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.
Each year, biologically based disorders of brain development – autism, attention deficit/hyperactivity disorder (ADHD), mental retardation, dyslexia, and subclinical neurodevelopmental disabilities – affect between 400,000 and 600,000 of the four million babies born in the United States. This means that between 10% and 15% of American children have some kind of learning disability.
Reported rates of autism spectrum disorder (ASD) are sharply increasing. The CDC reports that the rates of ASD increased …
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How environmental exposures can contribute to autism and ADHD
My family, my friends and my patients think being selfish is bad. I bet you do, too. I used to think so, as well. Twenty seven years in practice has taught that being selfish is good. Actually, selfishness is essential to an individual’s health.
Today, I saw a selfless young woman who was ill. She had an assortment of complaints. She had not felt well in months. If she was the …
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Taking care of yourself sometimes means being selfish
“Be a fountain not a drain,” an expression used by baseball announcer Rex Hudler, is one that has motivational content particularly in terms of an individual included as part of a team.
I would suggest that this expression would be appropriate when considering a basic team in medical practice: the doctor-patient relationship. It is critical in most clinical situations that both the doctor and the patient assume responsibility for making …
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Patients need to contribute to help their doctors
Occasionally, my vocation of treating obesity and my avocation of health care social media intersect.
This is one of those moments. This is the story of a health care social media betrayal in which obese children and e-patients are the victims. Nobody died, except medical ethics, good judgment, and trust in doctors. This is WebMD’s Health Care Social Media Disaster.
Recently, WebMD published the following “advertorial” from Kellogg’s: “Mums, kids & breakfast: The …
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Sponsored content on health sites can mislead patients
Though I had a less than comfortable childhood, I did not know what I missed in nurturing until I played football at around age 10. The coach, a big burly man, with a voice as huge as his girth, put his hand on my shoulder as he explained something to the team.
I have never been able to explain the feeling that went through me that day, that moment, like a …
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The art of medicine and the power of human touch
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
Regret is a harmful emotion. Regrets are best avoided. Its one thing to regret buying a stock that plummets. It’s another to regret that you ever smoked because your chest x-ray shows a large tumor.
People often don’t appreciate what they have until they’ve lost it. When you’ve lost your health, you will regret its loss for the rest of your (shortened) life. Imagine that you were supposed to take your …
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Regrets after patients have lost their health
Despite this culture’s obsession with good health, people get sick.
This piece is based on a story I tell in my book.
In 2001, I got sick with what the doctors initially thought was an acute viral infection. I have yet to recover. Diagnosis: Chronic Fatigue Syndrome—a little-understood illness that is as debilitating as its more justly named cousins that also compromise the immune and neurological systems. My case is particularly …
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How not to treat yourself when chronic illness strikes
There are some important new recommendations about tonsillectomy — taking out the tonsils — as a treatment for recurrent strep throats.
Some of us can recall a time when getting your tonsils out was one of the rites of passage of childhood. Usually a related procedure is added — an adenoidectomy, removing the adenoids as well. It’s called a T&A in the medical world, and it’s one of the …
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What do tonsils do and why would we take them out?
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
The conundrum continued behind conference doors at the American Telemedicine Association (ATA) conference in Tampa about the efficacy of mobile phone usage to improve patient health.
Lively discussions followed about the ROI for chronic disease management through mobile health and outcomes for remote patient monitoring focusing on whether telemedicine is excluded from meaningful use and reasons why telehealth should be a key component in Accountable Care Organizations (ACO).
As the debate …
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Chronic disease management through mobile health
I am utterly sick of the myth that living a healthy lifestyle will prevent illness.
- Granted, eating a balanced diet of nutritious food is better than grazing on ice cream and bon-bons all day.
- Getting regular exercise has distinct health benefits; moving as little as possible has a detrimental impact on people’s health.
- Is there anyone who isn’t aware of the health ramifications of smoking?
- Excessive alcohol consumption is another no-no.
The story goes …
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Will a healthy lifestyle prevent illness?
Hospital care for people with hearing loss can be ineffective when people cannot communicate. Most hard-of-hearing people do not know sign language because they lost hearing later in life and remain in the oral culture. Without effective communication, quality of care is impaired and patient compliance is often reduced. The patient’s bed needs to have proper signage and chart records to alert staff of special communication needs.
Ironically, many hard-of-hearing people …
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Accommodate people with hearing loss in the hospital
There are multiple costs to non-compliance, including financial, both personal and societal, and physical-emotional. When patients fail to comply with treatment protocols, fail to get prescribed tests, or fail to stop destructive behaviors, there is a societal cost.
Today, I want to address the physical and emotional costs of non-compliance. I just read a brilliant article by Roxanne Sukol, MD. Dr. Sukol’s article discussed the fact that diabetes starts …
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The physical and emotional costs of non-compliance
“More than half of all Americans may develop diabetes or pre-diabetes by 2020, unless prevention strategies aimed at weight loss and increased physical activity are widely implemented, according to a new analysis. Diabetes is an epidemic, ” according to Denise Mann in WebMD Health News.
At 14 months old, the doctor told my parents that the disease would ultimately take my life. The doctor motioned my father into the hallway of …
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The majority with diabetes do not lead a disciplined diabetic life
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
I had a “wow” experience recently when I accompanied my wife to interview a new doctor for her. As some reader may know she is being seen by specialists at MD Anderson Medical Center in Houston for Stage IV lung cancer. She has not had a local oncologist for the past 6 years, but she does now. And we both love this guy!
You need to understand that I have …
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Think about mindfulness when seeing a new patient
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
As patient safety advocates responsible for monitoring vital signs, managing pain and safeguarding a patient’s overall health through the surgical process, anesthesiologists are committed to informing patients about the anesthesia experience. The American Society of Anesthesiologists (ASA) and the Michigan Society of Anesthesiologists (MSA) have launched a new public education campaign to help patients better prepare and …
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Demystifying anesthesia to put patients at ease
Test your medicine knowledge with the MKSAP challenge, in partnership with the 
