Patients

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.

Cancer will always be a part of a patient’s identity

Ann Silberman

Patient

May 20, 2011

So, you’ve cut off your breast(s) and poisoned and radiated your body. You’ve hit all your medical milestones – surgery, chemo, herceptin. You’ve recovered and the hair on your legs has grown back to plague you, and you have gotten back to a normal life. Work, jobs, family. Shaving.

Yet you are changed. You didn’t expect this, but each time you get dressed or undressed, you can’t help but notice your mastectomy …

How patients can handle bad medical news

Maria Basso Lipani

Patient

May 20, 2011

When bad medical news hits, the blow can be devastating.

Shock is almost always the first thing people feel, followed by anger, fear and often a profound sense of sadness.

At times like these it came be extremely difficult to collect your thoughts and decide what to do next. Your head is likely to flood with questions that arrive at various moments – in the middle of the night, in the shower, …

Using Glee for teachable moments to teens

Natasha Burgert, MD

Patient

May 19, 2011

I am a “Gleek.” I admit it.

A Gleek is a self-described lover of Fox’s show, Glee. The show features a diverse group of teens who are in the school’s show choir. Glee focuses on the lives of these teens, in and out of school, while emphasizing certain storyline elements with entertaining Broadway musical-type performances.

The show itself, however, is not the point of this post. Last week was an unexpected …

Navigating any health care facility requires sophisticated literacy skills

Kevin

Patient

May 19, 2011

by Rima Rudd, ScD

We take the written word for granted.

Signs and billboards are everywhere – offering directional information, alerts, warnings, and advertisements. Streets, public squares, buildings, agencies, and institutions are numbered and named. We are surrounded by the written word in public locations and within public and private institutions. Individual entrances and even elevators in some large buildings carry names. The lobby, the inside …

How the quality of the scientific literature impacts the evidence

MedPage Today

Patient

May 18, 2011

by Tom Lang and George Lundberg, MD

A not-so-obvious truth is that evidence-based medicine is literature-based medicine.

That is, the quality of the scientific literature directly affects the quality of the evidence.

Quality, in turn, depends in large measure on reporting research completely and accurately.

In response to ample evidence that such quality is often missing from the literature, dozens of reporting guidelines, such as the CONSORT Statement for reporting randomized trials, are …

Practice variation from the perspective of an e-patient

Dave deBronkart

Health Policy

May 18, 2011

One of our purposes e-Patients.net is to help people develop e-patient skills, so they can be more effectively engaged in their care. One aspect is shared decision making. A related topic, is understanding the challenges of pathology and diagnosis. Both posts teach about being better informed partners for our healthcare professionals.

I’ve recently learned of an another topic, which I’m sure many …

Emergency medicine, we can do better

angienadia, MD

Physician

May 18, 2011

When someone gets sick, what are their options?

They can try to make an urgent appointment that day, but how many of your doctors actually offer that? Most people will have to wait for weeks, if not months, for a regular appointment. Even if you go to a walk-in clinic, the wait will likely be hours, and you’re not sure if clinics can take care of everything, so you head to …

Read more…

Emergency medicine, we can do better

Pediatrics is full of uncertainty, not unlike the practice of parenthood

Claire McCarthy, MD

Physician

May 17, 2011

Recently I wrote a blog about how the American Academy of Pediatrics (AAP) thinks that otherwise healthy children with ear infections should wait a couple of days before starting antibiotics, because many will get better without them.

Now there are two articles in the New England Journal of Medicine (here and here) saying that children with ear infections who are given antibiotics are more likely …

The myth of undocumented immigrants using American health care

Brad Wright, PhD

Health Policy

May 17, 2011

I hear it all the time: “All these illegals are coming over here and they don’t pay taxes, but they get all these government handouts and they’re clogging up our health care system …”

I often point out that many undocumented immigrants actually do obtain a taxpayer identification number for the express purpose of paying taxes in hopes that if a path to …

Prevent foot fractures while wearing heels

Orly Avitzur, MD

Conditions and Diseases

May 17, 2011

As 30-year-old New Yorker Carrie Donnelly began her bachelorette party in her new black open-toe five-inch heels, she fell, her foot going one way and her ankle the other.

