Posts tagged with "Michigan Medicine"

Patients care what their doctors wear

June 26, 2018

A survey of 4,062 patients at ten major medical centers nationwide by Michigan Medicine at the University of Michigan  has found that doctors should consider their white coats as much more than a fashion statement. In fact, one-third of respondents to the study, published on June 6 in Science Daily, said that what a doctor wears influences their satisfaction with their care.

Based on the findings, the researched have called for more hospitals, health systems, and practice groups to look at their dress standards for physicians, or create them, if they don’t already have one.

“Professional dress on Wall Street, law and nearly every other industry is relatively clear—and it typically mirrors what applicants would wear to their job interview,” says Christopher Petrilli, M.D., lead author of the study and an assistant professor of hospital medicine at the University of Michigan Medical School, who worked in the finance industry before entering medicine. “In medicine, the dress code is quite heterogeneous, but, as physicians, we should make sure that our attire reflects a certain level of professionalism that is also mindful of patients’ preferences.”

The study asked patients to look at pictures of male and female physicians in seven different forms of attire, and to think of them in both inpatient and outpatient clinical settings. For each photo, they rated the providers on how knowledgeable, trustworthy, caring, and approachable the physician appeared, and how comfortable the attire made the patient feel.

The options were:

  • Casual: Short-sleeved collared shirt and jeans with tennis shoes, with or without white coat;
  • Scrubs: Blue short-sleeved scrub top and pants, with or without white coat;
  • Formal: Light blue long-sleeved dress shirt and navy blue suit pants, with or without white coat; with black leather shoes with one-inch heels for women, and with black leather shoes for men, and a dark blue tie for men; or
  • Business suit: Navy blue jacket and pants with the same dress shirt, tie and shoes as in the “formal” option, no white coat.

Formal attire with a white coat got the highest score on the composite of five measures, and was especially popular with people over age 65. It was followed by scrubs with a white coat, and formal attire without a white coat. Indeed, when asked directly what they thought their own doctors should wear, 44% of patients said they preferred the formal attire with white coat, and 26% said scrubs with a white coat. When asked what they would prefer surgeons and emergency physicians wear, scrubs alone got 34%  of the vote; followed by scrubs with a white coat with 23%.

The results were largely the same for physicians of either gender except for male surgeons. Patients tended to prefer that they go with formal wear, without a white coat.

The setting of care mattered, too. Sixty-two percent agreed or strongly agreed that when seeing patients in the hospital, doctors should wear a white coat, and 55% said the same for doctors seeing patients in an office setting. The percentage preferring a white coat fell to 44% for emergency physicians.

Though the surveys were conducted during business hours on weekdays, the researchers asked patients what they thought doctors should wear when seeing patients on weekends. In this case, 44% said the short-sleeved outfit with jeans was appropriate, although 56% were neutral or disapproved of such a look even on weekends.

Interestingly, patients in the Northeast (38%) and Midwest (40%) were less insistent on white coats and formal attire;, compared with those in the West (50%) and in the South (51%). Northeasterners were more than twice as likely as southerners to prefer scrubs alone for surgeons.

“This is by far the largest study to date in this area. We used the expertise gained from our previous systematic review along with a panel of psychometricians, research scientists, choice architects, survey experts, and bioethicists to develop our study instrument. Given the size, methodological rigor and representativeness of these data, local, nuanced policies addressing physician attire should be considered to improve the patient experience,” says Petrilli, who treats patients in the hospitals of Michigan Medicine, U-M’s academic medical center, and holds a position at the VA Ann Arbor Healthcare System. He is a member of the U-M Institute for Healthcare Policy and Innovation.

The researchers note that while studies have shown that while physicians’ white coats, neckties and sleeves have been shown to harbor infectious organisms—leading some countries to require physicians’ arms to be “bare below the elbow”—no studies have shown actual transmission of infection to patients through contact with physician attire.

However, other research has suggested that physicians may be more attentive to tasks when wearing their white coats, perhaps increasing patient safety.

“Patients appear to care about attire and may expect to see their doctor in certain ways. Which may explain why even white lab coats received a high rating for ‘approachability’ — patients may see a white coat similar to a physician’s ‘uniform’ and may similarly also expect formal attire in most settings,” notes Petrilli. “Patients don’t always have the opportunity to choose their doctor. In this era of appropriately increased focus on patient centeredness and satisfaction, physician attire may be an important, easily modifiable component of the patient care experience.”

