A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
Thousands of patients undergo surgery every day, but many are unaware how to better ensure a safe and comfortable experience. Too often patients feel like they’re in the passenger’s seat when entering the hospital, even under the best circumstances. When planning to undergo a surgical procedure, with …
Have a safer hospital stay: Use a checklist
The pressure on physicians to provide better care at lower costs is coming from all directions – top down from policymakers who want more accountability in how healthcare resources are being used and bottom up from patients who want more transparency in how their money is being spent. Obstetrician and gynecologists have not been spared any scrutiny. As primary care providers for many women we are in thick of the …
Choosing wisely and delivering value in obstetrics and gynecology
I’ve been interested in apps for the caregivers of elders, but like many physicians, I’ve been too busy to seriously research them or try them out.
Time to change that. No, I’m not going to exhaustively research and review all caregiver apps on the market.
But, as I’ve been invited to give a technology talk to a local group of family caregivers later this summer, I would like to see if I …
Apps to help manage medications in the elderly: What I’m looking for
Kangaroo care (KC) is the practice of skin-to-skin contact with a premature baby and parent. In low and middle-income countries, where there are fewer medical resources, Kangaroo care has been shown to reduce mortality among premature babies and shorten the length of hospital stay.
Kangaroo care is also very beneficial in high-income countries even in the midst of extremely high-tech care.
Holding a premature baby skin-to-skin:
In praise of Kangaroo care for premature infants
A new crop of medical students will begin a residency in plastic surgery this summer. They have worked long and hard to secure these coveted spots. As a service to them and the profession, I wanted to take this opportunity to help make their path a little easier by offering a bit of advice.
When asked what you do, simply say that …
Being a plastic surgeon requires a lot of explaining
It is hard to see a child in pain.
I have seen quite a few children in the emergency departments of South Carolina in the past three years, more than I could have imagined just a while ago.
Now, in the interest of full disclosure, I am not a child psychiatrist by trade. Like any general psychiatrist, my training provided me with didactic …
A psychiatric disorder or a profound lack of discipline in our kids?
I’m lucky, I work for one of the best hospitals in the country and I have access to the best medical care that our society has to offer. With one glitch, that is — when I access that care, my medical records are put into a system that can be viewed by thousands of people, some of whom include my bosses, co-workers, supervisees, neighbors, and even some of my patients.
I …
Why the days of medical privacy are over
What is a natural death, anyway?
I get it – death is part of the cycle of life. Seasons change. The moon waxes and wanes. We are born. We die. Death is natural.
But what is a “natural” death? Seriously, what comes to mind when you think of natural death? Here is a video of a natural death, taken from the Planet Earth series:
Death in nature is often violent, brutal, …
A natural death: What exactly does that mean?
Next in a continuing series.
There’s a reason for the cliche — surgeon barks out the name of an instrument, scrub nurse whacks it into the hand. The reason is this: when you are focused on a particular area — especially if it’s one in which danger lies — you don’t want to look away. If you need to change …
Why surgical instruments are the way they are
Doctors are trying to rationalize our current story line: the loss of autonomy and pay cuts are a necessary evil for the greater good. We’re taking one for the excess-health care cost team. We’re willing to take this personal sacrifice for our fellow man and woman. It is the noble thing to do. It will be good for America’s healthcare system if we do our part, work harder …
The dual narratives that define health reform
As the weather heats up and the allure of grilling returns, it is important to consider some of the potential health risks. One of the great joys of my life is “manning” the grill – beer in hand, wafting smoke rising through the air, a delicious anticipation building. It seems worth the risk of consuming carcinogens present in the smoke …
Grilling with aluminum foil: What are the health risks?
Let me start by saying that I am by no means an expert in medical oncology and I have great respect for what my colleagues in this field are able to do for their patients and their families.
From my earliest days of internal medicine training at the University of Virginia, I can remember the oncologists as being some of the most caring and compassionate physicians around. However, recently I came …
Ask patients if they feel comfortable asking questions
You probably know patients who present with entitled attitudes and you may think there’s not much you can do about them. Entitled patients often demand excessive attention and may question your competence when they are not satisfied with how important you make them feel.
By using one or more of the following approaches, you can manage entitled patients respectfully while reducing your risk of stress and burnout.
1. Be on the same …
Entitled patients: 6 ways to respond
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Physicians are bothered by their patient’s fear. One of the worst parts of actually caring is that when other people suffer and especially when they are frightened, you suffer with them. It is bad when the trepidation is about something real, such as a new disease, but it is particularly disturbing when the source of the fear is confusion or bad information.
There are several common sources of inaccurate terrifying data. …
Looking up health information online: Do you really trust your doctor?
As physicians, we are all privileged to share with our patients the experience of illness, helping to inform and guide. When we as physicians become ill ourselves, we face unique challenges and gain unique insights. This column will explore those dimensions of experience, when doctors become patients.
We recently spoke with Robert S. Brown, MD, FACP, associate professor of medicine at Harvard Medical School and attending nephrologist at Beth Israel Deaconess …
Physicians gain unique insights when they become ill themselves
Below find excerpts of an email sent by a faithful reader. I have included the whole text, but broken it down to respond to each point accordingly.
I have really enjoyed your blog postings and the sensitivity you showed toward patients. But, your new venture is a real turn off, and makes it hard for me to want to read your posts anymore.
I have been waiting for this. Expecting it. I knew …
Responding to patient concerns after changing my practice
When we think of strokes, we imagine older adults. Yet, one out of every 2,800 newborns (under 1-month) suffers a stroke. In children up to 18, it occurs in 11 out of 100,000. I know how serious this can be – my daughter experienced a stroke before birth. The day before she was born, we discovered she had hydrocephalus (water on the brain). When she was a day old, an …
Recognizing the signs and symptoms of stroke in children
“Maybe we shouldn’t urge people to engage in their health care: it sets them up for failure and punishment from their clinicians.”
A senior patient advocate and researcher recently made this comment to a gathering of experts in patient engagement.
For a few minutes, I was inclined to agree with her. I thought back over the previous three months: the passive aggressive (and aggressive-aggressive) responses of some of my clinicians to my …
Does patient engagement set patients up for failure?
A few weeks ago my wife, my son, and I went out for dinner. My son, though usually well-behaved and pleasant, was boisterous and disruptive, alternately leaping off his seat to crawl under the table and banging his silverware on his water glass to see what different volume of sound he could make it produce. Our tolerance for disciplining him patiently having been exhausted in us both by our respective challenging …
Why setting consistent boundaries is important
Autism is a communication disorder where children have difficulty relating to other people. Pediatricians watch for speech delay as a sign of autism. Even before your child is expected to start talking, around a year old, you can watch for communication milestones. Problems attaining these milestones may indicate autism or other disorders such as hearing loss, vision loss, isolated language delay, or other developmental delays.
By six weeks of age, your …
How to know if your baby has autism
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