Patients and caregivers writing on KevinMD about illness and the health care system from the other side of the exam table: navigating care, the doctor-patient relationship, being heard, cost, 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 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 pay and who is left out when physicians leave insurance, see Direct primary care: what physicians say, in their own words. For what patients, families, and physicians have said about dying, hospice, and the decisions families face, see End of life: what physicians say, in their own words. For what physicians and family caregivers have said about growing old, dementia, nursing homes, and caring for aging parents, see Aging and dementia: what physicians say, in their own words.
Think of a time when you’ve felt very sick, maybe a case of pneumonia, a bad bout of the flu, or a more serious illness.
You probably didn’t feel much like “engaging” with people. That’s the term health advocates use to describe what patients need to do to be effective in managing their health care.
It’s very hard to act like the CEO of your own body when you’re unbelievably tired, or …
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What would your personal health checklist look like?
I believe that when people are in a crisis situation small things can become magnified; good and bad, and especially in the healthcare field. A perceived small rudeness may just be the tipping point that causes a patient to leave a practice or go to another hospital. On the other hand, a smile, a kind word or gesture can impact someone more than you will ever know and leave a …
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There are no small jobs in any organization
Healthcare innovation companies are just beginning to understand technology challenges that come with engaging patients with chronic diseases in care management and care transition. Many of healthcare IT vendors assumed that a simple access to portals with half-baked information and fragmented medical records will do the trick. Boy… were they wrong!
For the past twenty years, the HIT industry has focused on developing software solutions exclusively for healthcare providers. These companies …
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Without patient participation, there is no patient engagement
Worried about a government takeover of health care?
You should be, but it isn’t the bureaucrats and politicians in Washington that you should be most concerned about. Instead, it is the growing propensity of state legislators to dictate to physicians what they can and can’t say to their patients, what tests they must provide, and what advice they must give to them—the patient’s wishes, the medical evidence, and the physician’s clinical …
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Enough with government interference in the patient-doctor relationship
New York Times columnist Nicholas D. Kristof wrote a heartfelt piece “A Possibly Fatal Mistake” about his college roommate Scott Androes, who recently was diagnosed with metastatic prostate cancer. His story illustrates the problem with the current health care system. It isn’t about the lack of health insurance. It’s about the obstacles all patients face in making the right decisions and the right treatment.
Something that will increasingly be …
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The obstacles patients face in making the right decisions
I have watched more offices over the past few years close their phones and front desk during the lunch hour. If you close your office for an hour at lunchtime, what message are you sending your patients? You are declaring that serving your patients takes a back seat to serving yourself and your employees. Closing your phone lines at lunchtime means that you are creating missed opportunities for a vital …
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Improve patient service: Keep your phones open during lunch hour
I recently took call on the pediatric ward. Our team was caring for a young patient facing a new diagnosis of a chronic illness. In addition to stabilizing her symptoms, coordinating care with her new specialist, and managing her medications, I also see it as our job to make sure she and her family start to understand what is going on and what this diagnosis means for her.
How does this …
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Patient education is often an afterthought

I was driving home from a night shift and the scorching sound of Texas guitars flamed out of my car speakers. The group ZZ Top was old, but the song was new. It went like this, “25 lighters on my dresser, yessir. You know I gotsta get paid.”
Mostly, I was shocked that any members of the band ZZ Top were still alive, …
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An unexpected tip after treating a gang member in the ER
Generic formulations of drugs using active pharmaceutical ingredients are an immense cost savings to patients and healthcare systems.
On the other hand, questions remain as to whether generics are truly equivalent to brand name pharmaceuticals. Are the pharmacokinetics the same? Are they bioequivalent? While this is a difficult topic to research clinically, I would argue that the vast majority of brand name and corresponding generic drugs are indeed equivalent (though there …
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Warn patients that generic pills look different
The Surgeon had been handicapped by a burr in the plantar aspect of his left foot. All summer it had been causing discomfort on jogs, during soccer games, and,eventually, even just walking barefoot across the hardwood floors in the morning. There was something lodged in the thick skin of the strikeplate of his foot— a splinter, a piece of glass, whatever the hell— and it was really starting to cramp …
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Performing surgery is not about empathy
I want to clear up a misunderstanding often voiced in the healthcare blog universe: namely, whether health care is a right or a service. Our answer to this question will affect how we approach healthcare reform in the next Congress, so let me say plainly: health care is a civil right.
Civil rights are what we call those claims necessary to secure free and equal citizenship, secondary to basic rights. For …
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Why health care is a civil right
Have you ever returned home from a visit with your doctor and realized that you forgot to ask the one question that you really wanted an answer to? I certainly have. In fact during a recent visit with my doctor, I had every intention of asking her about a vague symptom that I had been experiencing in recent months. It was on the forefront of my mind, but when I …
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Improve doctor visits by bringing checklists to check ups
If you or someone you love is considering surgery or an intensive treatment, it really pays to be sure you understand the pros and cons.
While that seems like common sense, millions of people say “yes” without learning all the facts.
Some simply rely on the trust they have in their physician. Others assume the known benefits and risks are too complicated to fully understand. And some people just want to get …
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Give patients the pros and cons of treatment options
Most patients I see are surprised to find out that there’s something they should have brought to their doctor’s visit. Granted, I’m an emergency physician, and many of my patients come to me in emergency situations that they can’t plan for. However, most people have some heads-up for going to their doctor. Certainly if you’re going to your annual check-up or a routine appointment, you should bring these items with …
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Preparing for your doctor’s visit: 10 things to always bring
I’ve come to believe that seriously sick people are often subject to some very interesting comments from well-intentioned non-sick people. They are frequently inspired by platitudes from self-help-books, Google chat rooms (heaven forbid), or beliefs that have been around for so long that they are a natural part of common discourse.
To be fair, when we are confronted with the uncomfortable task of talking to a sick person, our conversation can …
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Attitude is half the battle when you’re sick
Most of us have find it challenging to make sense of the wave of information when we enter our cancer journey. This is foreign territory, with its own language, culture and routines. It takes time to absorb and understand.
We are not oncologists or hematologists. However, we can learn to improve our discussion with our medical team.
Build your knowledge. By the time you start your treatment, you will likely have searched the …
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How to strengthen the partnership with your medical team
Because someone rammed her SUV half-head-on into my car, this physician-surgeon has, of late, been a patient at physicians’ offices and outpatient surgical centers; and while medical sights, sounds, and sharp scalpels don’t scare me, one thing I’ve discovered about electronic medical records does. They may not be accurate.
I love my profession. I am a stickler for accuracy, and I like reviewing patient charts. I always secure a copy of …
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Find out whether your electronic medical record is accurate