I'm a resident physician and I deny having my BP taken in outpatient clinics.
The techniques used are ridiculously inappropriate:
"Ok, Mr. So-and-so, come with me." calls the nurse, as the pt who is irritated for having to wait 30 minutes quickly gets up to walk along unknown hallways, while rushing to finish a phone conversation, stressed and not knowing where to turn next..."Ok, now we're going to weigh you on this scale" while the pt thinks 'oh man, I've probably gained weight', followed by "ok, now we're going to measure your blood pressure." 'I don't want BP meds...let me try to relax...breathe slooowly...but I don't want the nurse to notice I may be trying to cheat this sudden examination.'
That's why the most appropriate way nowadays is to measure it at home, and keep a BP log.
One thing that I think would dramatically improve the routine screening numbers at doctors' offices would be to try and take it after the patient has been sitting down for a few minutes waiting for the doctor after the other vitals have been taken. If I'm going to sit around for 15m+ anyways, why not use some of that time to let BP stabilize?
Because it's a practically impossible workflow: economics dictate that on duty your time should already be filled up doing something productive.
If anything, the usefulness of an office BP is to screen only people whose heads or hearts are about to blow up from a crazy high reading. Current guidelines now recommend people keep logs at home.
I manually recheck BPs myself if the readings are off the charts.
Robotics in the future could help the workflow though.
One of my attendings has a running joke where he takes fresh interns in July and tells them "I will take you to <most expensive restaurant in my city> if you can take this patient's blood pressure correctly." He's been doing this for 30 years and no one has been treated to dinner yet. He's looking for the rest time, arm at heart level, everything.
People try to cheat BP tests? Because they dont want tp taks BP meds? Daaaang I'm trying to get my head around that. I guess I'm missing something because that sounds like an incredibly tangled way to be.
as someone allergic to the bulk of blood pressure medications (currently taking some very old ones that don't affect me as much as the new ones that "don't have side effects"), hell yeah I'd cheat a blood pressure test if I could.
the difference between being a little dizzy and not being able to walk more than 10 feet without having to stop and throw up is huge.
Not only the medical personnel is very often unable to properly measure the blood pressure, they also cannot properly take blood sample for potassium. They put tourniquet and order patients to pump their fist, so that the veins appear, but that cause muscles to release potassium into the bloodstream, causing elevated levels and misdiagnosis leading to incorrect treatment. I make people aware of that, and it should be widely spread so that doctors and nurses have the knowledge that they sometimes unwittingly cause harm.
my blood pressure is significantly higher at the doctors office than home. I measure my blood pressure each morning at home. My doctor is happy to accept those readings.
The techniques used are ridiculously inappropriate:
"Ok, Mr. So-and-so, come with me." calls the nurse, as the pt who is irritated for having to wait 30 minutes quickly gets up to walk along unknown hallways, while rushing to finish a phone conversation, stressed and not knowing where to turn next..."Ok, now we're going to weigh you on this scale" while the pt thinks 'oh man, I've probably gained weight', followed by "ok, now we're going to measure your blood pressure." 'I don't want BP meds...let me try to relax...breathe slooowly...but I don't want the nurse to notice I may be trying to cheat this sudden examination.'
That's why the most appropriate way nowadays is to measure it at home, and keep a BP log.