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.

How astroturfing disease affects patients

Marya Zilberberg, MD, MPH

Conditions and Diseases

March 28, 2011

One of the top hits that comes up on the Oracle of Googlius for “astroturf” is for the original company, now renamed SYNLawn, but still proudly stating, “We invented synthetic grass,” which is what astroturf is. More recently, this already synthetic term has become a verb, as in “astroturfing.”

My favorite of all credible information sources on the web, Wikipedia, has this to say about it:

Astroturfing denotes political, advertising, or public relations campaigns that are formally …

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How astroturfing disease affects patients

Life at a needle exchange

Jan Gurley, MD

Patient

March 27, 2011

I went to needle exchange to hang out. You may be asking yourself what a soccer mom from the burbs is doing perched on a folding chair in the parking garage of 101 Grove on a dark November night, surrounded by syringes.

I was there as a guest observer because I’m working on a series of articles about mortality and homelessness, as part of an Annenberg California Health Journalism Fellowship I …

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Life at a needle exchange

Overeating is a behavioral problem, not a surgical one

Dr. Joe Kosterich

Conditions and Diseases

March 27, 2011

Overeating is not a surgical problem.

This may seem to be a statement of the obvious, but the solution to a behavioral problem is not surgery. Overeating is not a surgical problem — it is a behavioral one. The problem is not because the stomach is too big and needs to be made smaller. It is a function of how …

Reduce variations in cancer care that do not improve outcomes

Merrill Goozner

Health Policy

March 26, 2011

Here are a few facts to enliven the next public discussion about death panels.

An analysis of Medicare claims by researchers at Dartmouth University found that nationwide nearly one in three cancer patients died in hospitals or in intensive care, the most expensive form of end-of-life care and contrary to most patients’ wishes. Nearly half are not offered hospice …

Vaccination and the killers of yesterday now overcome by modern medicine

Emily Gibson, MD

Medications

March 26, 2011

It’s only been a little over fifty years since vaccinations became routine for the childhood killers like polio, measles, mumps and whooping cough. People my age and older had no choice but to suffer through childhood infectious diseases given how effectively and quickly they spread through a community.

Most of us survived, subsequently blessed with life long natural immunity. Some did not survive. …

Guiding patients online is a new physician responsibility for the digital age

Kevin Pho, MD

KevinMD

March 25, 2011

The following op-ed was published on February 22nd, 2011 in AOL News.

If you woke up one day with an earache, you could call your doctor’s office for help. Or you could do what the majority of patients do today and Google what to do first.

Type “earache” into your Web browser and the results can vary wildly. Search engines can return results saying that an earache can be from the common cold, …

How can research capture the complexity of tiny moments?

Claudia M. Gold, MD

Patient

March 24, 2011

Recently, as I listened to leading researchers grapple with the question of how to design a feasible study of intervention for postpartum depression, I held in my mind an image of a particular moment in my office.

I was sitting on the floor with 10 month old Madison and her mother Nancy, who was struggling with postpartum depression. Nancy spoke of the strain Madison’s refusal to take a bottle and her …

Giving the patient and family precious minutes to say goodbye

Kevin

Patient

March 24, 2011

An excerpt from Doctor Confidential: Secrets Behind the Veil.

by Richard Sheff, MD

Dorothy suffered a second heart attack, leaving more of her heart muscle damaged and causing her to slip into congestive heart failure. There was not much we could do to reverse the many blockages in her arteries. Yet she was cheerful, as were her four children.

One morning Mary came to find me. “Dorothy says …

Patient volume and money instead of quality patient care

Linda Burke, MD

Patient

March 24, 2011

To everything there is a season and mine comes to an end today. For 720 weeks I attempted to give quality care to my patients. The task was not always easy especially when most of my patients held the unenviable position of having a high risk pregnancy and receiving Medicaid or being uninsured. Babies have a right to be born healthy …

How a patient support tool works to help patients and doctors

Ted Eytan, MD

Health Technology

March 23, 2011

When you go to see the doctor, how do they know (a) if you are due for any preventive health screenings like mammography or (b) if you have a chronic condition, if it is being monitored and managed?

And actually, not just if it is being monitored or managed, but are you able to achieve your life goals with good health? And what about …

Being a physician is not just about medicine

Kevin

Patient

March 23, 2011

by Sunjay Devarajan

“Mrs. Adams” slowly ambled into the family medicine clinic on a Wednesday afternoon. I immediately noticed her slight hunch as she made her way into the lobby.

