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Survival instincts propel 'difficult patient' to insist on quality care
Date:9/10/2008

CHAPEL HILL Michelle Mayer had to become a "difficult patient" before she could get her physicians to accurately diagnose the disease that was destroying her health.

And once the diagnosis was made, she had to continue to be what many physicians describe as "difficult" before she could get the best treatment for scleroderma, a chronic autoimmune disease in which hardening of the skin is a major element.

Mayer, a research assistant professor of health policy and management at the University of North Carolina at Chapel Hill School of Public Health, writes about her experiences as a patient in the September issue of Health Affairs, a publication aimed at enhancing communication between health policy researchers, legislators, decision-makers and professionals concerned with developing, implementing and analyzing health policy.

Mayer's essay from a patient's perspective is paired in the same issue by an essay from an Illinois physician, describing "difficult patients" from the physician's perspective. Their viewpoints are quite different, but, as the magazine explains, both Mayer and the physician decry policies that result in brief office visits that don't allow enough time for patients and doctors to get to know one another, discuss medical issues and reach appropriate decisions. They agree both patients and doctors need time to work together and listen to each other. Mayer said she is hoping to influence legislators and other policy makers to understand the consequences of certain policies and regulations.

In her essay, Mayer describes severe swelling and cold intolerance she developed in her hands 12 years ago while she was a public health student. She was diagnosed with Raynaud's phenomenon, a condition where small vessels of the hands and other parts of the body severely constrict in response to cold and stress, depriving surrounding tissues of oxygen.

"During the next six months I accumulated symptoms," she
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Contact: Patric Lane
patric_lane@unc.edu
919-962-8596
University of North Carolina at Chapel Hill
Source:Eurekalert

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