“When I woke up the next day, my ankle was throbbing and had become extremely swollen,” she said. It was a month before her wedding—the last thing she wanted to do was to walk down the aisle in a cast.

Super-high heels like …

Two words that hurt communication between physicians and patients

Kevin

Physician

May 17, 2011

by Paul Rousseau, MD

Communication between physicians and patients is critical to quality care and improved outcomes, however, such discussions often seem labored and fraught with anxiety and stress.

Physicians commonly speak too much and listen too little, while patients feel swept up in an unfamiliar and frightening situation with loss of control and little-to-no input into care.

As I have …

How malpractice hurts doctors and their future patients

Kevin Pho, MD

KevinMD

May 16, 2011

Little has been written about the impact a malpractice lawsuit has on physicians.

But physicians who’ve been sued have a higher rate of suicide, and emergency physician Edwin Leap wrote about how doctors are emotionally scarred from the grueling ordeal of a trial.

A recent piece from American Medical News puts faces on the toll:

The key to surviving is having …

Read more…

How malpractice hurts doctors and their future patients

Predictions on the future of medicine after health care reform

Wes Fisher, MD

Health Policy

May 16, 2011

Recently, an editorial from a plastic surgeon Lloyd Kreiger, MD, appeared in the Wall Street Journal entitled “ObamaCare Is Already Damaging Health Care.”

While I’m not sure I’m ready to concede that Obamacare has already damaged health care in America, I will agree the law is certainly is changing health care, aligning health care corporate interests with political interests, …

Osteoporosis Awareness Month, and how to prevent early bone loss

James Haddad

Conditions and Diseases

May 16, 2011

May is National Osteoporosis Awareness Month.

Osteoporosis is a poorly understood concept amongst the general public, and perhaps the best way to explain it is the presence of an insufficient quantity of bone – the bone that is present, however, is normal (or properly mineralized). This can be contrasted with osteomalacia (or rickets, in children), …

How an ACO will affect the relationship between a doctor and a patient

Randall S. Bock, MD

Health Policy

May 16, 2011

At the heart of medicine is the relationship between a doctor and a patient.

The more a doctor knows about his patients, the better. While visual changes and numbness might represent migraine symptoms for one patient, for another they could forebode a stroke. Having followed patients through the stages of life, participating in their medical experiences firsthand rather than solely reviewing those as written case-files — I can vouch that knowing …

Lunch money Pharma spends on physicians

Deep Ramachandran, MD

Medications

May 16, 2011

Actually I’ll take a Ford Shelby GT500 Convertible, thank you very much …

Today’s stream of socially conscious thinking comes to you after having feasted on a tasty lunch paid for by a drug company (and no, it wasn’t Pfizer).

It has spurred me to contemplate the ever increasing scrutiny paid to the relationship between the pharmaceutical industry …

Read more…

Lunch money Pharma spends on physicians

5 rules for living well with a chronic illness

Carolyn Thomas

Patient

May 14, 2011

Dr. Elvira Aletta is a clinical psychologist with a unique perspective on what it’s like to live with a chronic illness. In her early twenties, she was diagnosed with nephrotic syndrome, a rare kidney disease that usually affects young boys. Then in her thirties, she came down with a chronic autoimmune condition called scleroderma.

She’d never heard of that, either. She describes her …

What patients need to know about finding and treating osteoporosis

Juliet K. Mavromatis, MD

Conditions and Diseases

May 13, 2011

Osteoporosis is a condition that is sure to become increasingly diagnosed as our population ages.

Osteoporosis is significant because it is associated with an increased risk of bone fracture, including fracture of the hip and vertebra, which are the cause of significant morbidity, mortality, loss of independence and medical expense in the elderly. In current clinical practice, osteoporosis is diagnosed on the basis …

Medical students asking a patient about death

Jessica Gold

Medical Education

May 13, 2011

Like any kid who always wanted to be a doctor, I went to medical school to learn how to help people. Just wearing the white coat during orientation week had people looking at me differently, expecting me to know something more than I did just a week before. One of my classmates was even asked for …

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