In an age where technology dominates our medical world, communication between patient and doctor often leave me wanting. Over the last few years as a patient, I have learned a number of strategies to help bridge the communication gap with doctors.
For patients:
Speak up. Nobody likes confrontation, but it doesn’t have to be an argument if you are calm and respectful with your …
5 ways to bridge the communications gap with doctors
The continued implementation of the Affordable Care Act (ACA) in 2014 will be as controversial as in previous years.
Here are five main areas of concern:
1. The individual mandate. By what right does the federal government “force” its citizens to buy a product they may not want? The Supreme Court upheld the mandate in 2012, but that does not end the matter. Partly — perhaps largely — because the ACA sets …
5 controversies surrounding the Affordable Care Act
I would like to explain why Michael Kirsch’s article, “Why the ER admits too many patients,” is wrong, in all the myriad ways, in his contention that emergency physicians (EPs) admit too many patients because of improper motivations. Note that I am not going to argue that EPs don’t admit too many patients — that’s a legitimate discussion to have and there may be some merit …
The truth about admissions from the emergency department
“Here you go, doctor.”
My patient with incredibly well-controlled type 2 diabetes hands me his fingerstick log at his regularly scheduled office visit. Despite his multiple medical problems (congestive heart failure, coronary artery disease, chronic renal insufficiency, and gout, among others) his sugars have been incredibly well-controlled over the past several years.
Page after page of scrawled numbers, tiny smears of his blood on the pages, his fingersticks range from 90 to …
When is too much data a bad thing?
“Get the suits out of medicine.”
This refrain has become commonplace among physicians, who worry that patient care, the essence of medicine, is increasingly taking a backseat to bureaucratic demands on safety metrics and electronics health records as well as corporate measures of efficiency. Without physicians, after all, there is no health care system for administrators to administrate, they say. Not only do top-down regulations make patient care more cumbersome, they …
Is medicine for the suits or the white coats?
As we behold the continued wonders of Obamacare, we receive another reminder of the president’s empty promise: “If you like your doctor, you can keep your doctor.” The New York Times observed, “No matter what kind of health plan consumers choose, they will find fewer doctors and hospitals in their network — or pay much more for the privilege of going to any provider …
Walter White and the narrow networks of Obamacare
Red wine is good for you. Red wine is bad for you. News coverage of health studies can give readers cognitive whiplash, and for good reason.
“The reason the stories contradict each other is because the studies contradict each other,” reporter Virginia Hughes wrote in her blog.
In her post, Hughes explains why it can be so frustrating to write about complex health research for an audience of …
Responsible public relations for health study findings
Health care is but one element of what makes the biggest difference in health outcomes: Social factors play a far more significant role. Income and its distribution, education, employment, social supports, housing, nutrition, and the wider environment — what we have come to know as the social determinants of health — are the most powerful predictors of wellness and longevity. This has been understood for centuries, and empirically validated in …
Health has to go beyond health care
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 32-year-old woman is evaluated for a 6-month history of nonproductive cough. She has no history of recurrent upper respiratory tract infections and has never smoked cigarettes. She has no fever, dyspnea on exertion, hemoptysis, heartburn, or wheezing. She has worked in the same office for 7 years and has lived in …
MKSAP: 32-year-old woman with nonproductive cough
“I don’t like taking medicines.”
All physicians hear some form of this opinion very frequently. Even more frequently, patients don’t state this view outright but rely on it to completely subvert their doctor’s plans.
When I was new to practice such an utterance would shock and confuse me.
“I don’t want to take any medicines,” a patient would declare.
“That’s fine,” I would reassure my interlocutor. “It’s a free country. No one is going …
The problem with an anti-medication bias
Every player in the medical arena has found itself challenged by conflicts where one’s self-interest competes can skew what should be pure advice. This issue is not restricted to the medical universe. Every one of us has to navigate through similar circumstances throughout the journey of life. If an attorney, for example, is paid by the hour, then there is an incentive for the legal task to take longer than …
Why the ER admits too many patients
Medicine is becoming mobile. Physicians, nurses and other health care providers must be able to quickly assimilate and react to an overwhelming stream of data. Tablet technologies, such as the iPad, have been incorporated into the workflows of many clinics, emergency rooms and hospitals. Medical schools and residency programs are quickly adapting the technology for teaching. While tablets do present some …
For physicians, the applications of tablets are endless
CNET and others have published a story that Nike has fired as many as 55 people from its digital sports team’s hardware division, which is in charge of the FuelBand.
Later that evening, Nike tried to run damage control by putting out an official statement to Re/code that they will continue to support and sell the Nike FuelBand SE, despite the downsizing.
Rumors …
Nike abandons the FuelBand: What does this mean for wearables?
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There’s a war being waged on one of America’s most revered institutions, the emergency room. The ER, or emergency department (ED for the sake of this post) has been the subject of at least a dozen prime-time TV shows.
What’s not to love about a place where both Doogie Houser and George Clooney worked?
Every new parent in the world knows three different ways to get to the closest ED. It’s the …
Stop the war being waged in the emergency department
For the past couple of years I’ve been working as a traveling physician in 13 states across the U.S. I chose to adopt the locum tenens lifestyle because I enjoy the challenge of working with diverse teams of peers and patient populations. I believe that this kind of work makes me a better doctor, as I am exposed to the widest possible array of technology, specialist experience, and diagnostic (and logistical) conundrums. …
What is the source of deteriorating patient care?
A PubMed query of the phrase “social media” yields 8,747 unique peer-reviewed articles. When the search is refined to “social media medical education” there are 578 articles. When “professionalism” is also added to the search string, there are only 31 article results. This suggests that very few authors are writing about the topic: Approximately 0.4% of the available peer-reviewed literature about social media pertains to how we doctors should use and …
More medical academic literature is needed on social media
When we moved to Irving, TX and I decided to join a practice in nearby Lewisville, I realized I wanted to know more about the schools in the area and get a feel for the culture of the teachers that would be teaching my patients and kids. I searched online and found great and encouraging information about Carrollton-Farmers Branch, Irving and Lewisville school districts. I also looked up several teachers …
What would a flipped checkup look like?
Thousands of health care providers now utilize Twitter and other social media as a means of communicating and staying in touch. We follow conference hashtags from afar to keep up-to-date, and to e-meet new and interesting people who share a common goal. In this way, we are able to grow our networks, foster our relevance, improve our knowledge base, and reach out to assist others.
Whether we are physicians, nurses, or physical …
Use social media to help clear health misinformation
Antibiotic use is the direct cause of the rise of untreatable superbugs that are killing people.
Antibiotic use is also the cause of most cases of C. diff colitis in kids, a potentially life-threatening, difficult-to-treat gut disorder. Antibiotics have also been linked with recurrent wheezing in infants and inflammatory bowel disease. They can also trigger allergic reactions that can be …
Find yourself a physician who is stingy with prescriptions
In a recent blog post, I described a cultural shift involving the use of smartphones at Jacobi Medical Center, a large, acute-care hospital that’s part of New York City’s public hospital system. When research from an Einstein-Jacobi study demonstrated that smartphone use during inpatient attending rounds can lead to distraction, our hospital instituted a “smartphone policy” in the departments of medicine and …
How do millennials react to smartphone policies on rounds?
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