Thursday, August W, 1979
11 ■■HI" ■' ■ M I I I IHI ■ iiih ■■!■■■■■ .11.1 Lipii I li I mwi— ■>—-> I , i— ——mmmm —
Doctor - Patient Difficulties Often Result Os
By Dick Broom
> CHAPEL HILL ln all
their years of training, most
doctors are never taught
how to use an instrument
they rely on in HiagwMjwg
and treating 15-20 per cent of
their patients’ primary
medical problems.
Os course, they already
know how -to use the
telephone.
But they may not be
skilled at using it as a
medical tool, says Dr. Peter
Curtis, assistant professor
of family medicine in die
School of Medicine at the
University of North
Carolina at Chapel Hill.
“About 75 per cent of
problems presented in a
primary case setting can be
handled on the phone,”
Curtis says. “Yet, most
physicians learn to deal with
the phone only as a tool of
organization and ad
ministration.
“Because they don’t
receive any formal training
in telephone medicine, they
f often have trouble dealing
with patients’ problems on
the phone.”
For the past three years
Curtis has been studying
ways to improve the
Letter To
The Editor
Congressman Walter B.
Jones mentioned in his July
26 Washington Report that
Congress voted that no
federal funds would be used
to finance abortions in
Washington, D. C. It is
regretful that Congressman
Jones doesn’t support this
legislation since no
American city has ever
reached such a high abor
tion rate. There were 13,000
abortions compared to
10,000 live births in D. C. last
year. The government paid
for 5,250 of those abortions.
Con. Jones also voted
again this year against the
Hyde Amendment which
would retrict federal funds
from paying for abortions in
HEW.
Either the people of this
district want their tax
money to be usfed to JdU the
unborn of the poor or they'
have failed to let their
representatives know
otherwise. N. C. State
repesentatives Charles
Evans and Vernon James
and Senators Melvin
Daniels and Monk
Harrington all voted to
leave $2-million in the N. C.
budget to fund convenience
abortions for the next two
years. This was done at the
request of Governor Hunt
who is an avowed supporter
of abortion, who works to
make pbortion easily
available to poor, that class
of people he feels are un
desirable.
Your voice counts and we
should remember that,
“The only thing necessary
for the triumph of evil over
good is for good men to do
nothing.”
Sincerely,
Mrs. Mimi Weeks
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S Mtmiißiigfflr ■■■—J- I —■ I I
telephone skills of primary
care physicians and nurses.
He recently received a
$35,006 grant from the
National Fund tor Medical
Education to help support
an ongoing research and
training program in the
Family Practice Center at
the N. C. Memorial
Hospital.
The center’s research unit
keeps a record of all
physician-patient telephone
contacts-more than 1,000 in
the past three years.
“This information we’ve
collected and are using in
our educational program
may help doctors adjust
thehr skills and the way they
handle phone calls,” Curtis
says. “In our own program,
we monitor and analyze
residents’ responses in
various telsphone
situations. This is then fed
back to them as part of their
training.”
Social Security News Update
By Lee Wallio
Field Representative
MORE THAN JUST A
RETIREMENT CHECK:
Did you know that under
certain circumstances a
child may qualify for a
Social Security check based
on a grandparent’s work
under Social Security?
Or, that a divorced
woman whose ex-husband
has died may qualify for a
Social Security check based
on his record?
Or, that a dependent
parent may qualify for
Social Security baaed on a
deceased son’s or
daughter’s work under
Social Security?
If you don’t know about
these Social Security
benefits, you may have
thought of Social Security
simply as a program that
pays retirement benefits to
older people.
Social Security also pays
Booklet
Published
A booklet explaining some
of the important aspects of
pension plans has been
published by tOe* Depart
ment of Labor.
“Know Your Pension
Plan”, a 10-page booklet,
includes checklists which,
when filled in by.an em
ployee, provides a handy
outline of his or her (dan’s
provisions. The booklet also
discusses some of the
protections afforded to plan
participant* and their
beneficiaries under the
Employee Retirement
Income Security Act
(ERISA).
Copies of “Know Your
Pension Plan” are available
free of charge from:
Labor-Management
Servicm Administration
Administration
U. S. Department of Labor
Atlanta Area Office
Suite 540,
1306 Peachtree St., N.E.
Atlanta, Ga. 30300
Telephone: 404481-4000
The research unit’s
records show that ap
proximately SO per cent of
■n *»■!!■ to the Family
Practice Center durii* the
daytime and 80 par cent of
after-hours calls deal with
medical of psycho-social
problems rather than ad
ministrative procedures
such as making ap
pointments.
Although most calls
concern minor problems
such as colds and
headaches, many are
prompted by more serious
medical conditions in
cluding fractures,
lacerations and severe chest
pains.
One of the most important
skills of telephone medicine,'
Curtis says, is the ability to
distinguish callers who can
be treated over the phone
from those who must be
treated in person.
benefits to disabled workers
and the dependents of
retired, deceased, or
disabled workers.
The fact is that more than
a third of the 14,000 people in
the Albemarle area
currently receiving Social
Security benefits are the
dependents of retired,
deceased, or disa'bled
workers.