Research contact: MichMedmedia@med.umich.edu

Keeping the flame alive: Sex after 65

May 29, 2018

Many American seniors feel young at heart—and in other meaningful ways—based on findings of a National Poll on Healthy Aging released in early May. Specifically, the researchers say, 40% of U.S. adults between the ages of 65 and 80 are sexually active; and 73% are satisfied with their sex lives.

The nationally representative pol of 1,002 seniors was conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and sponsored by AARP and Michigan Medicine, U-M’s academic medical center.

Among the respondents, nearly three-quarters said that they currently are in a romantic relationship—and 54% of elderly couples reported that they still are sexually active.

But, whether or not they have an active sex life at the moment, about two-thirds of older adults say that they still are interested in sex, and more than half say that sex is important to their quality of life.

Among those who still are—or who want to be—sexually active, some need a little advice or help to get the job done. In all, 18% of older men and 3% of older women say they have taken medications or supplements to improve sexual function within the past two years.

However, just 17% of seniors said they had talked with a healthcare provider about their sexual health during the past two years. Most who had engaged in such discussions said they brought the topic up—suggesting, the researchers said, the need for more proactive conversations by clinicians with their older patients.

“Sexual health among older adults doesn’t get much attention but is linked closely to quality of life, health and well-being,” says U-M’s Erica Solway, Ph.D., co-associate director of the poll. “It’s important for older adults and the clinicians who care for them to talk about these issues and about how age-related changes in physical health, relationships, lifestyles and responsibilities (such as caregiving) affect them.”

Factors: Gender, age and health 

Relationships aside, there are a few other factors—gender, age, and health—that may affect a senior’s sex drive.

For instance, compared with the 45% of respondents with excellent, very good, or good health who reported that they were sexually active, only 22% of those who said they are in fair or poor health could say the same. Indeed, just 28% of seniors who are in fair or poor health said they were extremely or very satisfied with their sex lives.

Those respondents between the ages of 65 and 70 were nearly twice as likely as those in their late 70s to be sexually active. One-third of those in their late 60s said they were extremely or very interested in sex, compared with 19% of those in their late 70s.

What’s more, as they age, men and women look at sex differently. Women are a little less likely than men to be sexually active—31% overall, vs. 51% of men—but were more likely to be extremely or very satisfied with their sex lives.

While 84% of older men said sex was an important part of a romantic relationship, fewer older women (69%) said the same. But that still means that over two-thirds of women remain passionately in love, whatever their age or the length of their relationship.l

Research contact:  healthyaging@umich.edu

33% of U.S. adults take sleeping pills

November 22, 2017

America’s chronic insomnia is enriching pharmaceutical companies. In fact, according to a study conducted by BCC Research, Americans spent an estimated $41 billion on sleep aids and remedies—everything from ZzzQuill to Melatonin, to Ambien to Valium— back in 2015; and that number is expected to increase incrementally to $52 billion by 2020.

That’s not even counting the money that U.S. families spend on pillows, mattresses, white noise machines, and whatever else conceivably could work.

Now, researchers from the University of Michigan have found that 33% —one in three —adults in the United States uses medicine of some sort to help induce sleep.

What’s more, the researchers say, many U.S. adults do it without the knowledge of their doctors, according to new findings of a poll broadcast.

The poll was based on an online survey of 1,065 people, 65 to 80 years of age, nationally, who answered many questions, according to a report released in mid-November by the Institute for Healthcare Policy and Innovation at the University of Michigan; along with sponsors AARP and U-M’s academic medical center Michigan Medicine.

Overall, 46% of respondents said they had problems sleeping once or more each week. Fifteen percent of poll respondents said they experienced difficulty sleeping three nights or more in a week.

Among those who reported sleep disorders three or more nights a week, 23% said they used a sleep aid prescription; which is not advisable for the long-term, according to the medical community.

“Although sleep disorders can occur in people in any age and for many reasons, the problem cannot be treated by taking pills, whether prescribed, without a prescription or herb, no matter what the ad says on TV,” Preeti Malani, a University of Michigan doctor trained in a Geriatric Medicine, stated.

“Some of these drugs can create big concerns in older adults, from falls and memory problems to confusion and constipation, even if they are sold without a prescription,” she said.

What the poll does not offer is advice on what to do, if the pills are not recommended—except to exercise earlier in the day.

Lack of sleep also is dangerous. In fact, the university said, sleeplessness has been associated with increased risk of cardiovascular and metabolic diseases in adults and children.

Research contact: kegavin@med.umich.edu