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.
Search engines and the Internet are impacting patient behavior—eight out of 10 people use the Internet to look for health information, but only 25 percent of those people verify the credibility of their information source before self-diagnosing. It gets even more complicated when patients order drugs directly over the Web.
The debate among physicians about the credibility of online information is as old as the Internet itself. As a caregiver, …
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Manage malpractice risks with self-diagnosed patients
There is nothing like a good community health fair. Away from the formal, detached sterility of the office this is an opportunity to meet patients on their turf. No longer adorned with white coat, power outfit and accompanying entourage, physician meets patient as just another member of the community, an equal almost. With a backdrop of blaring music, sweltering heat and flavorful eats people young and old gather, eager to …
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Why I love community health fairs
Things have been a bit tough of late, the bad economy is starting to bite, and you’re feeling the pressure. To top it all, your body has been acting strangely in ways it never has before. Your muscles twitch in funny areas for hours at a time, you tire easily, and you have fleeting pins and needles in your limbs. Over the weeks these symptoms have become worse. The last …
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The trouble with Dr. Google
As medical practitioners, we are trained to fight disease, becoming familiar with all the metaphors of war, victory, failure, and the Cartesian views of deductive reasoning and mind being separate from body. Through said reasoning, we come to believe in a passive view of health; that health is an absence of something, in this case dis-ease. From that vantage point, it is no wonder medical practitioners have such high rates of burnout, …
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Why patients flock to alternative medicine providers
I worked with Joe over a year ago and now he returned to see me with a new problem. He had just been diagnosed with a rare degenerative disorder that would eventually rob him of the use of his limbs as his muscles weakened over time. Joe wanted to talk about how he could prepare himself for this decline.
Joe is in his sixties and has worked in high tech for …
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Making life meaningful despite a debilitating disease
If you’ve seen the news recently, you know that emergencies can happen unexpectedly in communities just like yours, to people like you. We’ve seen tornado outbreaks, river floods and flash floods, historic earthquakes, tsunamis, and even water main breaks and power outages in U.S. cities affecting millions of people for days at a time and now Hurricane Irene is coming. Health care professionals should be ready too.
I was …
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Hurricane tips that patients and health professionals should know
So you’re not having a heart attack like your wife thought. That’s the good news. But what is wrong, what did cause that pain, and what should you do from here on out?
That’s the purpose of discharge instructions, and it’s not enough for the ED staff to just print out some forms, say “sign here,” and send you on your way.
What constitutes good discharge instructions, and why are they critical …
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Talk to your patients before sending them home from the ED
Whether you are going to the hospital for an outpatient procedure or whether you will be admitted to the hospital for medical illness or surgical procedure, there are certain things you must know and certain things you must do in order to ensure that your reasonable expectations will be met.
- You must become informed about the terms and limits of your health insurance policy. See if the fees you are being …
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Top 10 musts for your hospital visit
Today, healthcare is criticized by the public as too high on technology and too low in touch. Computers take patients histories, provide differential diagnoses, and even supply educational materials to patients. A new specialty, tele-medicine, offers healthcare services to rural areas that were previously underserved or couldn’t afford the latest diagnostic technology.
A humorous story about technology occurred when a patient’s secretary called to say that her boss was too …
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Why technology should never takeover the patient encounter
Seniors spend a lot of time at hospital ER’s. Now, a small but growing number of hospitals in the US have built ER’s especially for the aging patient – with wider hallways, motion detectors, hearing and visual aids. To me, this is long overdue.
Older patients are avid consumers of emergency medical services. Older people make up a significant percentage of the total population of ER patients. A 2008 Read more…
An ER specifically built for older patients
A 44-year-old man came to my office to begin Suboxone in hopes of stopping his injecting heroin. He was raised well by married parents, whose other four children have not indulged in narcotics.
He lives with a friend, unable to contribute to rent while “not working” yet somehow he affords $50 per day for narcotics through (self-admitted) hustling (comprising: working as one tentacle of the drug-dealers’ network, shoplifting, borrowing with no …
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Personal responsibility is needed to treat drug addiction
My family, my friends and my patients think being selfish is bad. I bet you do, too. I used to think so, as well. Twenty seven years in practice has taught that being selfish is good. Actually, selfishness is essential to an individual’s health.
Today, I saw a selfless young woman who was ill. She had an assortment of complaints. She had not felt well in months. If she was the …
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Taking care of yourself sometimes means being selfish
“Be a fountain not a drain,” an expression used by baseball announcer Rex Hudler, is one that has motivational content particularly in terms of an individual included as part of a team.
I would suggest that this expression would be appropriate when considering a basic team in medical practice: the doctor-patient relationship. It is critical in most clinical situations that both the doctor and the patient assume responsibility for making …
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Patients need to contribute to help their doctors
I was working in an urgent care clinic when I walked into the exam room to see my next patient. He was a six-year old who primarily spoke Spanish, with some broken English. Jose’s mom was with him, she only spoke Spanish.
I sat down and picked up the phone receiver to contact our translator service. With the Spanish interpreter on the line I was able to proceed. I then asked …
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Take the effort to reach across cultural and language barriers
Regret is a harmful emotion. Regrets are best avoided. Its one thing to regret buying a stock that plummets. It’s another to regret that you ever smoked because your chest x-ray shows a large tumor.
People often don’t appreciate what they have until they’ve lost it. When you’ve lost your health, you will regret its loss for the rest of your (shortened) life. Imagine that you were supposed to take your …
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Regrets after patients have lost their health
Despite this culture’s obsession with good health, people get sick.
This piece is based on a story I tell in my book.
In 2001, I got sick with what the doctors initially thought was an acute viral infection. I have yet to recover. Diagnosis: Chronic Fatigue Syndrome—a little-understood illness that is as debilitating as its more justly named cousins that also compromise the immune and neurological systems. My case is particularly …
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How not to treat yourself when chronic illness strikes
