|
[Date Prev][Date Next]
[Chronological]
[Thread]
[Top]
[Dysphagia] disagree with doctor?
I find that medical services that I have been working with for a long
period of time don't disagree, but I have run into issues with some of
the medicine subspecialties where I have less of a presence. I do as
Heidi does but also try to give articles (Langmore's on causes of
aspiration pneumonia in Dysphagia 1998 is one and Dr. Taylor's
recommendations may be helpful also) to the doc butressing my
position. Ultimately you want to both convince docs to think through
their diagnoses completely and to demonstrate to them that you are
knowledgable.
Good Luck - it's a longterm project
Woodford A. Beach, Ph.D., CCC/SP
Senior Speech Language Pathologist, VCUMC
Adjunct Asst. Professor, Neurology
Adjunct Asst. Professor, PM&R
Asst. Clinical Professor, Otolaryngology/Head & Neck Surgery
Virginia Commonwealth University
Richmond, VA 23298
-------------------
> This happens quite a bit everywhere, especially when MD's don't note
the
> difference between aspiration pneumonia and aspiration pneumonitis.
I
> make sure I explain to the family that aspiration "pneumonia" can be
> caused by many things including refluxed material, vomit,
secretions,
> etc. I then explain the MBS and show it to them if possible. Then
> explain that you don't feel that they are at any risk of their
> meals/drinks causing an aspiration pneumonia (keeping in mind a
person
> can be aspirating, even though they don't do it on the MBS).
However,
> since many things can cause it, it doesn't rule out that it can
happen
> in the future from any of those factors.
>
> You can include this info in the patient chart so that the MD can
read
> it and gain the knowledge without feeling as if you are being
> disrespectful. We also inservice frequently (monthly in the ICU as
that
> is how often the MD's rotate there). Your other option is to find
or
> create some great take-home literature. Don't forget that families
and
> patients forget most of what they are told in the hospital:-)
>
> Heidi
>
> -----Original Message-----
> From: Jonathan Bennett [mailto:ajbennett05@yahoo.com]
> Sent: Friday, August 18, 2006 4:12 PM
> To: dysphagia@b9.com
> Subject: [Dysphagia] disagree with doctor?
>
> I'm curious about how many of you handle this type of situation. Of
> course, many of the patients that we see have pneumonia...but after
I
> see a patient, sometimes I do not believe that it is being caused by
> aspiration, yet, the doctors are labeling it aspiration pneumonia.
I am
> then put in the position where I have them on a regular diet and the
> family is asking how we are sure they won't end up with aspiration
> pneumonia again. If they end up back in the hospital, the doctors
and
> family will be angry and once again, labeling it aspiration
pneumonia,
> when in fact it may be viral, community acquired, etc. How do you
> handle both the patient and the doctor in these types of situations
> without losing respect of the doctors?
>
>
>
> __________________________________________________
> Do You Yahoo!?
> Tired of spam? Yahoo! Mail has the best spam protection around
> http://mail.yahoo.com
>
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
>
|
|