When I ran into Paul S. not knowing he had cancer, I barely recognized him and struggled with what to say. “What happened?” didn’t seem appropriate, although it was my initial reaction. I believe I said, “I barely recognized you,” which was true. I’ve been in many situations where I wasn’t sure what to say to someone who was ill or in distress; I wanted to be supportive …
What to say to a person who is sick
by Devin Gross
Here’s a question. It’s not a 5¢ or $5 question that anybody can solve on their own without much thought or effort. It’s a $100 ask-an-expert or think-about-it-for-a-second question.
What’s the point of patient empowerment?
Much of the current discussion of empowerment deals with patients who for one reason or another have had to fight for their care. CNN’s Elizabeth Cohen opens her book, …
The $100 question about patient empowerment
Grandmother Pat LaColla, 82, was lured by the hype—”get in shape without setting foot in a gym”—when she bought a pair of Skechers last year, wincing at the $100 price tag. Toning shoes like those she bought are the newest craze in athletic footwear, projected to grow 500 percent to become a $1.5 billion market this year.
Although the designs vary, toners typically have strongly curved, thickened soles. From the moment …
Are toning shoes safe or effective?
An excerpt from Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Care as You or a Loved One Gets Older.
by Mark Lachs, MD
Over my twenty-five-year medical career, the route by which people are admitted to the hospital for an overnight stay has subtly evolved in ways that most patients (and even many doctors) may not realize. Specifically, the proportion of patients who …
Tips for patients during an emergency department visit
Here is an unfortunate, but almost daily not-so-secret occurrence in my practice:
I am in the midst of an intricate follow-up visit with a rather complicated patient with diabetes, high cholesterol, and high blood pressure. I am feeling as though I am a CIA agent in a rather mission impossible assignment: she is here for lab results, is complaining of low back pain, and presents with an elevated blood pressure of …
Why answering a cell phone during an office visit is a problem
I need help. In dealing with obesity as a medical problem, that is.
I am pretty solid at arrhythmia management, but as an obesity doctor, not so much. If I was the teacher, and my obese patients were the students, I would surely be fired for poor student test performance. At least, if the core measure was the patient’s BMI.
If a student does poorly on an achievement test, is it the student’s …
Is it the doctor’s fault if an obese patient cannot lose weight?
by Adam Linker
A doctor at Sloan-Kettering Cancer Center recently advised that I submit to genetic testing without ever having met me. It turns out I may harbor a gene that increases my risk of developing prostate cancer.
This unsolicited advice was delivered via National Public Radio after a story on the JAMA study of preventive breast and ovarian surgery in women with BRCA1 or BRCA2 genes. Dr. …
Talk to your own doctor when hearing advice on the radio
by Marianne Mattera
Recently, a press release from Mount Sinai School of Medicine in New York City landed in my e-mail inbox. “Students with Humanities Background Equally Successful in Medical School as Traditional Students”, the headline read.
The press release summarized the findings of a study published in the August issue of Academic Medicine. David Muller, MD, and Nathan Kase, MD, reviewed data on the Mount Sinai …
A primary care physician who knows history and can relate to people
by Daphne Swancutt
I’m having a weird, visceral reaction to all of the recent brouhaha surrounding the term “e-patient.”
For some reason, semantically speaking, the term is slipping in to derogatorium. Up there with “cyberchondriac,” which definitely is derogatory. It’s kind of like research—one day, omigod, it’s Mecca; the next day, it’s the scab on a rotting wound.
Whatever.
I have a chronic condition—I’m not dying, it’s not …
All patients will soon become e-patients
by Diana E. Lee
Most of the resources I’ve read about how to prepare for a doctor’s appointment recommend bringing a loved one with you so that person can help you remember what the doctor said and make sure you get your questions and concerns addressed.
