The 40-years and Older Patient

Most of us tend to be healthy or at least without any significant medical issues prior to the age of Forty (40) Years, other than some minor illnesses here and there for which often times we are able to recover without further sequela..  While it remains a mystery why the human body begins to develop major illnesses or diseases after the age of forty,  we know that there are multifactorial issues that predispose the human being to developing illness or diseases,

Here are two clinical scenarios that one can use as a paradigm for making sure they are getting the maximum benefit through the health care process:

WELL-Patient   Versus   Patient with Illness or Disease

THE WELL, 40-Year old Patient Visit:

Doctor: What would you like to see the doctor about?

Patient: Well, I feel otherwise healthy without any symptoms, but I would like to have a general health-evaluation.

Doctor: Is this your first visit to a health care provider or doctor?

Patient: No, I have gone to visit a health care provider in the past for minor illnesses such as a cold, or flu, or minor trauma, but nothing really major or long lasting that would cause me to be concerned about my health. And, I am generally very aware and health conscious about being sick.  So, I exercise and promote good nutritional balance and dieting.

Doctor:  Great! So, what I understand is that you have not been diagnosed with any major illnesses in the past such as high blood pressure, or diabetes, or cancer, or any other major diseases, or have undergone any major or minor surgeries in the past and that you otherwise DO NOT have any current symptoms? Furthermore, I understand that you have not been on any short term or long term medications, or that you are not aware that you have allergies to certain foods or medications, or that you do not smoke cigarettes, drink alcohol daily, or use illicit drugs, and that you are employed or have your own business?  Furthermore, I understand that your parents are alive and well as elderly above the age of 75, and that there is NO genetic patterns of disease within your family tree that you are aware of.

PATIENT: Doctor, as I stated to you before, I feel as though I am completely healthy.

Doctor: I recommend that we obtain vital signs, and complete a physical examination, just to confirm your apparent healthiness.  Your Physical Examination is WITHIN NORMAL LIMITS.  Therefore, my impression is that you are a healthy 40-year old patient, and I recommend that you continue your habits for healthy living.  Now, there are some screening exams that are recommended including, but not limited to: Mammogram (for women); Prostate Specific Antigen/digital rectal exam (for men), among others.  I also recommend that you follow up with me within 1-3 years, or sooner if you become ill.

Patient: Thank you, Doctor/Health-care provider, I COMPLETELY understand your assessment and plan for my health-care, and will participate in partnership with you regarding my medical care!

DOCTOR: You are very welcome, and I applaud you on your efforts to remain healthy-conscious, and for participating in proper communication and partnership  for SAFE-MEDICAL CARE!

VERSUS

THE 40 YEAR-OLD PATIENT WHO IS SICK or HAVE KNOWN CHRONIC DISEASES OR HIGH RISK FACTOR FOR DISEASE/ILLNESS?

                              THE SCENARIO?

              IT’S COMPLICATED

START HERE WITH COMPLETE EFFECTIVE COMMUNICATION

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