“My grandson has HDHD.”
This was intriguing. I had just asked her one of my standard psychiatric interview questions about family history of mental illness. Maybe I hadn’t heard right, but it sounded like she was telling me about a new flat screen. Had her grandson just bought a fifty-two inch LED set in time to watch the Final Four this weekend? Had he mounted it on the wall on …
Doctors diagnose, sometimes we dispense, often, we teach
Lately when I ask my son to make a choice or do anything he considers difficult, he says, “Bus number twenty three. Number twenty three. Bus number seventy nine. Number seventy nine.”
He memorized not only the words but the exact cadence of how buses are announced at his school and recites this script instead of screaming. If you know David, this avoidance tactic is creative, a little annoying, and downright …
Tips to care for your child with extra medical or behavioral needs
Another crazy three days at work and I begin to think about the similarities of Seal Team 6 and nurses. Methodical. Precise.
Nursing is not a glorious profession. Even though my father thinks I sit at the bedside of the sick and dying and hold their hands all day, the fact of the matter is, I simply do not have the time. We run around attempting to tread water with …
Nursing is methodical and precise, like military special ops
One of my professors teaches psychology, but he was hired as a “generalist” meaning that he has no area of specialization when he’s teaching. He ends up with all the 101 classes. And I love that. Trained as a biopsychologist, he’s now known as a clinical psychologist and is one of the best in the area.
As I walked into the class the first day and he was going over standard …
3 easy ways for doctors to respect patients
I’ve spent a lot of space on this site writing about participating in your healthcare so you get the right care.
And, I talked about developing a “relationship” with your doctor so you can effectively communicate. Relationship does not mean drinking buddy, golf partner, or someone to do shopping with. What is meant by “relationship” is developing a trust that allows you to effectively and unashamedly discuss your medical concerns and question treatment options …
Why developing trust with your doctor is important
“Mom’s been writing goofy checks…”
“Dad stopped paying his bills….”
“Grandma wired her savings to Nigeria…”
Have you heard these phrases from the family caregivers of your elderly patients? Have you ever been concerned that your patient may lack capacity for financial decision making? How do you decide if they lack capacity? What is the clinician’s role in making these decisions? What is their responsibility?
These important questions are addressed in a terrific new article in …
Alzheimer’s inevitably leads to loss of financial capacity
I had a patient once—a fellow physician—who came to see me complaining of mid-back pain. When I examined him, I found I could reproduce his pain by pressing firmly on the spot he said was hurting him. He said pressing there also made the pain radiate around to his stomach, a phenomenon known as “referred pain” that meant his pain was almost certainly caused by a trigger point. I …
How early closure can cause doctors to misdiagnose
I’ve been sick since 2001 when I failed to recover from what appeared to be an acute viral infection. It has left me mostly house-bound, often bed-bound. In effect, I’ve had the flu without the fever for almost ten years: the aches and pains, the dazed sick feeling, the low grade headache, the severe fatigue. It cost me my career as a law professor; it cost me the ability to …
An apology to patients with chronic fatigue syndrome
A reader writes, “Can you do a post on what procedures constitute a thorough physical, in your opinion? I haven’t had one in several years and thinking of making an appointment now. The last doctor I went to didn’t even listen to my heart or go though the motions with feeling my belly and that stuff. And of the last 3 doctors I went to, I realized they didn’t …
There is no such thing as a complete physical examination
A cover story by Gardiner Harris in the New York Times spotlights the changes in modern psychiatry, from extensive, psychotherapy-based interaction to brief, medication-oriented “psychopharm” practice.
The article shares nothing new, particularly to anyone who has paid any attention to the rapid evolution of the psychiatric profession over the last ten years (or who has been a patient over the same period). While the article does a nice …
Do patients accept hurried, fragmented, disconnected care?
Ok, imagine this.
You take a video of your little girl’s soccer practice with your iPhone. Within moments it’s posted on YouTube for the grandparents to see.
Minutes later search engines called spiders begin to crawl across the data set of images on your upload. Face recognition technology identifies a face on the video and, with some assistance from the geo-tagging of the built in GPS metadata that accompanied the upload, …
Are our privacy rules robust enough to protect our patients?
Doctor D has been blogging about the doctor-patient relationship for a while now. It’s sort of the thing I’m known for. I’ve usually been on the doctor side of this equation. Most of my blogging, however, is to help patients figure out the weird world of medicine.
Doctor D recently found himself on the patient side of a nasty injury.
Even as Doctor D looked down and realized his leg wasn’t …
What this doctor learned when he was a patient
A guest column by the American Medical Association, exclusive to KevinMD.com.
Health IT holds the promise of improving the efficiency of a physician’s practice, but physicians can easily become overwhelmed by the broad range of products and the multiple, varying federal incentive and penalty programs currently underway. The American Medical Association (AMA) continues to be in close contact with the Centers for …
AMA working to improve e-prescribing incentives and help physicians adopt health IT
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For most women, a couple of irregular menstrual cycles or an occasional yeast infection are just a part of life — nothing that time or simple treatment won’t cure.
However, there are a few symptoms that warrant a call to the doctor. This article will cover when you should call your doctor for problems “down there”?
1. Pelvic pain. Pain at the time of ovulation is referred to as Mittelschmerz. However, if …
Women with these 5 pelvic symptoms should call their doctor
Are there moments when caregiving makes you want to scream?
Any number of things related to caring for your aging parent can cause you to feel like you’re at the end of the proverbial rope including:
But here’s where things get a bit dicey: While …
Caregiver burnout is just a fancy term for exhaustion
Many of you know that a judge in Pennsylvania has determined that the popular “I Heart Boobies” bracelets worn by middle school students are a form of free speech intended to raise awareness of breast cancer and cannot be restricted by schools.
As much as I love a good double-entrendre, I find the entire situation to be sad, particularly the misinformed comments I’ve seen made by parents of …
The problem with I Heart Boobies bracelets worn by middle school students
Darshak Sanghavi recently wrote an excellent piece in the New York Times summarizing the controversy over resident work hours.
The topic has been discussed here frequently, with ramifications ranging from the fact that errors arising from patient handoffs negate any benefit gained from restricting work hours, to surgeons not accumulating enough experience during their work hour-restricted training.
I’ve often …
Why work hour restrictions won’t improve patient safety
Which will improve a person’s health more? Running around the block for 20 minutes or sitting at a computer entering their cholesterol and blood pressure readings?
The answer is one reason why Google’s decision to end its electronic personal health record (PHR) service offers important lessons about health IT and will affect the way patients get their health information and the way physicians communicate with their patients.
A recent survey …
Google gave up on electronic personal health records, but we shouldn’t
As I look back over my 10 year career in obstetrics and gynecology, I am sometimes struck at how many things have been discovered in this time period.
When I started the origin of pre-eclampsia was unknown, and now we know that it likely originates in an overabundance of a molecule called Soluble FMS-Like Tyrosine Kinase, a competitive inhibitor to natural angiogenesis in the placenta. Ten years ago the origins of …
Explaining an abnormal pap smear is no longer simple
It’s hard to find anyone who would argue against keeping things “plain and simple.” Or would they?
Is it possible that the imperative to create simple health information has over-promised – hasn’t lived up to its billing? What if the complexity of health, science and technology information in the first half of the 21st century requires more than simple simplicity?
Think back to swine flu.
Dateline November 2009: We were awash in …
Why don’t simple messages convince people to take action?
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