One of the dynamics in modern medicine that I hope will change in the near future is how patients and physicians interact. I’d love for most doctor’s appointments to begin with a question such as this: Doctor: “Do you have any information that you’d like to share with me before I begin my examination?” Patient: “I’ve done some research about my condition and I’ve printed out some specific details I’d like to discuss with you.” In order for this type of exchange to be successful a few common sense steps are necessary. The first is that physicians embrace the concept of patients being partners in their own health care decisions. But patients will need to do their part as well. It’s not fair or practical to deluge time-pressed doctors with piles of paper work. Instead, it’s best to be as concise as possible and reserve added details if they’re requested.

This past week I found three messages on Twitter that could be used in the context of this new model of patient-physician communication. The first is a rather controversial recommendation that comes from a well-respected pediatrician by the name of Dr. Alan Greene. My second find is brought to us by the lesser-known but eminently fascinating physician, Dr. Bill Yates. He’s a leading source of neuroscientific research in the social media circuit. Finally, I’ll present a warning call put out by the integrative cardiothoracic surgeon, Dr. Mehmet Oz. He alerts us to the fact that certain food marketers are trying to change the image and name of high fructose corn syrup. All of these items have at least one thing in common: They provide thoughtful information which can benefit you and your health care team.

In a current tweet, Dr. Alan Greene offers up the following suggestion, “Remember to give all of the antibiotics even in your child is feeling better … NOT!”. According to Dr. Greene, certain bacteria have “learned a new method of protecting themselves, even from our strongest antibiotics”. Apparently, they use an enzyme known as NDM-1 (New Delhi metallo-B-lactamase 1) to outwit many broad-spectrum antibiotics. The most sobering news is that this example of antibiotic-resistance is likely to be a sign of things to come in future. However, Dr. Greene has some advice about how we can fight back against pathogenic microorganisms. (1,2,3)

• Discontinue using antibacterial dishwashing detergents, lotions, soaps and toothbrushes. On the other hand, alcohol-based sanitizers and disinfecting wipes do not promote resistance. But they’re unlikely to prevent illness to any significant extent.
• Support healthy immune function by eating well, exercising sensibly, getting adequate sleep and supplementing with probiotics (healthy bacteria) and Vitamin D.
• “Consider stopping antibiotics as soon as you are feeling better!”. Please consult on the appropriateness of this advise with your physician.
• Use antibiotics only when called for and definitely not for viral infections such as most cases of sore throats and upper respiratory infections.
• Request “the narrowest-spectrum antibiotic that will do the job”. Broad-spectrum antibiotics are “usually not the best choice”.
• Avoid food-based sources of antibiotics such as conventionally raised dairy, eggs and meat.

There’s no question that hot flashes negatively impact quality of life for countless menopausal women. Hormone replacement therapy can reduce this unpleasant symptom but it also carries the concern of various adverse consequences such as an increased risk of abnormal blood clotting, select cancers (breast and ovarian) and stroke. Thankfully, there is a safer alternative worth considering. A study published in the July 2010 issue of the Archives of Internal Medicine reveals that an “intensive behavioral weight loss program” effectively reduced hot flashes in a group of 338 menopausal women as compared to placebo (a “structured health education program”). Reductions in abdominal circumference, body mass index and weight were all associated with improvements in hot flash severity. Apart from symptomatic relief, the study participants almost certainly lowered their risk of cancer and cardiovascular disease as a bonus. (4,5,6,7,8)

It seems that the Corn Refiners Association would like to rename one of their best selling products. The plan is to re-brand high fructose corn syrup (HFCS) with a less controversial label: corn sugar. It does sound more natural, doesn’t it? The reason for this shift in titles has a lot to do with a largely ineffective advertising campaign to convince the public that HFCS is natural and wholesome … if consumed in moderation. But data from a marketing research firm (NPD Group) recently revealed that this strategy isn’t working. It appears that roughly 58% of the American public still believes that HFCS is an unhealthy ingredient.

At present time, no one knows for certain what decision the FDA will make in relation to the proposed name change. But regardless of what it’s ultimately referred to, it’s still the same chemically-manipulated sweetener that is suspected of contributing to dementia, fatty liver disease, high blood pressure, obesity and beyond. (9,10,11,12,13)

In preparing today’s column, I was reminded of a term coined by Dr. Bernie Siegel, a renowned advocate for cancer patients and survivors. He noted that “exceptional patients” generally had better outcomes during hospital stays and in their overall recovery and survival rates. What defines an exceptional patient? It’s someone who takes an active role in their health care. In the short term this may require more patience by physicians and their staff. They may need to field more questions and look over a print out or twenty. But the end result is likely to be a more satisfied patient with the real possibility of improved outcomes. Both of these developments can, in turn, improve the quality of interactions between patients and physicians and lead to greater feelings of satisfaction for health care workers as well. This seems like a win-win proposition to me.

Be well!

JP