Primary Care

An especially special friend of mine spoke with me about the uselessness of primary care physicians. And almost had me, but something came to mind when I read an article in the July 2, 2008 edition of the JAMA (Journal of the American Medical Association) by Dr. Michael Stillman. My friend presented me with the idea that general care physicians are not always very knowledgable about ailments or certain health problems that specialists would know. I had a personal experience that comes under this category. However, when the patient of a primary care physician is ill or injured, the primary care physician will know the patient well. One of the most important aspects of health care that is commonly overlooked is knowing the patient. Often such luxury is not possible with the busy schedule of doctors, or the lack of need to see certain doctors. Nonetheless, it can influence care dramatically. Dr. Stillman gave an example in his article where the medications of a patient had been changed to a more expensive regimen without his knowledge. The prescribing doctor would not have know that the patient could never afford those medications, but Dr. Stillman knew and prescribed the original, less-costly, and equally effective regimen.  A number of other issues come up as well when identifying the importance of primary care physicians. When making an important medical decision, trust between a patient and the doctor becomes essential. Patients, even if are under the care of a specialist may want to consult a phyiscian with whom they are familiar before making an important decision. Primary Care doctors may not necessarily save lifes, but they can certian help people maintain the highest quality of life possible. So with the greatest level of respect possible, I disagree with my friend [I will convince her I am right, and if she happens to read this before I try the art of persuasion…] (citation: JAMA July 2, 2008 p.21-22).

Seizures

What I Learned From My First Reading Session about Seizures

• More than 2 million people in the U.S. have had seizures and/or been diagnosed with epilepsy
• The term seizure is a symptom
• If a seizure is not epileptic, or if a diagnosis is uncertain, it should be described as paroxysmal
• There are about 32 types of seizures
• aprox. 50% of seizures never have an identified cause; the other 50% are usually due to underlying diseases or injury of the brain
• Seizures limited to one portion of the brain are called partial seizures
• Most seizures last from 30 seconds to 2 minutes

For a fairly common ‘symptom’ very little is known about seizures. Understanding seizures better could improve the lifestyle of thousands of people. Equally important, it could decrease the amount of fear in people who suffer a seizure and are unsure of why it happened, if it will happen again, or when it could happen. Tests to search for underlying causes can also be quite time consuming and expensive, often including an EEG, CT scan, and an MRI. Each test can be very important in indentifying problems, but the quality of the tests do not seem to meet the needs of epilepsy/seizure patients since only 50% of the time a cause is identified.