Patients and caregivers writing on KevinMD about the experience of illness and the health care system from the other side of the exam table: navigating care, the doctor-patient relationship, being heard, and what patients want physicians to understand. Physicians who have become patients write here too. For the record of what pain patients and physicians have said to each other about opioids and chronic pain since 2007, with patient authors cited at the same weight as physicians, see Opioids: what physicians and pain patients say, in their own words. For what patients, families, and physicians have said about dying, hospice, and the decisions families face at the end of life, see End of life: what physicians say, in their own words. For what women and the physicians who treat them have said about pregnancy, menopause, and the conditions dismissed for years, see Women's health: what physicians say, in their own words. For what physicians have said about consent, honesty, and who decides, see Medical ethics: what physicians say, in their own words.
I have been a victim of diagnostic overshadowing by a primary care physician. I’ve been dealing with major depressive disorder, recurrent, severe and anorexia for twenty-five years — practically my entire adult life. However, I work full-time and I’m a published writer. At the time I saw this PCP, I was on hefty doses of Cymbalta (an antidepressant) and Abilify (an antipsychotic which can also be used to boost the effects of an …
My illness has been as hard on my caregiver-husband as it’s been on me. I know how fortunate I am that he’s stuck around and that he never complains about the extra burdens he’s had to take on. My heart goes out to those of you who don’t have someone to care for you in this way.
Just yesterday I was searching for a local surgeon, and on one website he had 2 out of 5 stars. Hardly anyone was recommending him. Yet prominently featured on another site he had 4.7 out of 5 stars. Both sites had a good number of reviews. What’s going on? Is one site cherry picking the reviews? Is someone falsifying reviews on one of the sites? Which reviews can I trust? …
Pain is one of the few things in life universally common to all races, all ages, virtually all people for the history of time. Though it is always with us, it is also the most difficult of human feelings to describe or even talk about. Doctors in an attempt to understand the degree to which we hurt invented a 1 to 10 pain scale.
As part of the admission process for a hospice patient, the admission team will ask the patient about their spiritual orientation and/or religion. Because there is so much information and education to convey at the admission, the discussion of a patient’s spiritually may only be minimally discussed. It is important for the hospice team to be aware of a patient’s spiritual orientation because it can affect their choices regarding treatment …
All health care professionals must be skilled at effectively communicating with patients who have dementia. Some professionals may erroneously assume that only those employed in long-term care, assisted living facility, and other similar places need these skills. However, patients with dementia visit medical practices, acute care hospitals and other health care centers. This article will provide a framework to effectively interact with patients who have dementia.
When my 82-year-old uncle had a heart attack in the kitchen of his home, I was on the next plane to the East Coast. No one knew how long his brain had been deprived of oxygen before he’d been resuscitated. As I stood next to his bed in the hospital’s ICU, I feared that my uncle would not make it. I …
There is a saying in the world of education, “You have to care to teach.” Why is it then in health care, a profession of and about caring, we do such a poor job of teaching our patients? Is it because we are too busy or too rushed when we are sending our patient’s out the door of our hospitals, clinics or offices? After all, we have treated the patient …
A few years ago, as I prepared for neurosurgery, a nurse who worked there told me, “Spend as little time in the hospital as possible, because the longer you stay, the more likely you are to get sick.”
In a way, that statement seemed quite telling of what was to come for me and an indicator cost of care — the added cost of additional care, additional hospitalizations, and the additional …
I don’t know you and you don’t know me, but today you become one of the most important people in my life. You are the one. The one who I’ve entrusted to take care of my girl in my absence. The one who I’ve tasked with teaching her things that I cannot. The one who will make an indelible mark on her …
It was July 2012 and I was pregnant with my third child. As an experienced mother and labor and delivery nurse, I felt very comfortable at 29-weeks gestation and anticipated the usual course of pregnancy. However, at 30 weeks, I started battling with preterm labor issues. This eventually led to the early delivery of my son, a four week and stay in the NICU, and a life lesson in cost-awareness …
I wish I had a dollar every time someone gets misty-eyed about the physician-patient relationship — and two dollars every time they say protecting it is the key to health care. That might be true, if you thought health care was awesome circa 1960.
Hereʼs what the physician-patient relationship meant back then: Physicians say, patients pay. We have seen little progress since then. The claim that the relationship is now symmetrical …
Not long ago, Tracy Hume, a freelance writer who lives in Greeley, Colorado, sent me an email posing this question: “Do ER-affiliated urgent care providers ever try to escalate patients to the ER when it is not medically necessary?”
It seems that over the July 4th weekend, Tracy’s teenage son was complaining of a headache, nausea and abdominal pain, and was vomiting. He doesn’t complain much, she said, so thinking that …
My grandmother recently went into hospice care. At 94, she has lived a longer, richer life than probably most of us will ever hope to. Given the nature of the work I do, end of life care is not a topic I’m unfamiliar with. Initially, I spent a lot of time asking my mother probing questions about the care my grandmother was receiving. I imagine I did this partly out …
Jessie Gruman, who sadly died July 14, 2014, was someone I greatly admired as a person and as a patient activist. I interviewed her in late April for research I was conducting on patient activism, and she graciously allowed me to publish the interview, wanting, not surprisingly for those who knew her, to do everything she could to use her experiences …
Beginning with the Institute of Medicine’s (IOM) landmark Quality Chasm report in the late 1990s, the health policy establishment, the medical profession and the American public began to hear a new and disconcerting message: American health care was not patient-centered.
The IOM prescribed a number of recommendations to redesign health care delivery, one calling for patients as the source of control over their care. “Patients should …
A popular television commercial shows a group of older women playing cards. One woman talks about her friend who is struggling financially since her husband died (the husband only had a small life insurance policy). Another lady said that she doesn’t have to worry about that happening since her husband has an XYZ insurance policy. The other ladies immediately ask about the policy. Then a TV pitchman describes the policy …
Before losing my health insurance in 2009, it never occurred to me to be concerned about a little thing like a blood test. Since 1986 I’d been having three vials of blood drawn each year during my physical. My doctor would authorize it, the nurse would draw the blood in the office and send it to the lab for processing.
A few days later she would call me with the results …
I’m impressed by how much we struggle with seemingly simple health decisions when faced with sorting through too much information.
Buying sunscreen: It’s a simple task, right? Most of us do it every year about this time. And among actions we can take to reduce our risk of cancer in general and skin cancer specifically, this choice is fairly important.
So my colleague was surprised to hear this snippet of conversation as she contemplated …
The interview had lasted fifteen minutes so far, and we’d made minimal progress. I was a medical student doing a rotation at a physical medicine and rehabilitation clinic back in my home state, Wisconsin. It was the end of the day; to save time, the senior resident, Paul, had joined me in the exam room so that we could hear Leora’s medical history together.
