Interactions

Tuesday, February 13, 2007

Too Little, Too Early

Thanks so much for the article on preterm births ["Early Arrivals: A Growing Problem," Feb. 6]. I delivered twins at 30 weeks and 4 days almost six years ago at Virginia Hospital Center. We were incredibly lucky, and they are healthy. I recently read an article on the use of magnesium sulfate to try to stop early labor. As someone who went through "mag" treatments three times before giving birth, I was stunned to read that there is very little scientific research to demonstrate that mag actually works.

Christine E. Wormuth

Arlington

I would like to add another resource to your list: I am president of an all-volunteer, nonprofit organization for preemie parents called Preemies Today ( http://www.preemiestoday.org). It is our mission to help families reduce the stress related to prematurity beginning at birth and through the growing years.

We distribute Preemie Care packages, with information and hard-to-find items for families, to Inova Fair Oaks Hospital and Reston Hospital Center. Our Preemies Today newsletter is distributed to 11 local hospitals and health-care offices, as well as individual subscribers.

Mary Beth Hazelgrove

Centreville

While we have increased technology to the point that even some babies below one pound (less than a carton of butter) are forced to life, their lives are often very difficult. The leading causes of mental retardation and cerebral palsy are complications of prematurity. In addition, laws put into place by the Reagan administration remove choices from parents in these situations; parents often say they would have preferred their child [had] a peaceful death rather than submitting them to horrific medical care for months in the NICU, only to go on and live severely impaired lives. If we are going to address the issue of prematurity, we should start by abolishing the Baby Doe laws, as well as providing appropriate care for those impaired preemie survivors as they grow into childhood and adulthood.

Teresa Albrecht

Amherst, Wis.

How Much Do You Need to Know?

Thank you for "How Much Do You Want -- or Need -- to Know?" [Feb. 6]. It well reflects the feelings and experiences of the members of our support and advocacy group, COPD-ALERT. We are a major national online patient organization for people with chronic obstructive pulmonary disease, the fourth major cause of death in the U.S. and projected to become number three in 2020.

Vlady Rozenbaum

SilverSpring

Doctor-Patient Complaints

The realities of the practice of medicine today are a bit more complex than "Tell Me Where It Hurts" [Feb. 6] suggests. The patient-physician relationship has regressed as a result of a third party: the health insurance companies.

In primary care services this interference is particularly evident.

1.) Time spent with patients has decreased as the volume of patients seen daily has grown. Also, there are fewer primary care practitioners, and insurance companies demand that all patients are first seem by their PCP, before any referral. So quality suffers.

2.) Fewer patient services are covered, and because the PCP is the person who usually brings the news to the patient (your insurance will not pay for that MRI or for this medication), the first burst of anger and frustration is directed at the PCP (killing the messenger.)

3.) There is no effort on the part of the industry to educate patients about prevention and/or specific diseases, and the importance of compliance.

I agree with you: I should be a better physician and my patients should understand the limitations imposed by the system. But please, do not leave the insurance industry out of the picture.

Joseph Gutman, MD

Tempe, Ariz.

The latest Consumer Reports survey confirms what many of us have known for a long while -- one of the greatest barriers in providing adequate care is the lack of proper communication between doctors and patients.

The American Medical Student Association (AMSA) has worked to create an awareness of the need for cultural competency in doctors. Through changes in medical school curricula, outside training and collegial development programs, doctors must be better prepared to talk to their patients about everything from a headache to end-of-life issues. It is only through efforts to understand our patients as complete human beings that we can provide the care they need.

Of course our patients are often reluctant to tell us about certain symptoms or lifestyles contributing to their health. It is our job, as caregivers, to make our patients feel comfortable and to ask questions that gather the information we need, whether or not our patients volunteer it. That is the "care" in health care.

Jay D. Bhatt

President

American Medical Student Association

Reston