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.
Like last year, I’m participating in the Engage with Grace blog rally. I’ll be signing off until Monday. Have a wonderful Thanksgiving holiday.
Last Thanksgiving weekend, many of us bloggers participated in the first documented “blog rally” to promote Engage With Grace – a movement aimed at having all of us understand and communicate our end-of-life wishes.
It was a great success, with over 100 bloggers in the healthcare …
With the majority of American patients using the internet to research their health, it’s essential that they be guided to reputable sources of information.
Better Health’s Val Jones, in a recent presentation at the e-Patient Connections 2009 Conference, starkly framed the problem in a creative limerick, presented Pecha Kucha-style.
We found out that her real name was Cindy Chapman, and that she died alone and afraid.
Cindy was a paralegal, an activist and a fighter of lost causes who lived in Worcester, Massachusetts. She was part of an online community called RATEMDs, where she had many soul mates. Her posts on health care were funny and cynical and wise. Her screen name was Jane Q. Patient.
Last time I talked about how I had never really experienced the concept of nurses eating their young in action.
However, I have seen the opposite begin to evolve. I see this as a bigger issue in nursing these days. The “putting out to pasture” of seasoned, experienced nurses is happening more often …
On my last day of ward attending, I handed out an EKG that resembled the Dow Jones industrial average over the last 10 years (not pictured). The normal pattern of an EKG was completely disrupted: ST segments were markedly elevated, P waves were hidden, and beats were grouped in odd patterns. My medical team laughed and shook their heads.
I asked why.
A brave intern responded that he was completely at a …
In a piece from Newsweek (via Bryan Vartabedian), Yale emergency physician Christopher Moore details a common scenario: should he order a CT scan in an asymptomatic 15-year old who was hit in the back of the head while playing soccer?
Dr. Moore encapsulates his thought process: “In a case like this, evidence shows the chance of a life-threatening injury is vanishingly small. …
If getting sick weren’t so miserable, I’m sure more can appreciate the beauty of this video.
MedGadget points us to this NPR piece featuring Xvivo, a company that produces impressive medical and scientific animations. This one shows us how viruses infect cells and reproduce themselves.
Getting interrupted while in the doctor’s office can be annoying, both for the patient and physician.
In an essay in The New York Times, pediatrician Rahul Parikh notes that, in an average primary care office visit, doctors were interrupted twice. And in the ER, “emergency room doctors experienced an average of 10 interruptions an hour, compared with 4 an hour for primary care doctors.”
I am willing to bet that patients do not know that the medical community talks formally about “The Difficult Patient”. Courses are taught on how to handle these patients and there is even an ethics study on Medscape about it. So what is the difficult patient?
Every practice encounters them and they come in many varieties. They are the patients who abuse the staff, miss appointments repeatedly, “lose” …
One of the consequences of capping resident work-hours is increasing the frequency of patient hand-offs.
In a recent column in The New York Times, surgeon Pauline Chen cites a somewhat frightening statistic that during a course of a typical 5-day hospitalization, patients “are passed between doctors an average of 15 times.”
And residents sign over patients several hundred times during the first few weeks of training.
Amy Tuteur calls sexual exploitation “the most egregious violation of professional conduct that any obstetrician-gynecologist can commit.”
And in that context, she details an interesting scenario brewing in California. Stuart Fischbein is an obstetrician that’s widely hailed in homebirth circles, writing a book and being a foremost advocate of homebirths.
Unfortunately for him, he also exercised some poor judgment, as detailed in this newspaper report:
Recently I was on a canoe trip in Ontario, Canada with a close friend. As he and I were portaging our gear and canoe between two lakes I was thinking that the uphill path was difficult and wondered how many more steps it would take. The sooner it was done the better.
I often find myself counting steps during my daily activities as I know that the fewer physical steps it …
There are two important characteristics. The first is clinical skill: the ability to find a pattern in the patient’s signs and symptoms, the ability to identify the pattern, and the judicious use of medical tests to fill in the blanks of the pattern. The second characteristic is compassion: the ability to care about the patient and empathize with his or her situation.
The August 17, 2009 issue of TIME magazine ran a cover story entitled “The Myth About Exercise” with a subtitle claiming it won’t make you lose weight. The author of the article cherry picked bits of data from several scientific studies to make the case that exercise won’t help with weight loss, and might even lead to weight gain by causing people to eat more.
1. I acknowledge and believe that I will die someday. Everyone I love will also die. That inevitable outcome will be factored into all my personal health care decisions.
2. I acknowledge that just because a paid professional might be found to assert that he would have performed differently under similar circumstances, doesn’t mean a doctor or nurse committed malpractice. Judges who are overturned on appeal ought to …
“Every 10 years a doctor should be the patient,” said my doctor, squeezing me into pair of compression stockings that would make a sausage casing seem spacious by comparison.
“Seems like a good idea,” I thought, as I lay there on the table feeling optimistic about the opportunity for first-hand experience.
Long term care is a hot topic. When people talk about long term care, they are generally talking about nursing homes. Policy makers put a lot of attention on nursing homes because they cost so much money. About half of nursing home care is paid out of public dollars. In California, in the setting of our state budget fiasco, the high cost of nursing home care to the state has …
Overweight and obese children who received counseling from a family doctor did not lose more weight or get more exercise than youngsters who did not receive counseling, Melissa Wake, MD, of Royal Children’s Hospital in Melbourne, and colleagues reported online in the British Medical Journal.
Because the screening and counseling are so expensive, …
Bob Hebert, in his column in The New York Times, recently wrote that, “Life in the United States is mind-bogglingly violent. But we should take particular notice of the staggering amounts of violence brought down on the nation’s women and girls each and every day for no other reason than who they are. They are attacked because they are female.”
Missing a diagnosis is, obviously, something both doctors and patients continually want to avoid.
But when it happens, is it completely the doctor’s fault? That’s a question Pauline Chen addresses in a recent column. When it pertains to primary care, it all comes down to followup. She cites a recent study looking at breast cancer diagnoses and found that, “roughly a quarter of patients had experienced process …