“A case of back pain?” I thought to myself. “Perhaps an exacerbation of the scoliosis she’d had since childhood?” I shrugged my shoulders and carried on with my …

Cannabis use and medicine, the debate over benefits and harms

Kevin

Medications

March 22, 2011

An excerpt from Uses and Abuses of Plant-Derived Smoke: Its Ethnobotany as Hallucinogen, Perfume, Incense, and Medicine.

by Marcello Pennacchio, PhD

Few plants have generated as much debate and controversy as cannabis (Cannabis sativa).

Throughout the ages, it has been labelled both a dangerous drug and potent medicine. Where the former is concerned, law-enforcement agents and governments spend millions …

What to do with a prescription bottle with the wrong pills inside

Stephen Meyers, MD

Medications

March 22, 2011

Have you ever opened a prescription bottle to find the wrong pills inside? If so, you may have found it to be an expensive mistake.

Whatever the reason for the error (and there are numerous possible causes), here is how to best handle the situation.

Of course, it is always smart to confirm the medications, quantities and dosages at the pharmacy checkout. A mistake recognized at the time of purchase can be easily …

Accountable care organizations: The lost art of medicine?

Kevin

Health Policy

March 22, 2011

by Sharolyn Rhees Medina, MD

It’s no secret that healthcare’s inevitable move toward accountable care organizations (ACOs) has many physicians feeling a bit …nervous. Admittedly, most physicians are creatures of habit who fiercely defend their individual approach to patient care, focus on cures not cost, and dread the concept of “cookbook medicine.”

And under the ACO model, physicians …

Doctors should ask the people what they want for health care

Pamela Wible, MD

Patient

March 22, 2011

Americans typically rely on elected officials to uphold the will of the people. Now physicians—traditionally confined to exam rooms—are taking direct action to fulfill community needs.

In 2004 I decided to meet face to face with citizens in my hometown. I thought, “Why wait for legislation? I’m a board-certified physician. What’s stopping me from serving the public?”

So I led town hall meetings and invited ordinary citizens to create the clinic of …

A surgeon on those who understand murderers, rapists and child molesters

bongi, MD

Physician

March 21, 2011

(Editor’s note: reader discretion advised)

Recently I was involved in a discussion with a guy that was explaining how we should understand criminals. The emphasis was on farm murders but we touched on murderers in general, rapists and child molesters. My point of view was that I did not understand them and felt that he was justifying their actions. In the end I was informed that I was smug. Apparently that …

Family physicians who care for underserved patients

Kenneth Lin, MD

Physician

March 21, 2011

One of the ugliest incidents in my career occurred during my faculty development fellowship year, when I spent two days each week seeing patients at several federally qualified community health centers in inner city Washington, DC. Midway through the year, I was transferred from a health center that served an African-American population to one serving a mostly Spanish-speaking clientele.

Nearly all of the permanent Read more…

Family physicians who care for underserved patients

How obesity is like alcoholism

Arya M. Sharma, MD

Conditions and Diseases

March 21, 2011

Recently, I attended a scientific symposium on addictions.

One of the books I picked up at that conference, and read on my flight to Montreal, is A. J. Adams’ Undrunk: A Skeptic’s Guide to AA.

While this book is a very quick and highly readable introduction to AA (Alcoholics Anonymous), about which I knew very little, today’s post is not about this book.

The definition reads as follows:

Alcoholism is a primary chronic disease …

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How obesity is like alcoholism

Prostate cancer from a patient perspective

Kevin

Conditions and Diseases

March 21, 2011

by Dan Zenka

As a patient, I feel for anyone who is given a diagnosis of prostate cancer. Hearing the “Big-C” word can be upsetting enough. But the complexity of the disease—diagnosing it, trying to characterize it and selecting the appropriate treatment—can feel like insult upon injury. We need to talk about prostate cancers. With 24 known sub-types of this cancer—from …

Emotional issues that come with cancer during the teenage years

Stephen C. Schimpff, MD

Patient

March 18, 2011

When Clarissa was 13 she entered Johns Hopkins Hospital to be treated for relapsed acute leukemia knowing full well that she had only a 40% chance of survival. Today she is 16 and in excellent health. But it took 2 1/2 years of incredibly rigorous treatments to get there. Equally importantly it meant riding an emotional roller coaster for her and her parents.

Clarissa had …

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