Benefits for dependents
have been payable since
Social Security benefits
were first paid in 1940.
They are designed to help
prevent poverty and
economic dependency
within society by enabling a
worker to provide for the
day when he can no longer
supiport those depending on
his earnings.
What you don’t know
Experts on human behav
ior tell us that motorists and
motorcyclists who curb their
fipVt impulse to show annoy
ance or aggression on the
road are more likely to And
it progressively easier to share
the road.
VWdife Refuge To Open
Pungo National Wildlife
Refuge will be open to ar
chery deer hunting this year
from September 17 through
October 3. Bow hunting
permits are not required.
Regulations must be
obtained from the Refuge
office in the Strader
Building in Plymouth or at
the Refuge sub
headquarters or by writing
the Refuge at P. O. Box 267,
Plymouth, N. C. 27962.
Shotgun deer hunting on
the refuge will be on October
10,11,12,17,18,19,25 and 26.
One day permits will be
limited to one per person.
Two hundred (200) permits
THE CBOVAN HERALD
“If you gat everybody whs
calls to come in, that’s poor
use of the health care/
system. A lot of people will
be aeon who don’t really
need to bo seen.”
Curtis says that many
people who call physicians,
especially after hours, are
primarily seeking
“A lot of people call
because they are anxious or
afraid of what a symptom
might mean,” he "pto—
“Ha relative has Just died of
a heart attack, and they
begin to have chest pains,
they want somebody to tell
them not to worry.”
Often patients call with
what Curtis refers to as a
hidden agenda. They have a
specific concern but may be
afraid or embarrassed to
talk about it directly. For
example, a patient may
complain of a headache,
when Ms real concern is the
about Social Security can
hurt you. An application for
benefits is necessary before
benefits can be paid.
People who are unaware
of what Social Security
benefits are payable risk the
loss of benefits.
At the very least they lose
the opportunity to use the
information in their family
financial planning.
Preparedness Is Stressed
Many coastal newcomers
have never felt the full fury
of a hurricane, but longtime
residents can remember the
wreckage left behind by
Hurricane Hazel and others.
To remind citizens of the
dangers and what to do to
protect their lives and their
property when storms
approach, a week-long
series of films, speakers and
exhibits will be presented
August 19-25 at the state’s
three Marine Resources
Centers at Roanoke Island
near Manteo, Bogue Banks
near Atlantic Beach and
Fort Fisher near Kure
“The sinner who spends and
gives away is better than
the devotee who begs and
lays by." Sadi
per day will be issued as a
result of a public drawing to
be held on September 5 at to
A.M. in the Refuge office in
the Strader Building.
Applications for a shotgun
deer permit may be in die
form of a letter to the
Refuge Manager at the
above address. Print or type
your full name, address,
North Carolina hunting
license number, first
through eighth choice of
hunting dates and sign the
application. Up to five
people may apply togethe
as a party by enclosing all
applications in one envelope
marked “Party Hunt''.
Each applicant must in
clude a stamped, self
addressed envelope for
delivery of the permit or
rejection notice. Ap
plications must be received
at the Refuge Office or post
office box by September 3.
Each application will be
assigned a number and that
number will be put in a box
and randomly drawn.
Duplicate or fraudulent
applications will cause the
applicant to be disqualified
for the drawing.
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P°»«ibility of a brain tumor.
The problem, Curtis
la that physicians?
sometimes don’t perceive
the underlying reason for
tfae call.
“Usually within, the first
minute of the caQ, the doctor
has made up his mind what
the problem is and his mind
snaps shut. He doesn’t
really listen any more, but
spend the rest of the time
instructing the patient
based on that initial
assessment.
“Often, the patient’s
anxieties haven’t been
relieved, because the doctor
never gave him an op
portunity to bring out the
real problem.”
A patient survey taken by
the family practice research
unit revealed a significant
degree of misunderstanding
about the motivation for
patients’ calls. Interviews
More information about
the many kinds of Social
Security benefits is given in
the pamphlet, “Your Social
Security”, which is
available by telephoning
any Social Security office.
The Elizabeth City Social
Security office is located at
111 Jordan Plaza next to
Southgate Mall (phone 338-
2161) and is open 9:00 to 4:30
weekdays.
Beach.
Some of the topics to be
covered include preparation
for a hurricane, how a
hurricane forms, coastal
insurance needs, evacuation
plans and radio com
munications.
Admission is free and all
sessions are open to the
public.
The centers are public
education facilities ad
ministered by the Office of
Marine Affairs of the N. C.
Department of Ad
ministration. They are
cosponsoring the event in
cooperation with the
University Qf North Carolina
Sea Grant College Program
and the State Division of
Civil Preparedness as a
community service.
When you want to save energy...
The phone is the answer
itPwbe ■ I e i
hbt
I P«ei Crave?
TBSm; v for Norfolk
v Carolina Telephone
Overthe past decade, Americans have become
increasingly energy-conscious. New and old
homes alike are being better insulated. People
are purchasing more rnel efficient automobiles.
Air conditioners and heaters are running less.
