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.
On July 24, 1998, a psychotic schizophrenic gunman entered a side entrance at the U.S. Capitol. As he approached Rep. John DeLay’s office, he exchanged fire with two Capitol Police officers who later died of their wounds. The gunman was badly wounded as well.
Senator Bill Frist, a cardiologist, was leaving the Capitol when Congressional aides informed him that some men needed urgent medical assistance.
A New York Times article tells …
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Non-judgmental regard can show the best of humanity
In New York, I worked for an organization called Project for Psychiatric Outreach to the Homeless (PPOH). It has a humble history: Over 20 years ago, a group of psychiatrists were sitting around and discussing the need for psychiatric services for the homeless. They decided to volunteer their time and skills to this population.
The organization grew and, for both administrative and financial reasons, eventually became part of another social …
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The fiscal realities of health care are demoralizing
Health care professionals are a cynical lot. We joke about the “fad or buzzword of the month,” usually some vague concept heralded by the powers on high. Our job is to promote the idea, knowing full well that the “next big thing” is probably right around the corner.
Take “patient-centered.” It sure feels like a buzz word. I suspect most hospital and physician executives, and their ad agency partners, …
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Why hospitals and physicians should get serious about patient-centered care
I remember when my best friend was in the hospital thirty years ago and I brought her 3 year old daughter to visit. My friend could not speak. She could only blink one eye and was paralyzed on one side. How she was able to communicate was through the blink of her one eye. I felt her energy of wanting to spend time with those she loved. It was Christmastime …
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Compassionate care is a crucial component of care
The wards had an odd sanguine feeling that day. The large glass pane doors were streaming a glow from the summer outside, and all was right because I had actually managed to have a lunch break. The High Care Ward is where the most intense monitoring is done so that we doctors can observe suffering in slow motion. I can’t remember what brought me there but in the first bed …
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I wish House, MD was here
Marcie transitioned to my care when she turned sixteen. She felt too grown up now to be in the same waiting room with “kids” at the children’s clinic. But she wasn’t doing well.
Her pediatrician had suspected the problem shortly after birth. She wasn’t growing normally, had nasal congestion, and more respiratory infections than usual. A sweat chloride test was ordered which was positive. The diagnosis was cystic fibrosis (CF). The …
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Discussing end of life issues with a teenager
During my transition from public to private health, I have indeed noticed some interesting differences that have forced me to practice medicine a perhaps a tad differently. One big surprise: in private health, I have to admit that I have been pretty astounded to see that my patients quite heavily rely on the Internet before they even come to see me for their given ailments.
In public health, some of my …
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5 tips to evaluate medical websites
In May of 2001, I got sick with what the doctors thought was an acute viral infection. But I didn’t recover. As the months went by and I didn’t get better, I felt as if I’d entered a parallel universe that I didn’t know existed. One reason this universe is largely invisible is that many people living with chronic pain or illness don’t look any different from those around …
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The challenges of living with invisible pain or illness
Cancer screening has always been an emotional topic.
In recent years, both prostate and breast cancer screening have come under increasing scrutiny. Studies are beginning to question the benefits of early detection, and, in the case of prostate cancer screening, whether more harm is done than good.
In fact, the USPSTF recently downgraded their prostate cancer screening recommendation.
In a recent study from …
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The power of gut feeling in cancer screening
Three young mothers under the age of 40 are dead because they wanted to be beautiful. Kellee Lee-Howard wanted a slimmer body. Ditto Maria Shortall and Rohie Kah-Orukatan. Shortall worked as a housekeeper; Lee-Howard was the mother of six kids and Kah-Orukotan died at the same place where she received manicures. What do these women have in common besides being minorities? They had liposuction procedures performed by men who offered …
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Physicians who cash in on a woman’s desire to be beautiful
“By the time you see the doctor, you’re either dead or you’re better,” my mother-in-law told me. She had to have multiple tests, all with long waits to get the appointments and the results, before her health insurer would allow her to make an appointment with a specialist.
“Waiting is the bane of the medical system,” a former student, an R.N., concurred. Advances in medicine and technology have improved medical outcomes, …
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Waiting is the bane of the medical system
Everyone wishes they had baby skin. It feels so soft and smooth; it’s perfectly adapted to induce us adults to want to clean their diaper, no matter how many times they dirty them. Like their big eyes and cute noses, baby skin it part of the whole package of being adorable. But like their eyes, their skin, however beautiful, is immature. Baby skin is thinner, has less natural moisturizers and …
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How to protect baby skin during summer
I was thinking about food labels recently as I scanned yet another new food product at the grocery store. It’s become something of a hobby. “Oh, second ingredient evaporated cane juice (AKA sugar) and then at the end ‘natural’ (my quotation marks) flavors.” The verdict: processed food. I don’t need to know any more than that. Don’t care about calories or fat grams or the other things we have been …
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Sugar matters when reading food labels
Every once in a while, I come across a new concept or technology application that really captures my imagination.
This was the case when I became aware of an enterprise whose core business is patient-physician communication.
What patients actually say to their physicians — and what physicians actually say to their patients — is largely unknown.
A company called Verilogue ventured into this previously uncharted territory and began to audio record patient-physician interactions.
To …
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What patients actually say to their physicians is largely unknown
For the last 3 weeks, I’ve been working as a sub-intern on the family practice inpatient service in one of the local hospitals. It’s been quite a time! I’ve sure been kept busy, but learning a lot and seeing a lot. With a moment of downtime, I wanted to share a reflection I had yesterday.
We’re all familiar with the glamorous “saves” in medicine. It’s the car accident victim that undergoes …
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I do what I know is harmful for my body
“I don’t need no doctor ’cause I know what’s ailing me.
He gave me a medicated lotion
But it didn’t soothe my emotion.”
-John Mayer
If someone asked you to draw your image of medicine, what would you sketch? Would it be a person wearing a long white coat with a stethoscope? Would your picture be set in a hospital room, the ER, or the office setting? Would there be any patients in your …
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What does your personal image of medicine look like?
Never in recorded history have Americans been more distrustful of how the U.S. government spends its money. According to Gallup poll, Americans on average say that the federal government wastes 51 cents of every tax dollar, the highest level ever recorded since the poll was first taken in 1979. DTC marketers should understand that this mistrust is also leading to mistrust of marketing and advertising as well as big …
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How can pharma earn the trust of patients?
The doctor/patient relationship is certainly changing and evolving. A term I hear a lot today is: “patient engagement/activation.” Why is this concept so important and what does it mean? What can physician executives do to make it easier for our patients to become engaged and activated?
Judith Hibbard has pioneered the study of patient engagement, and she noted that one needs knowledge, skills, and emotional support to actively engage in one’s …
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Physicians should embrace patient engagement
It’s never so obvious to me that there’s a big essential difference between men and women as when we take a family trip to Target.
First, when you’re holding a small baby or even an older baby or even a preschooler, you get a lot of attention. People love to look at small babies. And by “people,” I mean “women” only. When I walk around with the baby, women are constantly …
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The difference between male and female patients
Running a medical blog has become much more challenging over the years. It has always been understood by medical and health care bloggers that you should never post information that violates a patient’s privacy. In other words, do not post patient’s names, photographs of patients, or any other information that can specifically be used to identify them.
However, changing patient demographics and limiting the information discussed such that the patient …
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The limitation of blogging about patients
