just mean planning for the usual life events. That means coming up with a plan for caring for the older loved ones in your family, too.

Planning and patience are no small feat when it comes to this topic. I found this article and thought it very useful. Their five steps to creating a caregiving plan for your family are so important:

  • Prepare to talk
  • Form a team
  • Assess needs
  • Make a plan
  • Take action

Unfortunately, I’ve seen my fair share of situations that have left families in despair when they’ve been unprepared for the inevitable. This includes having that difficult discussion about end of life care and choices (more on that later!).

Resources

Of course every family, individual, and situation is different. Even the best laid plans don’t always pan out. That’s why I think it’s so important to have lots of resources at your disposal, along with a lot of support. Here’s some of the articles and websites I found helpful:

  • National Council on Family Relations: ncfr.org

I hope this blog post has been helpful to even one person, or maybe shared with someone who will find it useful. Do you have any tidbits to add to my thoughts? Let me know!

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