And, more people are using.their telephones
to save gasoline.
By using the phone, you can avoid a search
from store to store for a particular item. Com
municating by telephone can save a trip
It’s for you j
NORFOLK CAROLINA
TELEPHONE COMPANY tsjllgd
UNITED SYSTEM
Improper Communication
with patients and physicians
after the calls revealed
miscommunicatiou in 30 per
cent of the calls prompted
by anxiety.
Curtis says physicians
should learn to ask the kinds
of questions that bring out a
patient’s hidden agenda:
“Is there anything else
you’re worried about?”
“Have I answered all your
questions?”
“Do you know someone
who’s had a problem like
yours recently?”
Taking complete medical
histories and finding out
what medications the
patient is taking are other
skills physicians routinely
use in face-to-face - en
counters but sometimes let
slip in telephone con
versations, Curtis says.
Besides sharpening
physicians’ com
munications skills, Curtis
says telephone medical
training should aim to
reduce some of the anger
and frustration that calls
from patients sometimes
arouse.
“As part of our program,
we also try to stress the
importance of being sen
sitive to psycho-social
problems and family
dynamics.”
Daniels Is Reappointed
CHARLESTON, S. C.
State Sen. Melvin
R.Daniels, Jr., of Elizabeth
City, N. C., has been ap
pointed to a three-year term
on the South Atlantic
Fishery Management
Council which is
headquartered in
Charleston, S. C.
He replaces Norman
Angel of New Bern. The
appointment was effective
August 11, according to
Richard A. Frank, Ad
ministrator of NOAA, acting
on behalf of the Secretary of
Commerce.
terms in the N. C. Senate
and is formerly Senior vice
president of the Peoples
Bank in Elizabeth City. He
is still active in banking on a
consultant basis.
Sen. Daniels brings a
thorough knowledge of
North Carolina fisheries to
the council from the stand
point of both commercial
Physicians are un
derstandably less patient
with people who call after
hours, especially if the
problem is not serious. But
studies also have found that
physicians tend to show
anger toward certain types
of patients and those with
certain diseases. Psycho
social problems are per
ceived as especially
bothersome, Curtis says.
“If a doctor is called at 3
A.M., he is likely to be much
more sympathetic if the
patient is bleeding than if
there’s been a big family
argument and the patient
has been thrown out of the
DOT Holds Meeting
JACKSONVILLE The
N. C. Board of Trans
portation in its monthly
meeting today approved 42
contracts totaling more than
$31.6-million for im
provements to highways
across the state.
Five of those contracts
were for major interstate
projects, which are being
advanced nearly four
months ahead of schedule
because of additional
federal funding announced
recently. They include
and recreational fishing, as
well as awareness of en
vironmental issues affecting
the coastal areas. He played
an active role in the
development of the Wan
chese Harbor Seafood
Development Project and
has introduced legislation
for the benefit of the fishing
community of North
Carolina.
The South Atlantic
Fishery Management
Council is one of eight
created by the Fishery
Conservation and
Management Act of 1976
which extended U. S.
fisheries jurisdiction out to
200 miles. The council is
responsible for preparing
Fishery Management
Plans for species within
the 200 mile limit of the
watersofN.C.;S.C.; Ga.and
the east coast of Florida.
'The hardest job of all is
trying to look busy when
you're not." William Feather
to the post office. Asking directions over the
phone can save a lot of wasted driving. There
are many energy "shortcuts" your telephone
can provide you, so use it often.
The quick, easy and
inexpensive tele-
phone... When you
want to save en
ergy, it’s the
answer. y
Page 3-B
house or has made a suicide
attempt.”
Physicians also >show
more frustration when
dealing with alcoholism and
gynecological problems. He
says that, in general,
women and elderly people
are not treated with as much
sensitivity as other patients.
Curtis emphasizes that
there may be many ac
ceptable ways--not
necessarily one best way-to
handle a patient’s call. But
he says there are certain
fundamental telephone
medicine skills that
physicians ought to be
aware of and practice.
safety improvements on a
portion of 1-40 in Burke
County, paving and signing
on two portions of 1-95
(Fayetteville Bypass) in
Cumberland County, and
safety improvements on two
portions of 1-85 in Guilford,
Rowan and Davidson
counties.
In addition to the in
terstate projects, there were
seven contracts awarded for
pavement markings at
railroad crossings and
school zones state-wide and
19 contracts for paving and
resurfacing roads in
piedmont and western
sections of North Carolina.
A contract bid on one
project was rejected by the
board because it was in
excess of staff engineering
estimates. The project --
widening of US-70 business
in Durham County - will be
readvertised at a later date.
Secretary of Trans-'
portation Tom Bradshaw
noted, “During this current
fiscal year (beginning in
July 1979) the trans
portation board has
awarded $50.4-million for
highway construction and
improvements. Such action
exemplifies the board’s
commitment to carry out
Governor Jim Hunt’s policy
on balanced growth and
economic development
through a • comprehensive
transportation system.”
The board also took action
on requests for funding of
primary, secondary and
urban road projects as well
as bridge replacement
projects.