Get your fair share 

Think for a minute about your last doctor's appointment -- then,
imagine yourself as the doctor, instead of the patient. Odds are, it
would go something like this…
 
First you'd ask for the patient's complete medical history (if it's
his first visit), followed by questions regarding what specific
problems or health complaints brought him in for this visit.

Then, you'll diagnose his health problem, order tests to confirm
your diagnosis, explain the condition to the patient, and give him
the best options for treatment.

All in about fifteen minutes. Maybe less.

Then, you'll do it all over again with 20-30 more people before the
day is out. In between, you'll make a complete set of notes of
everything discussed, answer phone calls and email, make rounds
at the hospital, stay up-to-date with new drugs and treatments
options, and maybe eat lunch (if you're lucky).

Ready to trade places with your doctor? Personally, you couldn't
pay me enough to keep this kind of schedule.

Let me tell you a little-known secret: Many doctors are as tired as
we are with the race against time during office visits. The fact is,
even though doctors are spending two more hours a week
providing direct patient care than they did in 1997, 34 percent of
them complain that it is not nearly enough for them to do an
adequate job -- up from 28 percent who held that complaint in
1997.

Some practices are trying creative solutions, such as being
available by email for some patient correspondence. Or separating
the workload between the doctors working in practice together,
designating one as a new specialist called the hospitalist (see what
is…below).

Still, it's no wonder that when many of our readers bring
nutritional healing recommendations and suggestions to their
doctor, they report getting a less-than-open response. Just having
the conversation with you costs extra time. Plus, researching the
ideas you suggest, and following up with you adds even more time
to their already jam-packed schedules. Not to mention that natural
remedies can take longer to work, and require more follow-up
visits initially.

Don't get me wrong, you still deserve your fair share of your
doctors' time and attention and to get the kind of care you want.
But by understanding their plight -- and finding ways to help them
help you -- you can make the most of your time together. Here are
some tips for doing just that:

1.) Be prepared: Write down the things you want to discuss
with your doctor and take a moment to organize your
thoughts before you go in.

2.) Do your own research: If you would like to try a natural
alternative to a medication you're on, or start a new diet,
bring along materials on the subject in case what you are
suggesting is new to them. Then, if it's not an emergency
situation, give them a few days to get back to you so they
don't feel pressured to figure out a response in just a few
minutes.

3.) Use email: If the doctor provides email access, use it --
wisely. This can help you keep up with your health
questions and concerns between visits and reduce the
laundry list of things you want to discuss during your
check-up.

4.) Be assertive: While you want to help your doctor help you,
don't back off on your needs out of empathy. Ask for what
you need, make sure you understand what you are being
told, and advocate for yourself.

You deserve to get the best possible care from your doctor. But it's
a two-way street. When you approach your doctor as your
healthcare partner -- and you make it more possible for them to
assist you -- you'll have a better chance of getting what you need,
and staying as healthy as possible. 

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A leg up

Q:  For years I winced when I looked at the bulging varicose veins
on my mother's legs, thinking how painful they looked. Now that I
am approaching forty years of age, have had two children, and
work at a job that has me sitting down for 12 or so hours a day, I
need only look down to catch a glimpse of my own growing
varicose veins. They are not painful right now, but I'm getting
worried. What can I do to keep them from getting worse?

JVW: Although it's not widely known in this country, there is an
herbal remedy that has become the standard of treatment for this
condition in Europe. It's an herb called horse chestnut, and it
comes in an oral form or a newer topical form. Most of the
research that has proven its effectiveness were conducted using the
oral form, so this is what I would recommend you use.

Skilled herbalist and regular Nutrition & Healing columnist Kerry
Bone suggests a dosage of 600 milligrams of horse chestnut
extract, containing 100 milligrams of escin -- the phytochemical
that acts as the active constituent in this remedy. He also
recommends combining the horse chestnut with two other herbs --
butcher's broom and gingko biloba, which are also helpful for
circulation. While this approach will not reverse what has already
begun, it may keep it from worsening or becoming painful.

Since you have so many of the risk factors for developing severe
varicose veins, you might also want to consider taking some extra
precautions, like taking regular walks and exercising. Elevate your
legs whenever possible, perhaps getting something that would fit
under your desk to put up your feet while you work. Take regular
stretch breaks throughout the day. Set an egg timer on your desk if
you have to -- every hour you should be up out of your chair and
taking a little stretch or stroll.

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What is...a hospitalist?

The term hospitalist refers to a doctor who handles all the hospital
rounds for the various physicians working in a practice together.
The emergence of the hospitalist as a specialty practice of
medicine in its own right has exploded since the term was coined
in a 1996 New England Journal of Medicine article -- jumping
from 300-400 in 1997 to approximately 6,000 practicing
hospitalists nationwide today. Professional hospitalist
organizations project that number to increase to at least 20,000 by
the end of the decade.

This type of position has gained popularity partly in response to
the overall time crunch physicians face: It eliminates the need for
each individual physician to go back and forth from the hospital to
the office environment.

However, while this position saves doctors a great deal of time, it
could potentially cause you problems. If you have worked closely
with your primary care physician to include natural therapies as
part of your health care approach, there is no guarantee that your
hospitalist will be as accommodating. You might want to ask your
physician who would be in charge of your care if you were ever
admitted to the hospital for any reason. Forewarned is forearmed.

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