A patient turns down hypertension treatment. What happens next is tragic.

Physician
October 8, 2015

I have previously written about a patient on this site: “How elderly patients can be stubborn to their own detriment.” In that post, I discussed how the patient repeatedly turned down appropriate therapy for her hypertension, saying she didn’t need the help.  Now I’m writing an update.

Due to the patient’s refusal to accept treatment for her hypertension, despite counseling on the part of her cardiologist and primary care …

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A patient turns down hypertension treatment. What happens next is tragic.

4 tips to better communicate with patients

Physician
May 9, 2013

I was listening to CBS This Morning recently as they were interviewing Alan Alda. He was discussing his acting career and being the host of Scientific American’s Frontiers (airs on PBS stations). Alan Alda relayed a personal story of his, having an intestinal blockage while he was filming an episode in Chile.

As he relayed this incident, he spoke of the physician who told him that he was going to remove the …

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4 tips to better communicate with patients

Let physician assistants be part of the primary care answer

Physician
December 19, 2011

There has been so much change in medicine, physicians are leaving primary care, and new ideas are being bantered about such as patient centered medical homes (PCMH) and accountable care organizations (ACO), in an attempt to try to address the problem.   To add to this strain, is the knowledge that medicine is going to have to be ready to absorb thousands of additional patients in the near future …

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Let physician assistants be part of the primary care answer

The culture of medicine needs to change

Physician
November 23, 2011

I’ve been involved in clinical medicine for more than 20 years and during this time I’ve come across numerous situations that created stress, or emotional upheaval within myself, and even times of burnout.  At one point, I came close to permanently leaving my chosen profession.  The culture of medicine is not geared towards allowing health care providers to de-stress, acquire emotional support, or discuss in an encouraging environment various conflictive …

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The culture of medicine needs to change

Let’s stop degree creep in health care

Physician
November 8, 2011

How long ago was it that we were all content with having the physician have a MD or DO title after their name, the clinic or hospital floor nurse having a RN after her name, the pharmacist having RPh after their name?

Now unless the pharmacist has PharmD after their name they can’t be a pharmacist.  And for the nurse, unless they have RN, BSN or RN, MSN after their name …

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Let’s stop degree creep in health care

What happened to the art of medicine?

Physician
November 2, 2011

During our medical training we are taught to use evidence based medicine.  This means using the most up to date scientific research data that has been analyzed and accepted as fact.  But does this mean every patient we see fits into the evidence based medicine algorithm that we have been taught to use?

I hope not.  For this would mean we would only be following half of medicine.  The art of …

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What happened to the art of medicine?

Patients have a part to play in their own medical care

Patient
October 2, 2011

Medicine has changed so much over the past years,   I look back even to when I finished my program and in the mere 20 years since I finished, medicine has changed dramatically.  I can remember when I was a student, seeing a patient with rheumatoid arthritis and advising her that the best treatment we could give her was a DMARD.  Now we have multiple monoclonal antibodies that not only …

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Patients have a part to play in their own medical care

Kids and their fascination with foreign objects

Patient
September 21, 2011

Kids will swallow or poke up their noses, or into their ears the strangest things.  I remember during my student days,  I was doing a rotation in pediatrics when a 6 year old came into see us.  I went in to take the history and her mom told me that her daughter had a very pungent odor to her, which she couldn’t get rid of.

I examined the patient and …

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Kids and their fascination with foreign objects

How elderly patients can be stubborn to their own detriment

Patient
September 11, 2011

The elderly population can be fun to take care of (they have more stories than you have time to hear), or they can be a handful in regards to all of their chronic complaints and numerous medications. But then, there are those senior citizens that come into clinic and tell us, “I don’t need to take medications, I haven’t taken medications my whole life, and look at where it’s …

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How elderly patients can be stubborn to their own detriment

Intuition saved this patient from a potentially fatal diagnosis

Conditions
August 27, 2011

I was working in a rural health clinic when I went into to see a new patient.  Amy was 18 years old, with her 6 day old newborn son by her side.

I introduced myself and then asked, “what brings you into the clinic?”

Amy responded, “Shortly after giving birth, I started having problems with shortness of breath, ankle swelling, and high blood pressure.  I told the OB residents and they brushed …

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Intuition saved this patient from a potentially fatal diagnosis

Take the effort to reach across cultural and language barriers

Patient
August 22, 2011

I was working in an urgent care clinic when I walked into the exam room to see my next patient. He was a six-year old who primarily spoke Spanish, with some broken English. Jose’s mom was with him, she only spoke Spanish.

I sat down and picked up the phone receiver to contact our translator service. With the Spanish interpreter on the line I was able to proceed. I then asked …

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Take the effort to reach across cultural and language barriers

Without wives, men’s health suffers

Patient
August 18, 2011

I was working as a PA in an internal medicine office seeing patients.  One afternoon, I was in the clinic hallway when I saw an elderly looking wife in her 60s actually pushing her husband into the next exam room.  He had his heels dug into the floor, but she was winning, due to his obvious shortness of breath and audible wheezing.

I walked in behind the medical assistant who …

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Without wives, men’s health suffers

Taking the time to answer patient questions

Physician
August 15, 2011

I was working in the bone marrow transplant clinic of an internationally known cancer center.  When I looked into the patient’s faces,  I saw hope as they were being worked up for a possible transplant.

I went into see a new patient.  She had leukemia and had relapsed after her remission.  Her sister would be the donor.

Gretchen, age 19 came in with her mom for the appointment.  She was tall, youthful …

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Taking the time to answer patient questions