“If you want to heal the body, you must first heal the mind.”
—PLATO
Some truths are timeless. Plato was born in 428 B.C. He understood that good physical health can only occur in the presence of sound mental health. We can “cure” a malignancy in someone with end-stage dementia, but are they really healed? Can someone without a single physical illness, but who struggles with paralyzing anxiety or the depths of depression, be considered well?
In an era dictated by guidelines and “quality” measures, it is easy to miss the forest for the trees. We can make all the numbers “reach the target” and miss the main problem. The action of chasing targets can also result in the added harm of unpredicted consequences such as overdiagnosis, and its cousin, overtreatment. Sound mental health requires not just adequate treatment but initial recognition. As marijuana becomes more available (medical and otherwise), one wonders if anxiety, insomnia, depression, and dysthymia will become even more hidden as patients self-medicate.
Screening for mental health problems is one route to identifying those at risk. Yet, I suspect you have a sense, a gut instinct, when you are with someone who is mentally suffering. One of my former mentors, Bill Damon, used to say that you know when you are with a depressed patient because you begin to feel depressed being with them (countertransference). This is true of anxiety as well; when you have an anxious patient, you begin to feel anxious. The treatment for these folks is not just about addressing their chief complaint but also addressing their hidden, often primary, issue.
We teach learners that 95% of patient visits involve a patient’s anxiety. If they have upper respiratory tract infection symptoms, patients often do not want an antibiotic, but mostly to be reassured their condition is nothing serious. If they have chest pain, they want your professional belief that the pain is not their heart. Even when tests are negative, patients look to us to treat their anxiety with our words.
Words have power—to encourage and to do damage. Their absence, not asking, also has consequence. My good friend Sanjiv reminds me to “speak only to create bliss.” That bliss may be to query the anxiety or depression of our patient, to offer a kind word to someone struggling, to compliment an oppositional adolescent, and to lend our voice to those who support health care for all.
Another Bill Damon quote is “Always touch the part that hurts, and remember that it’s often the heart.” Words have power to heal the mind.
Welcome to the 2018 edition of The 5-Minute Clinical Consult. This is a book of diseases, diagnostic methods, and treatment recommendations. Much of the work provided by primary care providers is focused on helping the patients help themselves to be healthier. Diet, exercise, safety, and prevention are the interventions that provide the greatest number of people with the greatest return on longevity and its enjoyment.
This year’s The 5-Minute Clinical Consult is here to assist in fulfilling our role as a health care provider. In each patient interaction, in addition to bringing your clinical expertise, remember how others view you, as a leader, and the power of your words and actions. Encourage them to dream more, learn more, do more, and to be more.
Our editorial team has collaborated with hundreds of authors so that you may deliver your patients the best care. Each topic provides you with quick answers you can trust, where and when you need them most, either in print or online at www.5MinuteConsult.com.
This highly organized content provides you with the following:
• Differential diagnosis support from our expanded collection of algorithms
• Current evidence-based designations highlighted in each topic
• 540+ commonly encountered diseases in print, with an additional 1,500 online topics, including content from The 5-Minute Pediatric Consult and Rosen & Barkin’s 5-Minute Emergency Medicine Consult
• FREE point-of-care CME and CE: 1/2 hour credit for every digital search
• Thousands of images to help support visual diagnosis of all conditions
• Video library of procedures, treatment, and physical therapy
• A to Z drug database from Facts & Comparisons
• Laboratory test interpretation from Wallach’s Interpretation of Diagnostic Tests
• More than 3,000 patient handouts in English and Spanish
• ICD-10 codes and DSM-5 criteria; additionally, SNOMED codes are available online.
Our website, www.5MinuteConsult.com, delivers quick answers to your questions. It is an ideal resource for patient care. Integrating The 5-Minute Clinical Consult content into your workflow is easy and fast. And our patient education handouts can assist in helping you meet meaningful use compliance.
The site promises an easy-to-use interface, allowing smooth maneuverability between topics, algorithms, images, videos, and patient education materials as well as more than 1,500 online-only topics.
Evidence-based health care is the integration of the best medical information with the values of the patient and your skill as a clinician. We have updated our EBM content so you can focus on how to best apply it in your practice.
The algorithm section includes both diagnostic and treatment algorithms. This easy-to-use graphic method helps you evaluate an abnormal finding and prioritize treatment. They are also excellent teaching tools, so share them with the learners in your office.
This book and website are a source to solve problems; to help evaluate, diagnose, and treat patients’ concerns. Use your knowledge, through your words and actions, to address their anxiety.
The 5-Minute Clinical Consult editorial team values your observations, so please share your thoughts, suggestions, and constructive criticism through our website, www.5MinuteConsult.com.