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.
Science seeks certainty. The problem in medicine is, the body is complex and our knowledge is incomplete. People who want certainty – physicians or patients – are kidding themselves. And if we expect docs to be perfect, it’s a setup for dysfunction.
Sometimes I hear of patients who believe their physicians dissed a proposed or experimental treatment that’s not understood. (I’m not endorsing wacky treatments here – I’m only talking about uncertainty.) …
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Expecting doctors to be perfect is a setup for dysfunction
Have I told you how much I love Amazon? Its the awesome! Let’s say I need something – an external hard drive. So I go to Amazon and I type in “external hard drives.” Boom. I get a list of, not surprisingly, external hard drives. Which one do I chose? Fortunately, Amazon has some great data and filtering options. I want a desktop drive, not portable, so I filter those out. …
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Choosing a doctor should be like the Amazon shopping experience
To deal with the aftermath of medical errors, an increasing number of providers are encouraging injured patients to participate in “medical apology programs.” The idea, proponents say, is for patients to meet with facility representatives to learn what happened and why. It gives the patient a chance to ask questions and it gives providers a chance to apologize, and as appropriate, offer compensation. These programs are promoted as humanitarian, and, …
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Protecting patients from medical apology programs
These days, it is not uncommon for people to need to find a new doctor. The most common reasons include a) moving to a new city, b) dissatisfaction with your former doctor, c) your old doctor no longer accepts your new or old insurance, or d) you were diagnosed with a new medical condition and need specialized treatment.
Often, people go to their insurance company website or provider book, search for …
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Useful tips when looking for a new doctor
Adolescence is filled with challenges – at school, at home, with friends, on stage and in sports. Even their own body betrays them from time to time. Acne, hair, changing bodies and voices, parents, siblings and friends are all possible sources of gut-wrenching shame for a normal teen. Parents of teens have challenges too – and high on the list is the challenge of talking about important topics like sex, …
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How to talk with your teen about marijuana
“I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life – well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.
But then I read what killed me: ‘serious complications following minor surgery.’
Now what the heck …
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A few more minutes with Andy Rooney
Cardiologist Dr. Richard Fogoros has issued this blunt warning to those at risk for developing heart disease: “You need to change your life. If you don’t, you will suffer the consequences – possibly decades earlier than is necessary.”
In his Heart Health Center column, he observed that most high-risk people end up making only half-hearted efforts to modify their heart attack risk. And he blamed doctors for enabling this lack of …
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What patients with heart disease need to learn from cancer patients
The milestone of the world’s population reaching 7 billion is a fitting time to reflect upon life expectancy. Life expectancy is a rough marker of humanity and medicine’s progress in the age-old battle to attain old age.
Those born in the US this year are expected to live until 78.37 years of age if current mortality rates persist. This puts us at a sobering 50th in the world.
How long is someone …
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Life expectancy is a simple number with immense ramifications
I’ve had irritable bowel syndrome for 20 years, and I’m angry. About the pain, and the suffering, and the limited diet, and the huge impact that it has had on my life. But mostly, I’m angry at my doctors. No, they didn’t misdiagnose me. No, they didn’t harm me. No, they didn’t treat me like dirt. But they still made me angry.
Before we go any further, let’s get one thing straight: I know …
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Why patients with irritable bowel syndrome are angry at their doctors
I am a writer as well as a doctor. My heroes are Keats, Chekhov, Williams, Coulehan, Coles, and other physician writers. And those greats of medicine too, known and unknown, who have spent their lives caring for people.
My writing is short. Really short. If it isn’t poetry, it scans like poetry. And one act plays. As in The Ride, my latest collection. Someone said if you can’t write poetry, you …
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Lives focused through the lens of medicine will burn your eyes
I see my oncologist for my twice-yearly checkup tomorrow, and while my visits have been blissfully mundane over the last three years, this time I actually have a list of questions and a couple of concerns over the lab results from my latest physical. It’s probably nothing, but once you’ve had cancer you can’t help but wonder which “nothing” is actually the edge of trouble’s long shadow. My family doctor sees no cause for …
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No act of kindness is ever wasted
It is well known that men see doctors much less frequently than women. The reasons are multifactorial and not all that well studied. It’s certainly not because men are healthier than women as they die on the average seven years before women. Clearly women are accustomed to seeing doctors at an earlier age than men for reasons relating to childbirth and birth control. Most accept the recommendations to get an …
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Embarrassment is one reason why men don’t see the doctor
The public gets much of its health-related news from lay-oriented synopses of scientific papers published in refereed medical journals or presentations at major medical conventions. Longer, more detailed commentary is published in the print media, but the majority are short pieces posted on many websites or blogs. I try to familiarize myself with information pertaining to cardiovascular disease as well as predisposing conditions such as diabetes and hyperlipidemia with the …
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The ability to quantify empathy
You heard me correctly. Do not go to your next doctor’s appointment. I repeat, do not go. Do not pass go or collect money.
Now that I have your attention, you may be thinking what is this crazy doctor saying? If I had a dollar every time a patient came in and asked for my advice but didn’t follow it, I would have been retired long ago.
Why is this?
Change takes time. …
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Why you should cancel your doctor’s appointment
The digital age has had a deep and likely permanent effect on the patient-physician relationship. I can’t tell you how many times I’ve had physicians beg me to provide them with a way to stop their patients from Googling their symptoms and diagnosing themselves before their first office visit and much to their chagrin, my answer is always the same, “You can’t stop them. Get over it.”
The Internet acts …
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Patients and physicians in the digital age
“Better” is another one of the difficult words I have to deal with on a daily basis.
“Doc, I’m better” can mean a lot of things and can lead to both misdiagnosis and poor treatment. Does “I’m better” mean you are well? If not, are you really better or is it just wishful thinking? How much better are you?
On a busy, stressful day, even the most skilled physician can fall for, …
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Doctor, I’m better: What does that really mean?
Physicians, nurse practitioners, nurses, psychologists, physical therapists, and a whole host of other health care professionals entered their respective professions to help people. One part of being an effective health care provider is to advocate for your patient when they need it. For example, if your patient (who is a mechanic) broke his arm and needs a note for the employer for a few weeks off, you provide it. If …
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When patient advocacy leads to patient enabling
On July 24, 1998, a psychotic schizophrenic gunman entered a side entrance at the U.S. Capitol. As he approached Rep. John DeLay’s office, he exchanged fire with two Capitol Police officers who later died of their wounds. The gunman was badly wounded as well.
Senator Bill Frist, a cardiologist, was leaving the Capitol when Congressional aides informed him that some men needed urgent medical assistance.
A New York Times article tells …
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Non-judgmental regard can show the best of humanity
Health care professionals are a cynical lot. We joke about the “fad or buzzword of the month,” usually some vague concept heralded by the powers on high. Our job is to promote the idea, knowing full well that the “next big thing” is probably right around the corner.
Take “patient-centered.” It sure feels like a buzz word. I suspect most hospital and physician executives, and their ad agency partners, …
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Why hospitals and physicians should get serious about patient-centered care
I remember when my best friend was in the hospital thirty years ago and I brought her 3 year old daughter to visit. My friend could not speak. She could only blink one eye and was paralyzed on one side. How she was able to communicate was through the blink of her one eye. I felt her energy of wanting to spend time with those she loved. It was Christmastime …
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Compassionate care is a crucial component of care
