Doctor’s Orders

My last article mentioned that women should have sex an average of three times a week to maintain vaginal health- doctor’s orders. I have received a lot of feedback from both sexes. Most of the men have said the article was superbly written and I’ve heard of at least one husband that clipped out the article and placed it on the refrigerator. Response from the women has been a bit mixed. There hasn’t been an argument against the logic or data that supports maintenance of vaginal health. Instead, most women would like their hormones fixed prior to embarking on a journey to vaginal wellness. (Quite a few of the women have been referring to fixing their man’s hormones…) Regardless of the gender, I always appreciate reader feedback and it is very gratifying to hear that at least some of my advice is heeded.

“Doctor’s orders.” I’m a third generation physician. My life experiences have led me to practice a bit differently than my predecessors. My grandfather’s generation- “I’m the doctor and you are the patient. If you have questions please keep them to yourself. Follow my orders exactly and you will get better.” My dad’s generation- “I’m the doctor and you are the patient. If you have questions I will be happy to entertain them. Follow my orders exactly and you will likely get better.” (Notice the progression to more patient centered medicine as well as the acknowledgement that medicine doesn’t always cure.) Not so much my generation, but the way I believe medicine should be practiced- “I’m the doctor and you are the patient. I will do my best to answer your questions in a way that you can understand. I will provide you with the necessary resources to learn more and together we will come up with a plan.”

What kind of crazy new age medicine is this!!! A patient gets to participate in developing a treatment plan? Let’s face it, folks. I can spend hours developing a treatment plan. If the patient doesn’t agree with the plan they will either tell you that it won’t work or they will nod politely and disregard everything they don’t like. Why waste time developing a plan that won’t work due to implementation issues? Instead, I prefer to spend time educating the patient and providing resources so that we both come to the same conclusion. Medicine has changed, patients have changed, and we, as physicians, need to change as well.

A closing anecdote- I recently ran into a patient at a social function. “Doc, I’ve lost 10 pounds without trying since you started me on this “new” thyroid medication and I feel great! I would still like to see some improvement in my sleep though, because the bioidentical progesterone just isn’t working anymore.”

Long story short- her sleep had improved and she asked if she could take progesterone in the morning because it was easier to remember. My wife and I both prescribe progesterone to help sleep. It works better to help sleep when taken at night! Give your doc the benefit of the doubt- if you decide that you are going to alter or adjust the doctor’s orders, be prepared when things don’t work the way they should. Talk to your doc! Make sure your plan and theirs are at least compatible if they aren’t identical.

Disclaimer: Dr Stephen Rath, MD, DABA is a board certified anesthesiologist, Air Force flight surgeon, paramedic, and pilot as well as the owner and medical director of Fusion Medical Spa located in Ruidoso, NM. He enjoys practicing crazy new age medicine because it works well with the local population. Comments or questions? His email address is: