My Humble Advice for Asthma Doctors
Here’s my humble advice for any doctor who manages asthma patients. This is based on my own experiences over the years. It’s also based on the many conversations I have had with my friends who also have asthma, and there have been many. It’s also based on things I have learned from hanging out in communities, like Asthma.net.
My humble advice for asthma doctors
Please, take us seriously.
Please do not say dumb things to us, such as "It’s all in your head" or "You are just experiencing asthma." If we are seeking help for asthma, please consider that we know what we are talking about.
If you newly diagnose someone with asthma, please educate that person, or give that person pamphlets explaining this disease and how best to manage it. Or you could recommend websites that specialize in asthma, such as this site.
At every appointment, ask us if we have any questions or concerns.
Please take whatever time is needed to answer all our questions and manage our concerns.
You should talk to all of your asthma patients about asthma action plans.
As you probably know, these are plans that help us decide what to do when we experience our early warning symptoms of asthma.
Most of us are very adept at managing our own asthma. So, consider this when preparing asthma action plans. I have had asthma for over 50 years and know pretty much what helps me. So, if I ask for you to write a prescription for prednisone, just so I can have it on hand in case I need it, please respect this.
This helps me in three ways. It helps me get the medicine in my system right when I know I need it. It saves me money for the $40 copay of having to see my doctor, and it prevents me from needing the ER, which costs a whopping amount of money. And, most important, it can save my life.
So, say we do not have prednisone at home. And we call you for a prescription for prednisone. Please refill it right away. If you do not feel comfortable doing this, get us into the office that day.
Listen to your asthma patients.
If we say we cannot breathe, we cannot breathe. This is important because we know our bodies best.
Listen to your asthma patients. If we say that something is not quite right, it’s probably true, even if we look just fine. It is probably true even if all the numbers from the test results look just fine.
If you are strapped for ideas on how best to help a person with asthma, please refer that person to an asthma specialist, such as a pulmonologist, allergist, or ENT.
Spacer and inhaler education is important.
I have noticed that a lot of doctors do not prescribe spacers. In the hospital setting, we give every person with a metered dose inhaler (like albuterol or Symbicort) a spacer. This is because spacers help the medicine get deeper into their airways. They also help improve coordination. I just find it amazing how many patients with MDIs do not have spacers. In fact, most do not. So, please understand how useful spacers are. When you prescribe an MDI, please prescribe a spacer.
I can tell you from personal experience that most people with asthma use poor technique with their inhaler and or inhaler/spacer. This is true even for those of us who are experts, such as myself. I have had my friends watch me using my inhaler and say, "Um, you just did that wrong." And of course I catch them doing it wrong too. So it goes both ways.
I see my patients using poor technique on a daily basis. And it's my job to coach them and help them improve their technique. So, I would recommend you have your asthma patients demonstrate to you their inhaler technique. You should do this for all your asthma patients, not just those new to inhalers and spacers.
That's enough for today. This is just my humble advice for asthma doctors.
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