
	Medical Edge


	About

	Television

	Radio

	Newspaper

		Participating Newspapers

	Magazine

	Contact


	About Mayo Clinic

	Make an Appointment at Mayo Clinic

Medical Edge Newspaper Column from Mayo Clinic

HOW TO GET THE MOST OUT OF A DOCTOR’S VISIT

DEAR MAYO CLINIC: I am concerned that my 83-year-old mother flies to Mayo Clinic in Rochester, Minn., for most of her health care.

She loves the fact that the doctors listen to her and remember who she is (even a year later). The doctors directly answer her questions, and they do an excellent job medically. Locally, there have been two times when my mother has felt that doctors have overlooked important aspects of her care. She flew to Mayo Clinic, and they fixed the problems.

How can she categorize what is a “local” medical issue, and what is a “plane flight” kind of issue? What role do we all play in speaking up and being our own advocate? I think she has a hard time telling doctors here what she thinks. She has reason to be frustrated, but I counter that she can find excellent health care in Seattle and needs to at least have a general practitioner here. Help save a daughter’s sanity. — Seattle

ANSWER: Considering several questions can help your mother determine where to seek care:
— Is the problem urgent and cannot go on untreated for another day or two? Seek care locally.

— Does the problem seem likely to be easily treated? Seek care locally.

— Are there multiple and potentially complex factors? Consider travel to a respected medical center.

— Is elective surgery likely? Seek care where there are experts in your condition.

One of the most frequent reasons we hear why people come to Mayo Clinic is how we coordinate care. Most patients are seen as outpatients, with evaluations, diagnostic tests, specialist consultations, discussion of treatment options and, often, initial treatment scheduled over four or five days. What’s packed into that week can take weeks or months elsewhere. Patients find that having so many experts working together makes the journey worthwhile.

But regardless of where your mother seeks care, she needs to share her concerns. It’s her job to communicate the problem clearly to her doctor and participate in the decision-making process.

Her physicians need to, first and foremost, listen to her concerns. If your mother isn’t sharing her concerns, or her doctors aren’t listening, the experience won’t be satisfactory no matter where she seeks care.

— Glenn Forbes, M.D., Mayo Clinic, Rochester, Minn.

Additional Resources:
Appointment Information
Why Choose Mayo Clinic?

READERS: The narrowing and hardening of arteries that underlie heart disease affect all the blood vessels in the body — not just those of the heart. As a result, a quick, noninvasive fingertip test that takes only 20 minutes to produce results may be an effective way to detect heart disease in its earliest stages. This early surveillance for heart disease is important because the disease is most treatable then, and further damage can be prevented.

Research reported in December 2004 shows a strong correlation between abnormal fingertip test results and early-stage coronary artery disease. Researchers therefore conclude that the fingertip test is a sensitive and useful means for identifying patients with problems.

The study assessed the healthy functioning of a layer of cells that lines the blood vessels, called the endothelium. The endothelium has been gaining increasing attention as a key player in blood-vessel health. That’s because it protects the vessel walls from injury and helps modulate vessel expansion and contraction — movements that are vital for maintaining appropriate blood flow and pressure.

Researchers plan to expand the investigation to include patients who do not yet have symptoms of heart disease. That way researchers can determine the fingertip test’s power to flag those at risk of developing disease — before any other symptoms suggest it.

Additional Resources:
Treatment of Cardiovascular Disease
Appointment Information
More Information on Heart Disease

- - -

Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.