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.
There has not been a more horrific scandal in the world of sports that I can remember than the child abuse scandal surrounding Pennsylvania State University.
Let it be said that I am very impressed with the reaction of much of the student body which is one of shock and disdain for the administration charged with covering up alleged abuses of children by a former assistant football coach. According to the …
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How mobile health can help child abuse victims
These days, it is not uncommon for people to need to find a new doctor. The most common reasons include a) moving to a new city, b) dissatisfaction with your former doctor, c) your old doctor no longer accepts your new or old insurance, or d) you were diagnosed with a new medical condition and need specialized treatment.
Often, people go to their insurance company website or provider book, search for …
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Useful tips when looking for a new doctor
The fact that Amber Miller did not fall or faint or develop complications while running in the Chicago Marathon is nothing short of a miracle. An ounce of prevention is worth a pound of cure. What on earth was her physician thinking when she was given the green light to half-run half-walk a 26.2 mile marathon? Miller was not your usual runner; she was approximately 39 weeks pregnant.
Although pregnant women …
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Running a marathon when pregnant
No matter how quickly you tried to switch the television channel lately, you probably couldn’t escape the trial of Dr. Conrad Murray or avoid hearing about propofol, an anesthesia drug that can be fatally easy to use.
What you may not have heard is that the American people just dodged a serious threat to their anesthesia care, and most don’t know how near a miss it was.
The Centers for Medicare and …
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Unsupervised anesthesia care by a nurse anesthetist is a threat to patient safety
Today, during my psychiatry rotation, a very grateful patient confronted my attending and thanked him profusely for saving him. The patient had been severely depressed and was at his wit’s end before they met. The doctor listened to him, analyzed his situation, and came up with a plan to help which included involving the patient’ family as well as using proper medication. The patient had a great response to this …
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The hesitation before shaking a patient’s hand in the hospital
I was at the Walter Reed National Medical Center where I get medical care as a retired naval officer, and decided to use my time between medical appointments to get a much needed haircut. I walked into the barber shop, took a number, and sat down to await my turn. The three chairs were occupied by young men getting haircuts. Their chests and lower bodies were covered with long blue aprons to protect them from the …
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A cancer survivor’s perspective on wounded warriors
I’ve been talking via email with my stepsister, Lori, whose teenage daughter has Asperger’s Syndrome. Our online conversation was mostly about the highs and lows of raising her neuro-diverse daughter and she shared with me many of the gifts that come along with having a special needs child.
Then, one day, this was the message in my inbox: “Today is a day in the trenches! It’s a battle and I’m bawling …
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Your worst days can bring out your best resiliency skills
Adolescence is filled with challenges – at school, at home, with friends, on stage and in sports. Even their own body betrays them from time to time. Acne, hair, changing bodies and voices, parents, siblings and friends are all possible sources of gut-wrenching shame for a normal teen. Parents of teens have challenges too – and high on the list is the challenge of talking about important topics like sex, …
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How to talk with your teen about marijuana
“I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life – well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.
But then I read what killed me: ‘serious complications following minor surgery.’
Now what the heck …
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A few more minutes with Andy Rooney
Cardiologist Dr. Richard Fogoros has issued this blunt warning to those at risk for developing heart disease: “You need to change your life. If you don’t, you will suffer the consequences – possibly decades earlier than is necessary.”
In his Heart Health Center column, he observed that most high-risk people end up making only half-hearted efforts to modify their heart attack risk. And he blamed doctors for enabling this lack of …
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What patients with heart disease need to learn from cancer patients
Firefighters are heroes because they run into a burning building. They run towards a fire, risking their lives to save others. No one would doubt that they are heroic, but most will wonder how this is even possible. How is it that some people can ignore our innate drives to survive to instead, help others do just that?
Doctors are not typically equated with this type of heroic measure, we give …
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The stigma of HIV continues today
I recently sat by a man whose young wife was dying. Her cancer was taking her away from her husband and toddler. She was sleeping intermittently as the pain medication we administered did its work. Her husband’s eyes were red from crying and he could barely suppress a sob. He touched her and looked at me. I barely kept my own composure.
I wanted to avoid that room and that patient. …
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Medicine introduces us to loss early in life
The milestone of the world’s population reaching 7 billion is a fitting time to reflect upon life expectancy. Life expectancy is a rough marker of humanity and medicine’s progress in the age-old battle to attain old age.
Those born in the US this year are expected to live until 78.37 years of age if current mortality rates persist. This puts us at a sobering 50th in the world.
How long is someone …
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Life expectancy is a simple number with immense ramifications
I’ve had irritable bowel syndrome for 20 years, and I’m angry. About the pain, and the suffering, and the limited diet, and the huge impact that it has had on my life. But mostly, I’m angry at my doctors. No, they didn’t misdiagnose me. No, they didn’t harm me. No, they didn’t treat me like dirt. But they still made me angry.
Before we go any further, let’s get one thing straight: I know …
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Why patients with irritable bowel syndrome are angry at their doctors
I am a writer as well as a doctor. My heroes are Keats, Chekhov, Williams, Coulehan, Coles, and other physician writers. And those greats of medicine too, known and unknown, who have spent their lives caring for people.
My writing is short. Really short. If it isn’t poetry, it scans like poetry. And one act plays. As in The Ride, my latest collection. Someone said if you can’t write poetry, you …
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Lives focused through the lens of medicine will burn your eyes
When patients are sick enough to require hospitalization, medical decisions often involve nontrivial tradeoffs between risks and benefits. They require discussions with patients and families from a variety of cultures and backgrounds. And sometimes these discussions break down.
Patient-clinician communication is increasingly recognized as an integral part of clinician competency. Indeed, family-centered rounding, increasingly practiced at Children’s Hospital Boston, is a critical step in this direction. Fully adopting this practice surely …
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Including communication as a system in work rounds
The longer I continue in practice, the more complex it becomes. I thought advances in our understanding of the molecular basis of cancer would clarify decision making; instead answers have led to more questions. In the spirit of the immortal Henny Youngman: Take the issue of cancer screening, please.
The story of screening for colorectal cancer (CRC) and prostate cancer has many similarities. The primary screening and diagnostic tool during my …
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Why more cancer screening may not be productive
I see my oncologist for my twice-yearly checkup tomorrow, and while my visits have been blissfully mundane over the last three years, this time I actually have a list of questions and a couple of concerns over the lab results from my latest physical. It’s probably nothing, but once you’ve had cancer you can’t help but wonder which “nothing” is actually the edge of trouble’s long shadow. My family doctor sees no cause for …
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No act of kindness is ever wasted
During my time at PPOH, I spent one day a week working at a geriatric adult home.
An adult home is a residence that generally houses people with psychiatric conditions. They can be run by either public or private agencies. At best, they provide services and supports for the residents so they can live independently. At worst, they provide very little other than shelter; they just take people’s money. (The latter has …
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Learning from patients at a geriatric adult home
Medicare is beginning to tie financial bonuses to hospital patient satisfaction scores.
