Health Scan: Abandoned doctors feel slighted

Doctors are more likely to feel hurt when a wealthy patient leaves their care.

By JUDY SIEGEL-ITZKOVICH
doctors 88 (photo credit: )
doctors 88
(photo credit: )
Israeli family physicians are status conscious. This statement does not refer to the type of car they drive, but which type of patients leave them for another doctor. A new University of Haifa study on doctor-patient relations has found that family doctors are more likely to feel hurt when a wealthy patient leaves their care than when a poor one seeks another doctor. The researchers, headed by Dr. Shlomo Hareli of the university's Graduate School of Business and the Department of Human Services, interviewed more than 116 practitioners and diagnosed the problem: "We found that a physician will be insulted more if a professor of electrical engineering leaves him than if a municipal cleaning worker does." The longer a patient has been with a doctor, the more his or her leaving will hurt the physician's feelings, the study also found. The team, which also included doctoral student Ornit Karnieli-Miller, Rambam Medical Center Prof. Shmuel Eidelman and Dr. Doron Hermoni of the Technion, questioned 64 women and 52 men. When a physician's sensibilities are hurt in this way, it may lower the doctor's self-esteem and ultimately the caregiver's ability to function. Hareli explained that a person with a higher socio-economic status is thought of as someone whose decisions carry more weight., thus if he decides to leave, it will impinge more on the doctor's feelings of self worth. TRANS FATS TO BE LABELLED FOR EXPORT Israeli food companies that export to the US and Europe will now be required to list trans fatty acids among the ingredients. Trans fats are hydrogenated, solidified fats that increase the risk of heart attack and stroke by forming fatty plaques in the blood vessels. A special device was purchased by the Bactochem lab in Nes Ziona to test foods for the amount of trans fats they contain. Israeli law does not yet require the separate listing of trans fats on products sold here, but the Health Ministry has said it has plans to require this. EYE-OPENING LASER Hundreds of glaucoma patients have been treated successfully with an experimental treatment called selective laser trabeculoplasty (SLT) at Assaf Harofe Hospital in Tzrifin. Developed by Dr. Mark Latina of Massachusetts General Hospital, the non-invasive technology has just been approved by the Health Ministry. Using an imported device called Laserex, an ophthalmologist is able to treat patients repeatedly, painlessly and without side effects for excess intraocular pressure. It is said to be especially beneficial for glaucoma patients unable to receive drugs because of contraindications or physically unable to treat themselves with eye drops on a regular basis. SLT treatment is not in the basket of health services, thus it costs NIS 3,000 per treatment. Dr. Audrey Kaplan-Massas of the hospital's glaucoma service says that the device works selectively on the tissue responsible for drainage of fluid from the corner of the eye. Until now, such patients have been treated with an argon laser device which can be used only once in five years and involves invasive microsurgery. About 4% of adults over 40 - or 250,000 Israelis - suffer from glaucoma, a condition in which fluid pressure inside the eye causes damage to the optic nerve. There are no symptoms, so people in this age group should be tested by their ophthalmologist on a regular basis. SWEET BABY Women who breastfeed longer have a lower risk of developing type II diabetes, according to a US study published in the Journal of the American Medical Association. Since the disease - caused mostly by multiple lifestyle factors such as diet, exercise and overweight - and its complications impose a considerable burden on the health care system (about a tenth of all money spent on health care in the US), reducing the prevalence offers many bonuses. Previous studies have shown improved insulin sensitivity and glucose tolerance during breastfeeding compared with non-lactating mothers. Although these and other findings have suggested that maternal lactation may reduce future risk of type 2 diabetes, no study has directly examined this association. Dr. Alison Stuebe of Brigham and Women's Hospital and Harvard Medical School in Boston led the study, in which data on nurses' health studies totalling 156,000 women were analyzed. They followed women over 16 and controlled for current body mass index and other relevant risk factors. The researchers found a 15% reduced risk of diabetes per additional year of breastfeeding. "These data suggest that lactation may reduce the risk of type II diabetes in young and middle-aged women. Further clinical studies are needed to confirm this finding and elucidate the physiological mechanisms for an inverse association between duration of breastfeeding and risk of type II diabetes," the authors write. MAN's BEST FRIEND Owning a pet is linked to health and wellbeing, particularly for older people and patients recovering from major illness, say researchers in a recent issue of the British Medical Journal. Research has suggested that pet ownership is associated with a reduced risk of heart disease, lower use of family doctors and a reduced risk of asthma and allergies in young children, as well as less absenteeism from school through sickness among children who live with pets. Explanations for the association between pet ownership and human health include social benefits and emotional support. Indeed, studies have shown that support from pets may mirror some of the elements of human relationships known to contribute to health. However, conflict between health and pet ownership can arise, say the authors. For instance, it is thought that up to 70% of pet owners would disregard advice to get rid of a pet because of allergies, while reports abound of older people avoiding medical care through fear of being admitted to hospital or residential care, as this often means giving up a pet. People do not own pets specifically to enhance their health; rather they value the contribution their pet makes to their quality of life. Greater understanding among health professionals is therefore needed to assure people that they do not need to choose between pet ownership and compliance with health advice, they conclude.