This is an example of a letter I wrote on behalf of
a fellow general ophthalmologist, my practice colleague, for his patient. The
patient, a young woman, was found to have papilledema during a routine eye
exam. For any non-MD readers of my blog,
papilledema describes a condition of bilateral swollen optic nerves as a result
of increased intracranial pressure. This is a dangerous condition that if left
untreated has very negative implications on not only the patient’s sight but on
the patient’s life. As a result of this finding, she was promptly referred to a
neurologist for the appropriate testing and management. Unfortunately, the
patient never kept the neurology appointment and the administrative staff made the referring ophthalmologist aware of
this.
In these cases, it is very important to reach out to
the patient and explain, once again, the importance of following up with the
treatment and management of such conditions. The patient here needed to
understand that her eyes—and her
health—were at grave risk.
When sending such correspondence letters, the
communication should be done in a language the patient understands. As this
patient was Spanish-speaking with limited English proficiency, this letter was written
in Spanish plain language (aka non-technical Spanish language). For purposes of this blog entry, I have
provided a translation of the letter in English as well.
*names have been changed for privacy purposes
Estimada Sra. Méndez*:
Recibí
recientemente un informe de la Dra. Smith*, la neuróloga. La carta me informó que usted se suponía
tener una cita de revisión con ella después del examen conmigo, pero le faltó
la cita. Usted recuerda nuestra
conversación durante su examen aquí, cuando le dije que usted tiene nervios
ópticos bien inflamados y hinchados.
Esto significa que usted tiene alta presión dentro del cráneo y necesita
más pruebas por la neuróloga (incluye una punción lumbar) y medicamentos para
tratar y curar esta condición.
También, la Dra.
Smith me dijo que usted no ha recogido de la farmacia las pastillas que ella le
recetó. Ella me dijo que ella ha tratado llamarla muchas veces, pero no podía
contactar a usted.
Esta presión que
tiene en el cerebro es muy peligrosa para su salud y la salud de sus nervios
ópticos. Si no recibe el tratamiento para
bajar la presión del cráneo, puede quedar ciega por esta condición. Por favor, le ruego que llame usted la
oficina de la neuróloga inmediatamente cuando recibe esta carta, para hacer el
examen de la espina y la punción lumbar y también, le solicito que recoja los
medicamentos de la farmacia.
Después de que
empieza usted el medicamento y tiene el examen de la espina, necesita regresar
aquí por otro campo visual para hacer un examen de seguimiento de los nervios
ópticos. Si tiene preguntas, llame esta oficina en cualquier momento. Si nos
necesita para hacer la cita para usted con la neuróloga, nos complace hacer esto
para usted.
Gracias por su
paciencia y atención en este sentido. Recuerda, la salud de los ojos y del cuerpo están en juego.
Sinceramente,
Dr. Johnson
*
Dear Mrs. Méndez:
Recently I received a report from Dr. Smith, the
neurologist. The letter informed me that
you were supposed to have a follow-up appointment with her after your exam with
me, but you missed that appointment. You
remember our conversation during your exam here, when I told you that you have
very inflamed and swollen optic nerves.
This means that you have elevated pressure inside your head and you need
more tests by the neurologist (including a lumbar puncture) and medication to
treat and correct this condition.
Also, Dr. Smith told me that you have not yet picked
up the tablets from the pharmacy that she prescribed for you. She told me that
she has tried many times to call you, but has been unable to contact you.
This pressure that you have inside your head is very
dangerous for your health and the health of your optic nerves. If you do not receive treatment to lower this
pressure, you can become blind from this condition. Please, I ask you to call the neurologist’s
office immediately when you receive this letter, to have the spinal exam and
lumbar puncture, and I ask that you also pick up the medications from your
pharmacy.
After you begin the medication and you have your
spinal exam, you need to return here for another visual field test to follow up
on the optic nerves. If you have
questions, call this office at any time. If you need us to make the appointment
with the neurologist for you, it would give us pleasure to do so.
Thank you for your patience and attention in this
matter. Remember, the health of your eyes
and your body are at stake.
Sincerely,
Dr. Johnson
The Eye Exam 2017 |
Superb kind of work by the author as on this particular topic people needs more precise information and special attention to it.Thanks a lot.
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Thank you for taking the time to comment, Ronald. I'm so glad you find this information helpful!
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