Thursday, July 01, 2010
Good patient, doctor relationships

By Dr. Anthony Policastro

Board certification in a medical specialty has changed over the years and I have written about this in the past. Prior to the 1970's, relatively few physicians even bothered to become board certified. Then, more physicians began specializing and, in the 1970's and 1980's, more physicians received board certification, which lasted for life. Once you were board certified, you never had to be tested again. The next step occurred in the late 1980's when time limited board certification was developed. Under this system, you had to recertify approximately every seven years. The re-certification required a written test and most physicians chose to follow the recertification process. The problem with the previous plans was that you either only needed to certify once or you only had to certify every seven years through a single test. The newest change to the process is what is called Maintenance of Certification, which will require ongoing proof that a physician is staying current. There are four parts. Part 1 is maintaining a license. Part 2 involves continuing medical education, taking courses that must be relevant to your field. In the past, you could take any kind of course even if it was not specifically related to what you do every day. Part 3 is the written test, which will now take place every 10 years. The big change is in Part 4. This particular portion of the certification addresses how a physician practices on a daily basis. The physician will need to follow practice guidelines and the patient will be asked whether that is actually happening. Then the physician will report that information to the Board. For example, I am a Board Certified developmental and behavioral pediatrician. I see a lot of patients with ADHD. For that reason, the expectation is that I will follow the ADHD guidelines. Thus when I see patients, I will give them a questionnaire to fill out and I will need to share the results of that questionnaire with the Board of Pediatrics. The questions on that questionnaire are likely to be the same kind of questions that other doctors in other specialties are going to be discussing with their patients. For example, there are several questions about the plan of treatment. They include things such as:

  • Has your child's physician given you a written plan for managing your child's ADHD?
  • Do you understand the plan for managing your child's ADHD?
  • Does the plan include what you want your child's ADHD treatment to achieve?
  • Do you understand why your child was diagnosed with ADHD?
  • Does your child understand why he or she was diagnosed with ADHD?
  • Do you understand the possible side effects of your child's ADHD medication?
As you can see from the type of questions being asked, there is an expectation that the patient has a good understanding of the diagnosis and treatment and what the treatment goals are. This is just one example of the way things will be changing in the future. Patients will need to be aware of the fact that completion of these kinds of questionnaires will be important for their physician to keep his/her Board certification. Patients should also be aware that the goal in all of this is to help them understand what is going on with their health care and make them active participants. We continue to move in a direction that will focus on making sure there is good physician, patient communication. We have come a long way in the last 40 years.

Online substance abuse survey The Delaware Advisory Council (DAC), a group made up of both state personnel and members from community organizations interested in reducing drug and alcohol abuse, wants to know what people see as the abuse-related problems in their communities, and use that information to decide how to spend federal grant money to address those issues. The DAC hopes members of the public will take part in an online survey designed to help the group appropriately steer federal funding in the direction it will have the biggest impact. The DAC oversees activities funded by a $10,678,000 federal Strategic Prevention Framework - State Incentive Grant (SPF SIG) to build and strengthen the State's ability to prevent drug and alcohol abuse. Delaware spends far more than that amount each year for treatment, law enforcement, prison and social services relating to drugs and alcohol. While a small amount of the money will fund work at the state level, most of it will be used to fund prevention in Delaware communities. Members of the general public can find the survey online at The survey is also available in Spanish at Those representing community organizations can find their survey at or in Spanish at For those with no computer access, surveys can be made available by calling 302-255-9428.

Autism Delaware tournament Sign up for Go Fish, a bass fishing tournament to benefit Autism Delaware's southern location and the advocacy, education and support services they provide to improve the lives of people with autism and their families. Go Fish will be held on Sunday, Sept. 19, at eight ponds throughout Kent and Sussex counties, and will be followed by a celebration at Milford's Bicentennial Park. Anglers of all ages and abilities are welcome.

Each team of two can register for $40 and will receive an information and fundraising packet. Prizes, including a grand prize of $500 and special youth prizes, will be awarded at the celebration. The public is welcome to attend the celebration which will include fun for all ages with music by Code Blue, food from Go Fish of Rehoboth and kids games. Nominal fees will be charged for games and food for those not participating on a fishing team. Pro bass fisherman Mike DelVisco will fish in the tournament Sunday and participate in the celebration. There are 160 slots for fishing so register today by visiting or calling 422-2255.

Stroke support group Nanticoke Memorial Hospital's next Stroke Support Group meeting is being held on Thursday, June 17th, 1:30 pm at Nanticoke Memorial Hospital's Mears Rehabilitation, 300 Health Services Drive, Seaford, DE. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. Modeled from the American Stroke Association, the hospital is engaging with speakers to provide education, community resources and emotional support to those who have been affected by this life-altering event. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support, and allow for networking. Refreshments will be provided. Pre-registration is not required for this FREE support group. For additional information, contact Nanticoke Memorial Hospital at 302-629-6611, extension 8626.

Quarterly infection report Delaware Health and Social Services' Division of Public Health issued data for hospital central line-associated blood stream infections for Delaware for the first quarter of 2010. An estimated 248,000 bloodstream infections occur in U.S. hospitals each year. A large proportion of these infections are attributed to a central line, which is a tube in the chest that returns blood to the heart. Bloodstream infections are usually serious infections typically causing a prolonged hospital stay, increased cost and risk of death. Collectively, Delaware's eight critical care hospitals reported eight infections between January and March. Only one hospital had an infection rate that was statistically higher than the national rate published by the Centers for Disease Control and Preventions' National Healthcare Safety Network. The Centers for Disease Control and Prevention reported that for the first half of 2009, the number of central line-associated blood stream infections in Delaware was significantly below the number expected based on data from 17 states.

Bereavement support group Compassionate Care Hospice, The Wellness Community-DE and Nanticoke Memorial Hospital will collaborate to present a monthly bereavement group, The Next Step. The group focuses on issues of loss that continue beyond the early stages of grief. Mary Van House, bereavement coordinator, will facilitate the group at 10 a.m. on the third Tuesday of each month, at the Nanticoke Cancer Care Center, second floor conference room. To register, call Lisa at 629-6611, ext. 2378.

Depression Support Group There is a free bimonthly Depression Support Group meeting in Laurel on the second and fourth Wednesday evenings from 7 to 8:30 p.m. Any person who has signs and symptoms of depression and is under the care of a professional counselor/MD is welcome to attend. To register, call 302-465-6612.

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. The program is facilitated by Nanticoke Memorial Hospital Cancer Center professional staff - Terri A. Clifton, MS, NCC, Cancer Care coordinator; Mary Brown, RN, DSN, manager Cancer Care Center; and Wendy Polk, nutritionist - with assistance from Lois Wilkinson, DBCC special projects manager, who helps facilitate the program at Bayhealth. Of particular value to newly-diagnosed women is DBCC's Peer Mentor Program through which they are paired with a long-term survivor for one-on-one support. To learn more about Beginning Your Pink Ribbon Journey at Nanticoke Memorial Hospital Cancer Center, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Man to Man support group Nanticoke Memorial Hospital offers a Man to Man support group meeting on the fourth Wednesday of each month. Man to Man helps men cope with prostate cancer by receiving information and peer support. Man to Man is a forum for men and their support network to learn about diagnosis and treatment options through presentations, written materials and videos. Specialists share information such as side effects and how to cope with prostate cancer and its treatment. News and information about nutrition, general health, research and treatment, as well as messages from men living with prostate cancer and other Man to Man activities, are offered to assist in the recovery process. Pre-registration is not required for this free support group. For more information, contact Larry Skala (337-3678) or Grafton Adams (628-8311).