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.
When is an ice cream label a health literacy tool?
When Dr. Barry Weiss decided to use an ice cream label as a tool to asses whether we (patients) are able to understand medical instructions. Funded by Pfizer-backed Clear Health Communication initiative, Weiss’s research resulted in the creation of “The Newest Vital Sign.”
A health literacy assessment tool, with findings published in the Annals of Family Medicine.
However, the document, Why …
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An ice cream label as a health literacy tool
Several years ago, I spoke at Baylor College of Medicine in Houston, where Michael DeBakey, the legendary heart surgeon, was master of the universe for nearly half a century.
I heard lots of DeBakey stories during my visit, but one in particular really stuck with me. “A few years back,” someone told me in a voice of hushed reverence usually reserved for descriptions of flawless beach days and single …
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Why physicians ignore fatigue
PLoS Medicine recently published an article commenting on an earlier study exploring the link between social networking and mortality.
The result speaks for itself: “the degree of mortality risk associated with lack of social relationships is similar to that which exists for more widely publicized risk factors, such as smoking.” You read that right, according to this study which examined over 300,000 participants in a meta-analysis, social relationships are as important …
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Mortality risk associated with lack of social relationships
Raghav Govindarajan, ACP Associate Member, a neurology resident at the Cleveland Clinic Florida, told us about a case he saw in India that has important lessons for clinicians everywhere. The patient was a 65-year-old man who presented with chronic symptoms of burning discomfort and weakness in his left leg.
His symptoms had started about seven years prior and he had been told that he had “neuritis.” He reported that he had …
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Social prejudices may limit the accuracy of patient information
A guest column by the American Medical Association, exclusive to KevinMD.com.
As the nation’s largest physician organization, the American Medical Association (AMA) is uniquely positioned to help physicians thrive in medical practice throughout the stages of their careers.
Because the AMA is led by physicians, we understand the many demands and rigors physicians face as they work to provide high-quality patient care, and we are proud to support physicians in their …
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AMA helps physicians care for patients
Ten years ago, I wrote the Pew Internet Project’s first report on the impact of the internet on health care, calling it “The Online Health Care Revolution.”
Back then, the idea that people were searching online for health information was revolutionary. All of a sudden, regular people had access to medical information that had always been locked up and out of reach.
Ten years later, I am ready to declare the access …
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The internet and online health information trends
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 …
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A postmortem on the patient safety movement
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. …
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$11,000 hospital bill from the emergency department
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 …
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Cholesterol medication cost should not be prohibitive
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 …
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A community of healthy seniors inspires this physician
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 …
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Patients adjusting their medications and controlling blood pressure
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 …
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Travelers with medical conditions fear increased TSA security procedures
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 …
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Bedside manner may need to include cost of care discussions
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 …
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Working at the student care center in college
There are some lessons we learn and keep re-learning in medicine. For me some of these recurring lessons are,
- Listen to your “gut.”
- Pay attention to the clues.
- Listen to your team.
- Don’t be afraid to call for help.
and
- Stick to your guns when advocating for your patient.
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 …
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Never forget to advocate for your patient
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 …
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Why you should care about prison healthcare
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 …
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Taxing soft drinks to combat obesity
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 …
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Caregiving requires that caregivers need practical and emotional support
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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Never hesitate to seek a second medical opinion
