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Doctors discuss ways to combat ‘white coat syndrome’

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EAST BRUNSWICK – Hoping to rid residents of “white coat syndrome,” Dr. Farrah Fong and Dr. Karen Lin served as the co-hosts to the “Get Over the Fear of the Doctor” discussion event.

“Both [Fong] and myself, we are family doctors so as family doctors we take care of [patients] from, as we say, from ‘cradle to grave.’ We deliver them, we follow them until they grow older. So at our practice, we have many generations,” Lin said.

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Lin is the assistant dean and professor of Family Medicine and Community Health at Rutgers Robert Wood Johnson Medical School. Fong is a resident physician, according to Lin.

Fong said white coat syndrome has an official and unofficial definition, but it simply means someone who is afraid to go to the doctor or someone who feels anxious when they see a doctor. Up to 20 percent of the population suffers from this.

This fear is understandable and is especially common amongst children because they associate going to the doctor with getting vaccinations and other uncomfortable things so they get scared, according to Fong.

“Sometimes we have patients who come in and their blood pressure is fine when they are living their everyday life, but when they come in it’s much higher than usual. … So when we have a patient like that we have them check their blood pressure at home and keep a log so that we can make that it really is fine when they’re at home,” Fong said. “When they see us, we at least know it’s just because they are a little bit anxious about being in the office.”

Using PowerPoint slides and a microphone, Lin and Fing hosted their discussion on June 13 at the East Brunswick Library.

“When [people] are younger [or] when they are children they go [to the doctor] because their parents bring them there. When they are teenagers they go to college and all of a sudden that traditional family doctor is no longer there, so at the school only when they have problems will they go to a student health center,” Lin said. “Once they graduate from college and then get a job, the job comes with insurance but a lot of times we found out that they don’t necessarily go to the doctor, especially young healthy men.”

Getting a health checkup is important because it allows doctors to check their patients’ blood pressure and blood sugar. It also allows doctors to perform cholesterol screenings, cervical cancer screenings, mammograms, colon cancer screenings and provide immunizations, according to Fong.

Others reasons why people avoid going to the doctor include lack of time, money and/or insurance; they prefer self-care or alternative care; they have a dislike or distrust of doctors or of medical treatments; discomfort with body examinations; fear of having a serious illness; guilt about unhealthy behaviors; they use the internet instead, according to Fong.

Another reason why people don’t want to see the doctor is due to the country’s healthcare system, according to Fong.

“They make doctors try to see as many patients as possible in a very short amount of time and because of that it is hard to build the relationships with our patients that we used to be able to do when the family doctor would be the person to come to your home and spend time with you and be able to treat everything at the same time,” Fong said. “Now, we are delegated to these little 15-minute slots where we somehow have to address everything.”

Fong said that news stories, lawsuits, commercials and stories online about medical errors and medications have increased people’s distrust toward the medical community as well.

In order to cope with the fear of going to the doctor, the first thing a person should do is to identify what he or she is worried about, essentially deconstruct his/her anxiety. Then confront anxieties and deal with them rationally. Patients can also ask for analgesics or anesthetics because this can be helpful for procedures that may be more uncomfortable, according to Fong.

“I think that a lot of times we are afraid of something because we feel that we can’t control it and once you feel in control it can be a little easier,” Lin said.

Before going to their doctor’s appointment, patients should make a list of questions, know their medical history, bring a medication list or bottles and bring blood tests/imaging results, according to Lin.

When a patient has more than one doctor, Lin said, “You need to let doctor A know what doctor B prescribed and let doctor C know what other people prescribed, otherwise the medication will always have different kinds of side effects.”

During your appointment, patients should make sure they have their worst concern addressed, ask for clarifications/explanations if they don’t understand what the doctor is telling them, ask for written instructions and/ or resources and set a follow-up date, according to Lin.

“Our role is not to just to give medications [and/or] to prescribe the blood test, our role is to actually provide some education so the people will have a better understanding,” Lin said.

After the appointment, patients should follow their doctor’s recommendations, call or return if their symptoms worsen or aren’t improving and follow up as scheduled, according to Lin.

If a patient is worried about getting a procedure, Lin said doctors at hospitals or a doctor’s office can explain what a certain procedure entails so he or she can be more comfortable.

If a patient is afraid of or uncomfortable with his/her doctor, patients might want to consider seeking out a new doctor who they can better talk to.

Another way to cope with the fear of going to the doctor is for patients to try cognitive behavioral therapy. This form of therapy can help to reframe a patient’s state of mind and teach him or her coping techniques, according to Lin.

Taking a family member or close friend to an appointment can often provide support and/or comfort for a patient, according to Lin.

Contact Vashti Harris at vharris@newspapermediagroup.com.

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