Thursday, June 21, 2012
Communication key with patients

By Dr. Anthony Policastro I started my pediatric residency on June 23, 1972. This year on June 23 I will have been a pediatrician for 40 years. Many things have changed in medicine over that period of time. There are many new drugs and new procedures. There is a lot more knowledge. However, one thing has remained consistent - the fact that the physician and patient relationship is built on communication. People talk about "bedside manner." What they mean is the ability to communicate. Some physicians are better at communication than others. As a result, the patients feel comfortable listening to them and following their instructions. What we often do not realize is that communication is essential for patients in complying with the treatment plan that the physician provides. There are four ways that communication can result in a treatment plan not being followed or understood. The first way is that the patient might not communicate the real issue. Patients will sometimes develop a concern that they have a certain disease. For example, someone may have a set of symptoms. They are concerned that those symptoms might represent cancer. They go to the doctor because they are concerned about cancer. They tell the doctor the symptoms they have and expect the doctor to tell them that they have cancer. When that does not happen, they leave dissatisfied. If they had taken the time to tell the doctor their real concern, the physician could have addressed it. There would be an opportunity to explain why the physician did not think the symptoms represented cancer. There would have been an opportunity for the physician to perform some tests to prove it was not cancer. Thus the patient really needs to let the physician know what the exact concerns are. Otherwise, there is a breakdown in communication. The second way is when the patient does tell the physician their major concern but the physician does not hear it. For example, a mother could bring a child in with a fever. The physician can examine the child and find an ear infection. The physician realizes that the ear infection is causing the fever. The physician gives an antibiotic to treat the infection. The antibiotic clears the infection in 24-48 hours. However, when the parent goes home, she gives the first dose of antibiotic. She then takes the child's temperature. There is still a fever present. She then gets upset because the antibiotic did make the fever go away. In this instance, the physician failed to pick up on the primary concern. The mother needed to be given separate instructions for handling the fever until the antibiotic got the infection under control. The third way is related to the physician explaining things to the patient in a way that the patient does not understand. Physicians may use complicated medical terms and give complicated directions without writing them down. That makes the directions hard to follow. The fourth way that miscommunication can occur is when the physician will give directions that the patient for some reason misinterprets. For example, over the years I have treated patients with oral antibiotics for ear infections. Occasionally a mother will ask me about which ear is infected so she knows which ear to pour the antibiotic into. Communication remains a basic part of medical care. It continues to be at the core of what we do. No matter what kind of medical advances occur, the patient and physician will still need to communicate. There are many ways that communication can be a problem. This has not changed in the past 40 years.

New state chapter of 'Nurses House' A new foundation will provide vital resources for nurses facing difficult times. Several nurse leaders from the Delaware Organization of Nurse Leaders are forming the first Delaware chapter of Nurses House, a national not-for-profit organization which provides financial support to RNs in need due to a medical issue or emergency. By completing a comprehensive application documenting an illness and financial need, a nurse may qualify for assistance with medical bills, utility payments and other temporary support. It is the only national charitable organization assisting nurses. The organization is funded by donations from nurses and friends, nationwide. The Delaware Chapter of Nurses House will be holding fundraising events throughout the year to raise money for the national organization. Donations to Nurses House are fully tax deductible. To make a donation, you can send a check or money order to: Nurses House, Inc., The Veronica Driscoll Center for Nursing, 2113 Western Avenue, Suite 2, Guilderland, NY 12084 For more information or for questions about Nurses House, contact Ann Keane at 744-7099.

Grant will help returning vets The Mental Health Association in Delaware will receive a grant for $30,000 from Wounded Warrior Project (WWP), a non-profit organization whose mission is to honor and empower Wounded Warriors. The grant will support program expenses associated with the launch of two professionally led groups for family members of returning veterans. Aligning with WWP's commitment to enhancing the mental health of Wounded Warriors and helping foster healthy readjustment to civilian life, these support groups will improve the health and well-being of veterans and their families throughout Delaware. The groups are offered in collaboration with the VET Center's in Wilmington, Dover and Georgetown.

To learn more or to register for the groups, contact the Mental Health Association in Delaware at 302-654-6833 or 800-287-6423.

Foundation helps people with autism The Specialisterne Foundation in Delaware, a Danish non-profit organization, has employment opportunities for Delawareans with high-functioning autism spectrum disorders using its highly successful model. The foundation's goal is to establish one million jobs across the world for people diagnosed with autism spectrum disorders and similar challenges. Specialisterne ("the specialists" in Danish) employs primarily high-functioning individuals with ASDs, mainly Asperger syndrome, with many having a second or third diagnosis as well. According to Thorkil Sonne, founder and president of Specialisterne Foundation, Inc., the strong memory, pattern-recognition skills and perseverance that are shared by people with ASD are "a natural advantage" in software testing, quality control and data entry. "Since Specialisterne was founded in 2004 we have developed a unique approach to identify and develop the potential in high-functioning people with autism and establish comfort zones in which they can use their special talents to solve valuable tasks for the corporate sector," said Sonne. The Specialisterne Foundation, which is incorporated in Delaware, is also working with local stakeholders to raise the needed funding to start further local operations in the United States. For more information about Specialisterne, go to,, or contact Sonne at

Parent Coffee Hour Autism Delaware will hold a free parent coffee hour at 9:30 a.m. on Thursday, June 28, at the Holiday Inn Express in Seaford. For details, visit or call Autism Delaware at 302-644-3410.

Space available at Camp New Hope Delaware Hospice has spaces available at Camp New Hope, which will be held from July 10-13, at Trap Pond for Sussex County, for children and teens ages 6 to 17, who have suffered the recent loss of a loved one. The New Hope program, including Camp New Hope, is a free community outreach program. This inspirational day camp takes place over four days, connecting children in similar age groups in order to help them process their feelings of loss and grief. Learn more about Camp New Hope by contacting New Hope Coordinator for Sussex County, Angela Turley, at 856-7717, ext. 3104, or

First aid classes at Nanticoke Nanticoke Memorial Hospital will offer community First Aid classes to anyone interested in learning first aid on Tuesday, June 19 from 6:30 to 9:30 p.m., at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn basic first aid that will enable them to administer help during the first few moments until emergency responders arrive. Classes are open to participants ages 13 and up. The course covers cognitive learning, role-playing, and skill practice. Cost is $30. Payment and registration is required by no later than five business days prior to the class. Late registrations (if seating is available) will be an additional $5 fee. To register, or for more information, contact the hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.

HIV/AIDS Support Group A new support group for HIV/AIDS will meet every other week beginning Wednesday, June 27 at 7 p.m., in the Branford Lounge at Epworth United Methodist Church at 19285 Holland Glade Rd., Rehoboth Beach. The group is sponsored by Epworth UMC, CAMP Rehoboth, the AIDs Delaware and Delaware HIV Consortium. For more information, contact David at

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. To learn more, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Parkinson's Support Group A Parkinson's Support Group is being held in Seaford on the third Monday of each month from 10 to 11:30 a.m. at the Nanticoke Senior Center. The group focuses on educating members about Parkinson's through guest speakers and small group discussions. Persons with other movement disorders are welcome to join the group as much of what is discussed is not limited to Parkinson's. New members are encouraged to attend. Reservations or advance notification is not required. For more information, call Dennis Leebel at 302-644-3465.