But when I read Paula Kamen’s book All in My Head: An Epic Quest to Cure an Unrelenting, Totally Unreasonable and …
Bringing a friend or family member on doctor’s appointments
If you had asked me what I thought forgiveness was when I was a young adult, I probably would have said that it is something you do for others—others who have wronged you in some way, to give them a break and let them know that you are no longer angry or upset with them.
As I’ve matured emotionally over the years, my view of forgiveness has evolved significantly. Some of …
Forgiveness shaped by the stories of people’s lives
by Liz O’Brien
A long time ago — when managed care-style employee healthcare benefits were a new thing — we worker bees learned we might have to throw our old family doc under the bus.
We were given a booklet of providers on the network panel, and if the faithful retainer who had served our family for years wasn’t on that list, it was sayonara — unless we …
Anecdotal accounts of patient experiences with local physicians
by Emmanuel King, MD
What if you could improve patient safety, cut costs, broaden your medical knowledge and find 20% more time in your workday? On October 1, 2010, that is just what we can expect when clinical pharmacists move from the back room to the bedside in ten general medical units at the Hospital of the University of Pennsylvania.
As we all know, medications play an intensely complex and ever-growing …
Improve patient safety and cut costs with clinical pharmacists
I walked into Room 22 to find a very interesting patient who presented to our ER with complaints of abdominal pain and associated nausea and vomiting.
The patient sat on her cot with her pant legs rolled up above her knees, refusing, according to her nurse, Gwen, to put on a treatment gown. Her left leg hung in the air, her ankle crossed over the knee of her right leg. Her …
Moments of internal struggle in the ER
We all hate it when the cable company tells us that the technician will be at our house sometime between 11 a.m. and 5 p.m. Fantastic! Going to the pediatrician’s office can be the same way.
Your appointment may be at 9 a.m. but you may not get out of the office until noon. Unfortunately, this is the nature of running a medical practice. What should take ten minutes for one reason or another …
Tips to make your appointment as fast and efficient as possible
An excerpt from Why Some Things Should Not Be for Sale: The Moral Limits of Markets.
by Debra Satz
Sometimes what critics of pregnancy contracts have in mind is not the effect of such contracts on the relationship between reproductive labor and a woman’s sense of self, but their effect on her views (and ours) of the mother-fetus and mother-child bond.
On this view, …
Contract pregnancy ethics and moral issues
Assumptions are ubiquitous. Neither patients nor physicians are exempt. Sometimes they are justified, other times entirely misguided.
Webster’s defines “assume” as “to take as granted or true.” The cliché’s have probably always existed: Doctors are greedy and paid too much, and are uncaring. Some patients believe doctors do care and that their doctor actually likes them. That’s an assumption too. Some assumptions are newer. Patients assume doctors will substitute their prescription …
Assumptions in medicine can inhibit care
Every time you subject the patient to an invasive procedure you take the risk of causing complication. I have done hundreds if not thousands of procedures which makes me even more aware of the risk I take every time I stick a needle or cut into the patient. We can do everything possible to enhance the safety, yet we cannot completely eradicate the risk of adverse events.
With the recent progress …
Applying the minimally invasive concept to patient management
Have you ever read what your physicians and nurses have written in your medical chart? If not, would you want to?
The OpenNotes project is a recently launched observational research study that involves 100 primary care doctors and about 25,000 patients. Lead author Dr. Tom Delbacoa, a primary care physician at the Beth Israel Deaconess Medical Center, poses the research question succinctly: “After a year, will the patients and doctors still want to continue sharing notes?”
In the study, …
Why OpenNotes and access to the medical chart is important
I heard a prominent speaker talk about studies at the National Institute of Aging. The speaker described several new large and well funded trials aimed at preventing illnesses associated with aging, such as dementia and disability. These studies are terrific, and worthy of funding.
I was disappointed, however, that little was said about funding for studies of older adults already living with dementia and disability. Research in prevention will not help these patients. I asked: where is the …
Adults living with dementia and disability need research funding
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