Anytime I have a patient who is a smoker or former smoker in with a disease directly as a result of their smoking, I will turn to all family members in the room and ask if any of them smoke. If any of them say yes, I immediately begin into a painful smoking lecture I am sure they have heard many times before (although I'm not sure if I can bill a CPT 99406 and 99407 for families).
I tell them to look at their family member sitting in the hospital bed. I tell them that exactly what happened to them will happen to you. I explain to them that people are susceptible to to ill effects of smoking to different degrees, with genetics driving some of the determinations. I draw a graph of lung function decline through time for a smoker compared to a non smoker.
And then I tell them that it's never to late to quit. And sometimes it works. Like the 30 year old father of two that I lectured as his 57 year old mother lay in bed with end stage respiratory failure. When I met this gentleman several days later, he showed me the patch on his arm. He's going for it.
If not me then who? It's my business as a physician, whether you like it or not. And sometimes it works.
I think it would surprise you, how FEW physicians straight talk to patients.
ReplyDeleteI don't know if they fear pissing off the patient or they are just thinking it wouldn't make a difference but I think it would.
Sometimes people need more of a smack than a suggestion.
~~Also..I have to tell you that I love how much your dogs love each other..they seem almost human~~
I love that you approach your patients and their families this way. I think if more doctors were to address obesity, smoking, etc. in their patient encounters -- they're patients would be better-served (whether the patient realizes it or not).
ReplyDeleteAs an MS-1 I love reading your blog and appreciate posts like this.
Oh my...I hate it when people use their/they're/there like above.
ReplyDeleteForgive my earlier post (grammatical errors don't count if you discover the error first).
Power to you to continue pointing out the consequences of smoking and/or other destructive behaviors. I like how the L.A. Coroner's office has a fund for hosting group visits by at-risk kids to see the direct results of their violence.
ReplyDeleteMarco