I was reading the other day in a magazine the personal account of a woman who had a “perfect example of a mitral valve click” (a type of heart murmur) that was so textbook in sound that she was asked to be a listening post for a class of medical students. She was pleased to help, but was disappointed in how of the 15 examiners no one treated her like …
Patients and families must be tireless in expressing any frustrations
What if you passed a regulation, and nobody cared? Obesity is quickly emerging as a major policy issue, with related health costs consuming 10 cents on every health dollar – and rising. Policymakers, then, are eager for ideas. Top of the list: regulations to force chain restaurants to post calorie counts on their menus. This past Friday, the FDA released proposed regulations to force restaurants to do exactly that.
New York …
Obese Americans don’t actually realize they are obese
Several questions have come my way recently about what kinds of job opportunities might exist for patient advocates. I refer people to an article I’ve written elsewhere, but the real answer is – to be a true advocate, you must analyze who is paying for your services, and what your responsibility will be to them.
Finding an employer
In 2011, most of the job possibilities for patient advocates are found either …
Considering patient advocacy as a career
I know of few students who aspire to serve in end of life care. I sure didn’t. If anyone had told me that I would spend the first decade of my professional life serving the dying and their families as well as thinking, writing and talking about death and I dying, I would have thought that person to be morbid, strange, and sad. Most of society does not think …
A day in the life of a hospice professional
I was just thinking the other day how much I need my mom friends. The ones I’m fortunate enough to have in real life and the ones (you) who come here, read, offer support, share your stories, and commiserate at times.
All of you moms are incredibly important to me. It doesn’t matter to me whether you’ve breastfed or bottle fed, whether you are a champion of sleep training or prefer co-sleeping, …
Forget the mommy wars, offer support instead
Medicine has changed so much over the past years, I look back even to when I finished my program and in the mere 20 years since I finished, medicine has changed dramatically. I can remember when I was a student, seeing a patient with rheumatoid arthritis and advising her that the best treatment we could give her was a DMARD. Now we have multiple monoclonal antibodies that not only …
Patients have a part to play in their own medical care
Patients want to be cared for by doctors who show an interest in them as individuals. It has been a well-known statistic that the average doctor interrupts a patient within 16 seconds after the doctor-patient interview begins. You know full well that few patients can learn to develop an emotional attachment in 16 seconds. This article will discuss 7 steps to develop rapport that will make patients like you, will make them …
7 ways to make patients like you
I’m worried about the future. Everyone I know is stressed. Patients fail to follow up as directed. They fail to take their medications as directed. They have too much to do. Their priority lists are in shambles.
With all the responsibilities that today’s multitasking society thrust on my patients, they don’t even have the time to pick up the phone and call each other; instead, they text, IM, SMS, and email. …
Sometimes cyber-medicine is fraught with danger
As a patient care provider and someone who is occasionally a patient myself, I am going provide some suggestions on ways to know when it is time to consider seeking a second opinion or time to seek a new health care provider. This top 10 list is taken from personal experience.
10 reasons why you need to change doctors
A friend of mine recently took an exotic trip. While shopping in a market, she picked up an appealing item and asked the seller what it cost. She was given a price that seemed high, and paused to consider whether the impulse seemed justified. The shopkeeper grew confused in the silence. Finally he asked my friend, “Don’t you want to know if I can do better?”
Clearly this person was outside …
Health care consumers require a crash course on bargaining
Patients may soon be universally able to view their lab results thanks to a new rule proposed by the Department of Health and Human Services. This means patients may access without permission or release by their providers. This is a victory toward patient empowerment and a step in the right direction.
Classically patients do not see their lab results. The busy primary doctors are often left with nothing more than …
The empowered patient is a relief for physician practice
I once asked a man in his 30’s why he was on disability. He had fallen attempting to ford a swift stream while fishing. He replied: “Well, the judge said I have a bad attitude, I don’t like people and I can’t hold a job.” Shocking as it sounds, it wasn’t very different from other reasons I’ve heard. “I don’t remember, my Dad put me on it.” “I have anxiety.” …
America’s broken disability system
Recently, two executions by lethal injections were carried out in America. One ended the life of Troy Davis in Georgia, the other with too much hate Lawrence Russell Brewer in Texas. Death and dying offer complexity and complications in the profession medicine bound by policies, mandates and laws driven by internal (e.g. professional associations, medical boards) and external (e.g. federal, state, medical center) forces.
Lethal injections involve delivering a fatal dose …
Lethal injections are not good medicine
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Patients often pursue litigation simply to obtain information that has not been forthcoming. Research shows that the three things patients want most in the face of medical error are: information about what happened; a sincere apology; and measures to prevent the error from happening to someone else. Financial compensation is lower on the list. Patients generally seek attorneys out of anger rather than greed. When unanticipated adverse outcomes occur, error …
Patients generally seek attorneys out of anger rather than greed
I’m getting married in November and am not “registered” anywhere. Doing so hadn’t even occurred to me until people started asking, “where are you registered?”
At first, I simply laughed. Dan and I have enough for two households. Now I’m re-thinking the bridal registry thing.
Here comes the under-insured, chronically-ill bride going on two years without primary medical care … and I want to register at the Mayo Clinic.
My bridal registry wish list …
A bride who wants to register at the Mayo Clinic
I would like to share a story about my son’s recent surgery that, while only one simple case, reveals the foundational problem with the U.S. health care system.
I write this story as a father of a 12 year old boy who has cerebral palsy. Jack is fortunate to be healthy and active with minor medical needs. As he has grown he experienced some issues with contractures in his right lower …
It is not easy being a patient-consumer, but it can be done
In med school budding doctors are told: “When you hear hoof beats, think horse.” The problem is that sometimes when you hear hoof beats, it’s a zebra, and when that “zebra” is a disease, your patient leaves your office misdiagnosed. I’m that patient.
In 1998 I had my first abdominal attack. I vomited for days and walked hunched over like a frail octogenarian. (For reference, I was extremely fit and twenty-seven …
Learning the hard way that there is an art to medicine
There are many tips to saving money on medical costs like asking your doctor only for generic medications, choosing an insurance plan with a high deductible and lower monthly premiums, going to an urgent care or retail clinic rather than the emergency room, and getting prescriptions mailed rather than go to a pharmacy.
How about getting your old medical records and having them reviewed by a primary care doctor? It …
Doctors can help patients make informed decisions and prevent overtreatment
If death was the end zone, George had been on the one yard line twice in the last five years. And I, as part of his team of doctors, watched as he stubbornly maintained his goal line stand. Miracles rarely happen in medicine. They certainly don’t happen to the same person more then once.
Yesterday as George glided into my office you would have never known that eternity’s grip had been …
My good intentions had helped start a reaction
Pity me as I wish to be pitied. That is the plea of the tortured protagonist in Leo Tolstoy’s brilliant 1886 novella, The Death of Ivan Ilyich.
Tolstoy was born in 1828 into Czarist Russia’s landed gentry. Though orphaned at a young age, he enjoyed the typical privileges wealth and title afforded—passive income, summers in the country, and enrollment at Kazan University. But it was later, after dropping out of school and …
Ivan Ilyich gives voice to the agony of the afflicted
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