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.
The outsourcing of work by businesses to the cheapest available workers has received a lot of attention in recent years. It has largely escaped notice, however, that the new labor force isn’t necessarily located in Southeast Asia, but is often found here at home and is virtually free. It is us, using our laptops and smart phones to perform more and more functions once carried out by knowledgeable salespeople and …
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Interactions about our health care are increasingly conducted online
“Where there is love of humanity there will be love of the profession.”
-Hippocrates
Reading some of the blog posts and comments on the Internet, you might get the impression that a majority of American doctors hate their jobs. Actually, according Family Practice News, only 35% of my colleagues are unsatisfied with their careers, but that is still a remarkable number.
Are Hippocrates’ words implying an answer to why some doctors today don’t …
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Why doctors and patients have turned against each other
Kids will swallow or poke up their noses, or into their ears the strangest things. I remember during my student days, I was doing a rotation in pediatrics when a 6 year old came into see us. I went in to take the history and her mom told me that her daughter had a very pungent odor to her, which she couldn’t get rid of.
I examined the patient and …
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Kids and their fascination with foreign objects
Print out the eye chart, cover one eye, and see how you read it from 20 feet out. I failed line 8 abysmally.
I went for my annual check-up, and I must say, this doctor was thorough. In fact, he was too thorough. He told me way more than I ever wanted to know.
During the two-hour examination, I found out I’ve gained weight (too much ice cream), my blood pressure …
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Appropriately dejected after an annual physical
Ever dream of quitting your job, moving somewhere deliciously tropical and spending the rest of your days doing what you love (and even making a good, or great, income from it)?
This story isn’t about me, though some of you may know that I spent 2004-2008 living my dream life in Mexico (Puerta Vallarta and Los Cabos), making much of my income from my writing, dancing, coaching and speaking and occasional …
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Quitting your job and living the dream
How many times have you said to a friend or relative in need, “Let me know if there’s anything I can do to help,” and when you didn’t hear back, fail to follow-up? I’ve lost count of the number of times I did just that—fail to follow-up when I didn’t hear back from someone in need, even though I would have been happy to help in any way I could.
Yet, …
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How to ask for help when chronic pain or illness strikes
Year: 2002
Setting: Gleneagles Hospital, Singapore
Position: Private general practitioner
I am the first and only non-Anglo-Saxon, foreign, private general practitioner in the city-state and the physician of reference for 14 embassies, consulates and a high commission from Europe, Asia, South America and Africa. One afternoon, a nurse comes into my consulting room saying that an ambassador from a European country has had an accident and that he insists on being seen immediately.
I …
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You cannot treat a patient against his will
I walked up to the closed door and paused, exhaling a deep breath weighted with disappointment, trying to clear my thoughts for the conversation about to come. My clenched fist was briefly suspended, mid-air, ready to knock. Beyond the door, I could hear muffled conversation and movement.
A calm, pretty woman stood beside me. An emergency department case manager. She held a notebook and pen, ready to jot down any useful …
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How our resuscitation efforts would be interpreted by fate
A torn meniscus. It did not disable but it impaired, and unpredictably. My stomach learned quickly to tighten at the sound of A.’s peculiar whimper in response to a crippling pain that would shoot through her at seemingly innocuous movements of the afflicted leg. We have health insurance of sorts, the type that will help you keep your home if tragedy strikes, but that does not shield you from the …
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The inability to locate price anywhere in the hospital
No pediatrician can answer the question: “What’s the most important thing I can do to keep my child healthy?” without listing three of four things. I’m no different, but right now family dinners are at the top of my list. You could argue that immunizations, car seats, bike helmets, 9-1-1, sleep, or good hand washing are just as important, and I won’t disagree. But it’s hard to overlook the overwhelming …
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Why the family dinner is important for your kids
As a geriatrician in a locale with many elderly retirees, I am frequently asked how long mom or dad (or both) can stay in their home and live safely and successfully. It is clearly a complicated issue even if the individuals involved are cognitively and mentally intact, physically capable and financially able to pay for support and help.
There is much to consider. Are the patients physically able to maneuver within …
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Patient safety in the elderly staying at home
One of my patients thanked me for saving his life. Apparently, many years ago I had told him that most men’s first complete physical is in the emergency room in the midst of their heart attack or stroke. I have been in practice long enough to have forgotten many of the things I have told patients. I try to capture the pearls I have learned over the last 30 …
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Using the emergency room for routine physicals
Last
July,
I
found
myself
needing
to
visit
a
doctor
for
an
urgent
medical
issue.
My
period
had
started
in
April
and
never
stopped.
It
was
light,
so
it
wasn’t
too
much
of
an
annoyance,
but
after
three
months
I
figured
I
needed
professional
help.
I
had
started
graduate
school
in
Michigan
the
year
before
and
was
back
home
in
California
for
the
summer.
I
wasn’t
sure
if
the
new
insurance
…
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Unexpected medical bills on a graduate student’s budget
Up until last May, my experience of medical costs was limited to the $100 per month premium I contributed towards my employer-sponsored insurance and the nominal co-pays associated with well-child checkups and generic prescriptions. There was never any hesitation in seeing a doctor or filling a prescription. That all changed when went I back to school.
I blindly signed up for the school-recommended family insurance and naïvely assumed myself, my …
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Care costs a lot and it’s not straightforward what the cost is
con·nect (from dictionary.com)
verb (used with object)
1. to join, link, or fasten together; unite or bind: to connect the two cities by a bridge; Communication satellites connect the local stations into a network.
2. to establish communication between; put in communication: Operator, will you please connect me with Mr. Jones?
To connect with your patients is truly the key solution.
Connect takes on two meanings:
- Establish a relationship; develop, dig, pursue
- Maintain via all available tools: email, …
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To connect with patients is key
All of us are role models, whether we see ourselves that way or not. Of course I love to imagine myself as a positive role model, but my eleven-year-old daughter has already informed me that things will be way different at her house when she’s a mama. However, we’re not going to focus on how uncool I am, instead, I’m going to share the stories of a couple of people …
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All of us are role models, whether we see ourselves that way or not
Today was a rough day at work. My schedule of 10 patients for the afternoon rapidly ballooned into 17. People were sick and miserable. Those who were healthy were frustrated by the long wait. I heard myself apologizing over and over to each family.
The day was mostly a chaotic blur. Babies crying, phones ringing, parents reprimanding children on the brink of a meltdown. I don’t remember much of it, except …
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Children who curse, and the power of words
