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.
I recently wrote about the importance of a differential diagnosis. Today I want to assume that you have a definitive diagnosis and discuss how we deal with that illness. First, some ground rules.
There are hundreds of medical texts and unlimited amounts of information on Google that help define an illness. They all portray the “textbook” description of how the illness should present, what symptoms …
We all know of the folly “Just Say No” as it just does not work. I disagree that a physician should ignore the requests of her or his patients, based solely on the perceivable abuse of the drug Oxycontin.
This is an opiate that works wonders for patients in chronic pain situations, …
My mom is sick. Because of what can only be described as my crazy family dynamics I did not find out for 24 hours that she was taken by ambulance to the hospital in septic shock from pneumonia.
She was hypotensive on arrival (not good) and pancytopenic (low white cell count, low hemoglobin, and low platelets – not good either). A CT scan showed multiple large, irregular lymph nodes in her …
I am infinitely blessed by The Girl Effect. As I look back through the generations of my family, I see it rolling toward me, through me like a wave.
I am sure it started even before my grandmother stole her parents’ car with intent to drive by herself from Austin to Chicago to see the World’s Fair in 1924; I just don’t have much history to work with prior to that. …
I will be leaving my current practice in a couple months and starting work at a different clinic in a different city. This type of transition really brings to light how much I had really gotten to know patients on a personal level. This became surprisingly clear not too long ago.
One day, I saw a patient on my schedule that had historically required more of my emotional energy. We often …
It was a dimly lit room, up on the sixth floor. I am not sure why they would not fix the light in that corridor. Even during the day, I would find this area poorly lit.
Maybe it was not the light but the grim atmosphere of oncology floor. Some of the patients there had terminal illnesses but they would still act like they had decades to live. You would be …
These are values I try to live by and incorporate into my daily work. Treatment of chronic pain is the scenario that puts me and every practicing primary care physician in a no-win situation regularly in the office. To try to make physicians feel more comfortable treating pain most states have tried …
So I’m watching the 6 pm local news last night and see a piece on KARE-11, my local NBC affiliate, about “a new buzzword called ‘cyberchonrdria'” — used to describe people who “Google their symptoms online and then worry over the multitude of results and possible diagnosis …”
But it’s clear from what they posted online that this was not …
Recognize the title? It’s from Steve Martin’s 1978 stand-up album, Wild and Crazy Guy. Martin lists How to Make Money Off the Mentally Ill as one of the many books he’s written. The joke is supposed to be on Martin himself, inviting us to ask, “What kind of disreputable jerk takes advantage of the mentally ill?”
In case you have not heard about it, there is a very gut wrenching court case St Louis Park, MN. A doctor in the hospital system is going to court to replace a patient’s wife, Lana Barnes, with a substitute decision maker, claiming that she is making futile and reckless decisions to prolong her near-vegetative husband’s life.
Our federal and state governments are being crushed by debt. There are many reasons for that debt, and addressing the reasons for the debt are a necessary aspect of decreasing the debt. For example, if a family household had overdrawn its checking account by …
It’s strange being on the other side for a change. I remember bringing my son to his first doctor’s appointment. A new mom. No stethoscope around my neck. No patient schedule, replaced instead by the constant grind of breastfeeding.
I knew it was just another routine newborn check for our pediatrician, but every maternal fiber in me believed that my son must be the cutest baby that ever walked through that clinic. …
American Medical News published an informative essay by Kevin B. O’Reilly on December 13, 2010, about errors in diagnosis and why doctors make them.
According to Gordon Schiff, MD, associate director of the Center for Patient Safety Research and Practice at Brigham and Women’s Hospital, “The problem of diagnostic errors has gotten short shrift in the broader patient safety movement.” The article focused on …
Social media is changing how we communicate and how we define “relationship.” I was speaking to someone last week who said to me, “Social media isn’t coming it’s here!” He’s right.
And while many voices in our professional communities are wary about social media, I see positive opportunities at every turn. Here are just 5 ways social media will change …
I woke up in the middle of the night last night and I could not fall back asleep. I had a moment of brilliance laying there in bed. I had discovered a new medical disorder, Wimpy Parent Syndrome (WPS).
For years I have been seeing it in clinical practice, but have been unable to put my finger on exactly what was taking place. Then the idea of WPS came to me and everything …
If you’re sick, you need people to empathize with you, right? Maybe not.
Empathy is one of those words with a wide variety of definitions, especially in academic settings.
From Wikipedia: “Empathy … cover[s] a broad spectrum, ranging from feeling a concern for other people that creates a desire to help them, experiencing emotions that match another person’s emotions, knowing what the other person is …
One of the “Crown Jewels” of the 2010 holiday movie season may be The King’s Speech. The film centers on Colin Firth, who plays King George VI of Britain, and Geoffrey Rush as Lionel Logue, the speech therapist who helps the king deal with his stutter.
Born Albert Frederick Arthur George, the second son of King George V, he spent most of his early years out of the spotlight, which centered …
Recently, KevinMD.com picked up my post on empathy or should I say the lack of it. I received some engaging comments.
One comment in particular caught my attention.
The contributor for some reason equated “being empathetic” with “giving in” to patient requests presumably during routine office visits. Here’s a direct quote:
Give the patients what they want! Antibiotics are OK for colds. The patients want them. So …
Pauline Chen had a post in the New York Times recently about surgical informed consent. Informed consent is an important part of the surgeon/patient communication transaction.
Surgeon reviews the proposed operation, the rationale behind it, and the possible complications. For example— a patient comes in with biliary colic. We describe the anatomy and pathology. We aver that surgical resection will lead to …
One of my Facebook updates on my private account was that I “have a love-hate relationship with interleukin-6. Yes, macrophages and T cells, I know you are doing your job, but how many proinflammatory cytokines does it really take to fight this thing? What’s that? Be grateful you guys are even working? Oh, all right. I’ll shut up and eat my soup now.”
