I believe that when people are in a crisis situation small things can become magnified; good and bad, and especially in the healthcare field. A perceived small rudeness may just be the tipping point that causes a patient to leave a practice or go to another hospital. On the other hand, a smile, a kind word or gesture can impact someone more than you will ever know and leave a …
There are no small jobs in any organization
I remember, some years ago, sitting with a relative across a large wooden desk in a doctor’s private office. We discussed symptoms for half an hour during an initial consultation. On a different occasion, I recall another doctor pinning an MRI on the wall, circling an area and articulating exactly why the radiologist overlooked a diagnosis. There once was a doctor who stood bedside, outlining what was known, what was baffling and …
How entertainment has altered our desire for diagnosis
Visiting the dementia unit of a nursing home is never easy.
First off, you have to find your patient amid the assemblage of people–mostly women–seated in wheelchairs, recliners, wingbacks, sofas and assorted walkers, or wandering around.
Then, you must make yourself known to the person you’ve found. Here’s where the harder questions arise: How can I introduce myself and convey my role–a hospice chaplain–to someone who has outlasted language? Is my state …
The long years between the last words and the final breath
If you want to know if restaurant food is safe, there’s help. Just look at the signs in the window showing that the eatery got an A, B or worse on its latest government inspection report. There are government inspection reports for hospitals too, but you won’t see them on the front door or any place else in the hospital, for that matter.
Hospital inspections conducted by state departments of health …
My search for helpful quality information on hospitals
I want to clear up a misunderstanding often voiced in the healthcare blog universe: namely, whether health care is a right or a service. Our answer to this question will affect how we approach healthcare reform in the next Congress, so let me say plainly: health care is a civil right.
Civil rights are what we call those claims necessary to secure free and equal citizenship, secondary to basic rights. For …
Why health care is a civil right
When I learned recently that I would need cataract surgery, I researched New York City hospital ratings from three well-known sponsors: US News & World Report, the federal government’s Hospital Compare and the Leapfrog Group. After writing about what I discovered, I wondered if perhaps a few measures might offer a clue or two about how to better honcho some of my care, like the one that asks hospital patients …
Having patient satisfaction data isn’t enough to choose a hospital
Have you ever returned home from a visit with your doctor and realized that you forgot to ask the one question that you really wanted an answer to? I certainly have. In fact during a recent visit with my doctor, I had every intention of asking her about a vague symptom that I had been experiencing in recent months. It was on the forefront of my mind, but when I …
Improve doctor visits by bringing checklists to check ups
My first week at my new job at a French-speaking university in a city of 95% francophones, I learned a useful new expression: vouloir le beurre, et l’argent du beurre. This translates literally as, ‘to want the butter, and the butter money.’ It’s the equivalent of wanting to have your cake, and eat it, too, but with a more explicit focus on dairy fat. (It is a French expression, after …
Let’s help patients with the tradeoffs in medicine
If you or someone you love is considering surgery or an intensive treatment, it really pays to be sure you understand the pros and cons.
While that seems like common sense, millions of people say “yes” without learning all the facts.
Some simply rely on the trust they have in their physician. Others assume the known benefits and risks are too complicated to fully understand. And some people just want to get …
Give patients the pros and cons of treatment options
Most patients I see are surprised to find out that there’s something they should have brought to their doctor’s visit. Granted, I’m an emergency physician, and many of my patients come to me in emergency situations that they can’t plan for. However, most people have some heads-up for going to their doctor. Certainly if you’re going to your annual check-up or a routine appointment, you should bring these items with …
Preparing for your doctor’s visit: 10 things to always bring
I’ve come to believe that seriously sick people are often subject to some very interesting comments from well-intentioned non-sick people. They are frequently inspired by platitudes from self-help-books, Google chat rooms (heaven forbid), or beliefs that have been around for so long that they are a natural part of common discourse.
To be fair, when we are confronted with the uncomfortable task of talking to a sick person, our conversation can …
Attitude is half the battle when you’re sick
The word medicine, in today’s world, seems to indicate a hard science in search of cures for many kinds of human ailments, such as cancer. However, I believe that the true definition of medicine is the practice of healing. Medicine is both an art and a science because it involves both human and technological interaction. The art of compassionate care and social interaction must be combined with the science of …
Both the scientific and the social sides of medicine are needed
Most of us have find it challenging to make sense of the wave of information when we enter our cancer journey. This is foreign territory, with its own language, culture and routines. It takes time to absorb and understand.
We are not oncologists or hematologists. However, we can learn to improve our discussion with our medical team.
Build your knowledge. By the time you start your treatment, you will likely have searched the …
How to strengthen the partnership with your medical team
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Behind the doors of our communities throughout America lies a hidden shame as well as daily criminal acts called elder abuse. These crimes are committed on our most vulnerable and dependent elderly – those with dementia, Parkinson’s, unable to walk, oftentimes bedridden, and unable to cry out in pain.
Even more horrific are the abuses and neglects which occur in the “sanitized” corridors of the for-profit nursing homes throughout the country. …
The hidden shame of elder abuse
“Wait until you see what is waiting for you in the next exam room …”
My clinic nurse was barely able to contain a smirk. This meant one thing to a doctor in training: the next patient must be a “train wreck,” with so many things wrong that I would never get beneath the surface during my brief visit. I was running 30 minutes behind, so I took a deep breath.
As …
A driver’s license that needed rescinding
Just as preparing for a lengthy hospital stay requires planning, so does returning to home after the hospital. While your condition and strength will shape the best approach for you, my experience following my stem cell transplants may be helpful should you find yourself in this situation.
Before you leave get the information you need. Most hospitals are pretty good in providing written information sheets on follow-up care, related instructions, and …
Plan your return home after a long hospital stay
As a longtime consumer reporter, I’ve always thought the best way to see how the marketplace works is to put yourself in the shoes of someone buying the product or service you’re investigating. After learning recently that I may need cataract surgery, it was time for me to check out the hospitals where that procedure might take place.
To begin my quest for the best, I searched for ratings for four …
Even when using rankings, differences among hospitals may be subtle
Physicians, hospitals and other providers are being misled by industry pundits claiming that more health information technology (as in EMRs, PHRs, smartphone apps, and web portals) is the key to greater patient engagement. It’s not.
If health information technology were all that was needed to “engage” patients then patient and member adoption rates of provider and payer web portals offering personal health records (PHRs) and electronic health records (EHRs) would not …
There is no app for patient engagement
I was curious why Lahey Clinic, a nonprofit group practice outside of Boston, started asking patients, “Are you safe at home?” during intake. Trying to find this out turned into an exploration of the inconsistent state of intimate partner violence screening in the US.
“Are you safe at home?”
The first time I was asked “Are you safe at home?” during patient intake at Lahey Clinic, I was surprised that such a …
Break the cycle of intimate partner violence
Over the past few years, I have had more than my share of navigating my way through the emotional and practical aspects of my treatment for mantle cell lymphoma. While at the back of my mind the broader questions – why me?, how long will I live? – remain, once I got over the initial anger and depression after the initial diagnosis (and after my relapse), I found these practical …
5 ways to help make a cancer diagnosis more manageable
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