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.
Humans have invented tools to solve problems for themselves since day one. We need to bang something into the ground. That rock over there will work. We need to communicate with one another over a distance. Hey, how about some smoke signals?
The social web is just another tool to solve our communication problems in addition to smoke signals and the telephone. It’s absolutely wonderful at spreading new ideas, new being …
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The problem with social media and health
Last year, I was referred to two different dermatologists because I have two skin conditions and each dermatologist is an expert on one of them. (I know how fortunate I am to have access to this level of medical care.) Something amusing happened at each visit.
After examining me and deciding on a course of treatment, the first dermatologist said, “When you get home, don’t look up this condition on the …
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Tips for your online health information search
When dealing with patients and families coping with life threatening illness, one of a physician’s greatest interventions may be that of empathy. Defined simply, empathy is the responsiveness to the emotional state of another person—we try to understand another’s experience. It is a process that requires effort and intention. Sympathy is an awareness of another person’s situation and is an almost “autonomic” type response. Sympathy is important and is part …
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Empathy should be the basis of patient care
Your doctor’s exam room is getting overcrowded. Modern US health care means that, like it or not, you and your physician are sharing that once private space with an insurance executive constantly hissing in your doctor’s ears to move it along. You are also sharing it with pharmaceutical marketers, lobbyists from the food industry … special interest groups of every stripe.
Now move over and make room for one more interested …
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How political agendas erode the doctor-patient relationship
The manner in which a physician communicates information to a patient is as important as the information being communicated. Patients who understand their doctors are more likely to acknowledge health problems, understand their treatment options, modify their behavior accordingly, and follow their medication schedules. In fact, research has shown that effective patient-physician communication can improve a patient’s health as quantifiably as many drugs—perhaps providing a partial explanation for the powerful placebo …
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Essential patient communication tips for physicians
It’s always amazing to me how quick folks can be to offer advice. Unwanted advice. Medical advice. Near strangers jump at the chance to give input without a second thought. Isn’t everyone quick to judge a doctor they’ve never met, particularly when the doctor is treating something they’ve never even heard of? What does this say about me? When someone does this to me, they are basically telling me that …
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How dare strangers tell me to ditch my doctor
Ever been put on hold when calling your insurance carrier? Or had so little time with your physician that you could not discuss everything you thought was important?
Our care is generally good in the United States but not as good as it could be nor as good as it should be. There are multiple problems to consider.
First, ours is a medical care system not a health care system. It is …
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Patients are not the customer
As are many clergy, I am a pastor who is deeply involved in the medical lives of many of my parishioners. Because of what I have seen, particularly but not exclusively with end-of-life issues, I found myself increasingly averse to engaging the medical system for my own health needs.
However, I could no longer ignore some troubling symptoms. With trepidation, I ventured in.
I have been referred by my primary care physician …
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The vulnerability of patients needs to be respected and honored
Primary care physicians are the point of first contact that people like you and I have with a hospital or health systems. We are 13 times more likely to visit a primary care physician in any given year than we are to need a hospital stay.
Primary care physicians are very important. Yes they are they the first line of care for many people. The primary care physician’s office …
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The medical exam wasn’t designed to engage patients
To have cancer is to change forever. It is a devastating declaration. Each of us copes with the diagnosis differently. How people adjust and move on with their lives are lessons in humanity.
I take care of a patient who explained to me how he deals with incurable cancer. Stan is active and able to enjoy grandchildren, friends and hobbies. He describes himself as happy, despite his terminal diagnosis. The key …
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To survive with cancer, you need to accept that you are going to die
Everyone who knows a person with chronic pain is aware that it comes with a huge price on quality of life, but indeed chronic pain also have a heavy economic price for the society in general. A price we might be able to reduce by awareness and intervention for those who need it and especially for those who need it most.
The size of the economic burden is of cause different …
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Chronic pain has a price
Recently, my mother died.
She was giving, kind, funny and would do anything in her power to help those who needed her. As a single parent divorced from a drug addict, she was all that I ever truly had in the realm of parenting and, as a result, she was everything to me. And she touched and was loved by so, so many people. She also had asthma and, most years, …
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My mother fell through the cracks of the system and died
A while back, my brother-in-law was experiencing low back pain and my sister told me that the doctor had diagnosed it as a “herniated disc.” The conversation eventually evolved into a discussion about the difference between a “herniated” disc and a “ruptured” disc. My position was that ruptured was worse; my sister’s that they were the same thing. Since inquiring minds want to know these things, I decided to look …
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Shared language between doctors and patients
For the past month, the case of Amanda Trujillo has resonated deeply among nurses, triggering an avalanche of postings on Facebook, Twitter and in the nursing blogosphere. Trujillo is the Arizona nurse who was fired in April 2011 after providing education and making a hospice care consult request for an end-stage liver disease patient. This patient was slotted for pre-transplant evaluation …
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Why physicians should care about Amanda Trujillo
You would think that for doctors, who work with life and death issues every day, the issues of our own frailties or the tenuous line between health and sickness for our own families would be, if not accentuated, then at least more immediate than to those who, say, do investment banking for a living. But the strange thing is that despite our easy familiarity with human mortality, it is not …
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Why maintaining a distance is necessary for doctors
A recent article in the Wall Street Journal is getting a lot of attention: More Doctors ‘Fire’ Vaccine Refusers. The article discussing the increasing frequency of pediatricians who are “firing” patients/families from their practices because they refuse to take recommended vaccines for fear of autism or other concerns (rampant on the internet, but all proven untrue).
It is important to note that not only should physicians be able to fire patients, …
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Why doctors should be allowed to fire patients
I first realized something was amiss when I picked up my prescriptions and the pharmacist explained that she could not fill the anti-malarial medications as prescribed: “Your medication plan only pays for 30 days of pills, and your prescription was for five pills.” The pharmacist continued: “Your PBM [that’s an acronym for pharmacy benefits management company, the type of company that coordinates many peoples’ medication coverage] only fills this medication …
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Should doctors talk about the cost of drugs with their patients?
It is said that “turn around is fair play.”
So if providers (physicians, hospitals and other health care professionals) expect patients to become more engaged in their own care, isn’t it fair for patients to expect their physicians to also get more involved in their care?
If you look closely at “proxy measures” for physician engagement, you will see that this is a legitimate if not equally important line of inquiry.
Hello? Hello? …
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Why patient engagement is reciprocal
