I often ask my patients to record their measurements at home in a diary, and bring them to the next appointment. I find that this improves the self-efficacy of the patients and their family members in taking care of their illnesses, and helps us doctors take better care of them! At the same time it’s an ideal, and reality loves to wash away our best laid plans..
Some patients do check their parameters, some don’t. Some of those patients who do go to the trouble of measuring them regularly, may not record them! And those who diligently record them may forget to bring those readings when they come for a follow-up consultation! And some of those who keep meticulous records, stop after a few months.
I often tell my patients, “Your proper treatment will only start when you start maintaining a record, till then we’re just playing with your illness!” And truly, the home record is vital in adequately managing Hypertension and Diabetes Mellitus, and I’ve found it useful in other illnesses too, like Typhoid fever, and Food allergies.
I keep wondering how to inspire patients and family members to keep better records. I think I got some answers last year..
In the middle of a busy outpatient clinic a couple of months back, I saw two young men, one after the other, for the same complaint. Both had suffered limb injuries a few months prior, and had developed scar hypertrophy with itching. But that’s where the similarity ended.
“Doctor, can you come quickly, my mother is unwell!”
Even after doing thousands of home visits, I dread phone calls like these. If it’s an actual emergency, I can hardly help with the meagre tools I have in my bag, and the family had better call the ambulance and rush the patient to the hospital without waiting for me. On the other hand, there are genuine conditions in which a home visit by a doctor can help much more than transporting an unresponsive elderly to the unfamiliar environs of a hospital ICU. It’s quite tough to decide on the phone, which is which.