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.
It is not enough to know that a patient’s medical condition warrants an MRI. For most insurance companies, a diagnostic test of this sort requires what is known as a prior-authorization. But, the doctor saying the patient needs this test often fails. The insurance company has a certain guideline the patient must travel first before they will consider the test.
For example, a patient with back pain and numbness in one …
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How can patients navigate our complicated health care system?
Countless times as a patient both at two hospitals in New York City, I have witnessed doctors arrogantly waltzing into an examination room and arriving not alone but with an entourage. Like Greeks bearing gifts, they arrived with something unwanted and threatening: medical students, interns, residents, and fellows. And not once, in all the many times that I have been subjected to this ignominious practice, was my consent ever obtained …
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Is physician shadowing immoral?
The ability to access health information via the Internet is creating a generation of empowered, informed patients. While this is almost always beneficial to both patients and the patient-physician relationship, it does call for changes to traditional counseling methods. Widespread access to myriad health information sources has divided patients into two subsets: those who prefer traditional counseling and those who become “personal health researchers” or PHRs.
While some patients will continue …
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How to care for patients who are personal health researchers
I have a very interesting job: I travel around the country providing neuromonitoring to surgeons in the operating room. I’m also an anesthesiologist assistant, certified and licensed to provide anesthesia. Throughout my ten-year career in the OR, I’ve been the guest of nearly a hundred hospitals in the U.S. and the UK. No two hospitals are the same. My career has allowed me to meet hundreds of incredibly caring doctors, …
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Here’s how your attitude affects patients
Imagine driving through an unfamiliar area, and there are no street signs. How would you feel? Frustrated? Scared? Angry? You would feel these emotions because you had no direction or guidance. Patients need direction when they enter the health care system. Signposting is a tool to provide direction.
On the streets, there are posts that have signs. They provide direction; they tell us where we are going. Hence, the name, “signposting.” …
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3 ways to better communicate with patients via signposting
In my first year in the hospital, as a third-year medical student, there was one refrain I often heard from physicians and staff alike: This is a hospital, not a hotel. It was an expression of the frustration engendered by “needy patients,” those who were upset that their breakfast was late or that the room was too hot or that they couldn’t speak with the physician just this second. Often, …
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Patients and doctors should give each other the benefit of the doubt
Just as summer is in full swing, the back-to-school advertisements are running. This time of year can be exciting for many — the first day of elementary school, high school or college. For the rest of us, we try to be lifelong learners: learning from our successes and failures, learning from others and if we are lucky learning by reading.
Reading is a skill learned in the early school years. Children …
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Literacy is a health care problem no one talks about
In 1996, I had an illness that nearly killed me. I was exhausted, felt awful, could barely stand up and had trouble remembering things. Yet, I somehow had to find the energy not only to take care of my newborn and 5 year old, coordinate our upcoming move, consult with doctors and other medical providers on my condition and treatment, and receive treatments that might or might not help me …
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8 ways to be your own health advocate
As a physician, I am often discouraged when I turn on the news and read about the state of health care in our country. I can see all 397 sides of the debate and some truth in all sides. The enormous cost of medicine is overwhelming to comprehend for patients and families and even to those of us in medicine.
I think it is important to know all that goes into …
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This is what to remember in health reform: We are all one patient
Several years ago, when I was working as a hospital physician in Florida, a patient’s wife said something that has always stuck with me. The service was very busy on that day, and I was doing my best to get through everybody in a timely manner. I was with a patient whose wife was at the bedside, beside herself with worry. I was focused on the main presenting complaint, but …
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Make the patient feel like the absolute center of your world
“Doctors are not the problem. Patients are.”
Anyone who has ever thought the above statement is true has not tapped into the vast well of knowledge and intellect found in their own patients. Training patients to be better patients brings the joy of medicine back into your practice.
All of us, at one time or another, sat in a classroom. The teacher spent the first day going over the rules of the …
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Are patients really the problem?
After sixteen years of chronic illness and even after writing a book titled How to Be Sick, I still can feel sick of being sick. (When I use the word “sick,” I’m including chronic pain.) If you’re as intimately familiar as I am with sick of being sick, you know it how unpleasant it feels.
Here are ten strategies to help you through this difficult emotional time.
1. Start by acknowledging how …
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10 strategies to try when you’re sick of being sick
As a pediatric allergist, I treat several conditions that commonly affect children, including asthma, food allergies, eczema and allergic rhinitis. Almost everyone knows someone affected by some form of allergic condition, which makes for frequent questions from families, referring providers, and the public at large.
Early in my career, I noticed that many patients (and even colleagues in other specialties) were asking me questions that were either outdated or born entirely …
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Searching online from a patient perspective can make you a better doctor
“Do no harm.”
This is a key phrase in the Hippocratic Oath; one that I announced with conviction at my medical school graduation. I swear to do no harm. What would Hippocrates, the Father of Modern Medicine, think about the concept of harm reduction?
Canada has a drug problem. We are one of the world’s largest per-capita opioid consumers. The country is facing what has become known in the media as the …
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Doing no harm to addicts might be doing a lot of harm
I was scheduled to attend a medical director’s retreat the other day, but because of a horse emergency the day before, I had to stay home, so I offered to skip the retreat and see patients instead.
It would have been almost an entire day hearing about trauma informed care and the lifelong impact of adverse childhood events. As a primer, the conveners of the seminar emailed a “dear doctor” letter …
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Why we shouldn’t pigeonhole patients into groups
Now more than ever, health insurance is a staple story in the 24-hour news cycle. Opinions vary widely on the issue, as do politician’s thoughts on the matter. Debates rage, tensions grow, and deeper divides are formed as our government wrestles with this colossal dispute. Nestled at the heart of it all though is a basic question:
Is health insurance a right or a privilege in the United States?
I’m alive today …
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Having access to health care saved this patient’s life
Pacing refers to spacing out your activities during the day so that you’re able to stay within the limits of what your body can handle without exacerbating your symptoms. Another way to think of it is that pacing is a way to keep you inside your “energy envelope” — the envelope that contains your energy stores for any given day.
First, an admission: Even though pacing may be the single best …
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5 effective strategies for pacing when you’re sick or in pain
I’m convinced this will be a year of reflection for our family — as we’ve witnessed so many transitions in the past year I find myself deep in thought. As I reflect, I’m full of appreciation for the journey we’re on. I’m full of gratitude for so many of the people who have helped us along the way — especially the amazing doctors who have become like family. This past …
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To the doctor who saved our son’s life
Most of us have grown accustomed to Google and Facebook. When I had an Android phone, I quickly got over the initial creepiness factor of going into a restaurant, bar, or store and having a message from Google popping up with reviews, menus, or coupons. I liked that Google could recommend times to leave or asked if I went to a certain spot often. But Facebook and Google are basically …
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Why Internet privacy matters for patients
