Are patients better off than they were ten years ago?
Just over a decade ago the Institute of Medicine (IOM) released its celebrated report on patient safety, To Err is Human. Many credit that report, which was released with great fanfare, with launching the patient safety movement. So it’s appropriate to assess the movement’s impact eleven years later. How did we do?
On November 25 the New England Journal of Medicine published …
by Steve Sanders, DO
“What am I going to do now Doc?” asked Mike, a down on his luck, 29 year–old recently unemployed truck driver, as he handed me his hospital bill.
Mike was seen at our local emergency department on a Friday evening with complaints of indigestion. Earlier that day he and his wife Susan celebrated their second anniversary by splitting a store bought pepperoni pizza. …
Recently, I had a patient visiting me for the first time. He basically a “syndrome X” type of guy: middle-aged, overweight, high cholesterol, high blood pressure. He’s not the most personally careful individual, with a history of domestic altercation, some prison time. Almost goes without saying he drinks too much and smokes cigarettes.
Well, he wanted his cholesterol medication restarted since he has just now started receiving “insurance”, MassHealth, Massachusetts’ state …
I have been genuinely blessed by my career in medicine.
When I started medical school, I was living through a very rocky time, dealing with severe, at times suicidal depression. I was working through an outpatient alcohol and drug rehabilitation program, and I was about 40 pounds overweight. I had grown up with a very negative and fatalistic attitude toward life which resulted in chronic misery and a number of personal …
We are no longer surprised when a patient is asked if they take their blood pressure medicines every day, and we are told “it depends.”
Yes, it can be amusing to hear how one member of a couple decides that they know more than their physician, and makes decisions based on home blood pressure measurements. Sample quotes may include “she thinks she is a doctor”, or “I decide what to give …
by Brian Loew
Travelers with medical conditions hope that the TSA pat-down incidents involving bladder cancer survivor Thomas “Tom” Sawyer, at Detroit Metro Airport, and to breast cancer survivor Cathy Bossi, at Dulles Airport, are isolated incidents. But these reports are already creating a chilling effect on air travel for people with medical conditions and disabilities.
This group of travelers could benefit the most from holiday …
by Dennis Grace
For years, if you asked for a recommendation for a physician, the answer included some mention of bedside manner.
I mean, we’re human beings first and patients second, so we think it’s great that she’s a brilliant doctor, but is she pleasant? Is she respectful and patient? Nobody wants to work with a know-it-all, especially one who gets to hear about our bowel movements …
For five years I worked at GlassHospital’s Student Care Center.
I don’t get no respect, neither.
One of the great things about GlassHospital is that it sits on the campus of a well-known and fairly well-respected former Big Ten university.
Like all colleges and universities, our place acts in loco parentis to the students that grace its campus. This means responsibility for our students’ health and well-being.
I loved working at the Student Care …
There are some lessons we learn and keep re-learning in medicine. For me some of these recurring lessons are,
and
I encountered a young patient recently, just at the cusp of adolescence and adulthood, who had undergone a procedure related to a sports injury. Other people had been …
It was kind of amazing how little coverage the recent report on healthcare in our prison systems got. Heck, you may be thinking, I don’t think that’s amazing – why waste airtime on that topic – why should I fret and worry about the healthcare that prisoners get when my child is burning up with fever and coughing up a lung and I can’t even afford to take her to …
One commonly heard propositions to combat the obesity epidemic is to tax soft drinks. No doubt, sugary soft drinks are a common and important source of “empty” calories, but will taxing soft drinks really reduce obesity rates?
This assumption was now examined by Yale University’s Jason Fletcher and colleagues, in a paper just published in Contemporary Economic Policy.
The researchers collected information on taxation of soft drinks with respect to specific excise …
Mr. B, the patient who first stirred my interest in family medicine, was a spry former World War Two fighter pilot who came to the ER complaining of an irregular heart beat. I remember him regaling me with stories about the Battle of Britain while his wife dutifully stood by his side in the chaos of the crowded emergency room at a private hospital affiliated with my medical school.
It was …
To celebrate your 50th birthday you head to your doctor’s office to get your yearly exam. He rewards you for your diligence by poking and prodding you, sticking you with needles, and arranging for a colonoscopy (happy birthday!). He also sends you for a stress test out of concern about your strong family history of premature heart disease.
A slightly abnormal treadmill test leads to …
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An article in the Wall Street Journal, Taking Medical Jargon Out of Doctor Visits, emphasizes that the use of medical jargon leads to poor communication between physicians and patients, and consequently leads to ineffective medical care. Federal and state officials are now pushing healthcare professionals to use simpler language to communicate medical advice to patients.
I could not agree more with this mission. The gap …
It is hard to believe that those we love will die.
We can’t bear it. It’s too harsh, too complicated, too fraught with emotional baggage and unfinished business and things never said. It’s too final. Dead is dead, after all. From the moment of our birth, we are dying. Death can be painful, tragic, too soon, too quick, too slow, too easy, or too hard.
So we soften it up a bit.
She …
First aid is defined as the immediate care given to an acutely injured or ill person. It can literally be life-saving so it behooves all of us to know some basic principles.
What follows are some rules that cover common conditions and general practices:
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How can patients get a straight answer from a doctor?
The answer is really very simple: Don’t accept a non-answer answer from a doctor on a question that really matters to you!
If you get a dodgy, vague, or useless answer don’t take it lying down. Politely insist that the doctor elaborate and clarify until you get a reply that you understand.
We doctors are totally scary, but if you have to have …
Diana Cole told me, “The internet saved my life,” and recounted a story about using the internet to identify a bat bite and learn about rabies in bats, leading to an emergency room trip.
She later introduced me to her sister, Carolyn Kingston, who attributed her successful outcome from hip replacement surgery to her use of the internet. I asked Carolyn about her general use of the internet for health, her …
by James Merlino, MD
The patient experience is the right thing to do, and a business necessity. But improving it is not necessarily easy.
The fact is, large medical centers are at a real disadvantage when it comes to performing well on HCAHPS. The Centers for Medicare & Medicaid Services (CMS) do not discriminate or differentiate the scores of small community hospitals from those of large academic tertiary care …
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This item has nothing to do with OpenNotes itself – it’s what I’m seeing now that I’ve started accessing my doctor’s notes. In short, I see the clinical impact of not viewing my record as a shared working document.
Here’s the story.
In OpenNotes, patient participants can see the visit notes their primary physicians entered. Note – primary, not specialists. I imagine they needed to keep the study design simple.
So, …
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