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.
Many patients erroneously believe that x-rays and CAT scans have no risk.
In their minds, they are non-invasive studies that can cause no harm. Since there are no incisions or anesthesia, they regard the experience as having the same risk as taking a family photograph. How wrong they are. In my mind the danger from non-invasive radiology studies may surpass the risk of hard core medical treatment. True, radiology tests won’t …
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CT scans and x-rays draw patients into risk and overutilization
Chaperones are increasingly recommended for routine use in Western medicine. There are semi-official recommendations in both the UK and USA. The AMA has long had this.
The rationale for using chaperones is twofold. In theory their primary purpose is to protect, comfort and assist the patient. In reality though, the usual purpose is to protect the physician against claims of sexual assault or harassment.
Preferably, chaperones should be real professionals, ideally …
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Are chaperones a hindrance to patient privacy?
At the risk of dating myself, I recall a time when “The Three Rs” summed up American education. In case you aren’t familiar with this phrase, it stands for “Reading, ‘Riting, and ‘Rithmetic.”
I think it’s high time we develop “Three Rs” for patients. Right now, Patient World is ruled by “E” words such as “empowered” and “engaged,” with “empowered” the big one. I think “empowered” is turning into a label, …
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Responsibility, respect and relationships are important for patients
Primary care physicians often have to see patients with a litany of issues. Often within a span of a 15-minute office visit.
This places the doctor in the middle of a tension — spend more time with the patient to address all of the concerns, but risk the wrath of patients scheduled afterwards, who are then forced to wait.
And, in some cases, it’s simply impossible to adequately address every patient question …
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Patient complaints do not fit the primary care office visit
Merry Christmas!
I’d like to thank everyone for your continued readership.
Doctors, patients and other health care professionals need to be heard, and there’s no better place to do so than here, on social media’s leading physician voice.
This year, KevinMD.com had a regular rotation of 175 guest contributors, and surpassed 1.75 million visits, 2.95 million pageviews, 33,000 followers on Facebook and Twitter, and 40,000 RSS subscribers.
I am truly …
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Posts of the year on KevinMD.com, 2010 edition
When I realized that I would be moving to a different county within Southern California and would have to change jobs, I knew it would be inevitable that I would have to say goodbye to my patients. I was dreading this. I mean, really dreading it. I don’t like goodbyes. I feel as though I am breaking up, and in a way I am.
Like any other relationship, my patient-physician relationships …
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Say goodbye to your patients the right way
If I was Surgeon General, I would follow the lead of our country’s first Mom.
This is serious folks.
We, as an American society, need to solve the obesity crisis. Not just for our physical health, but for our country’s financial stability.
Reducing the spiraling costs of health care is wanted by all. So far, prevention of the diseases which contribute most to our health care costs, (heart disease, cancer and orthopedic issues, …
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Solve the obesity crisis to ensure our country’s financial stability
As the saying goes, when you’ve got a hammer, everything looks like a nail. Send a patient to a surgeon, and he very well might get surgery. Send a patient to a psychiatrist, and he very well may end up on psychotropic medication.
As physicians, we need to take responsibility for our own actions. We should not prescribe or perform procedures unnecessarily. However, even if we are responsible for our own …
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Physicians need to take responsibility for their actions
In a report from the Archives of Internal Medicine, it was reported that most hospitalized patients (82%) could not accurately name the physician responsible for their care and almost half of the patients did not even know their diagnosis or why they were admitted. Of the physicians, 67% thought the patients knew their name and 77% of doctors thought the patients “understood their diagnoses at least somewhat …
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Pay close attention to what doctors say to patients
Advocates of alternative health attribute all sorts of fantastical properties to the human body. The body supposedly “knows” how to live a long healthy life; the body is supposedly “designed” to work perfectly. The tenets of natural childbirth philosophy also invoke these fantastical properties. The body “knows” how to give birth; a woman’s body is “designed” to give birth.
On their face these claims are obviously false. The body doesn’t “know” …
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Natural lifespan and whether a woman is designed to give birth
by Kelly, MD
There is a reason why people often say “the art of medicine.”
It’s not just the fact that so much of what we do is based on culture and habit rather than science, but also the fact that there is a lot of finesse when it comes to relationships as a doctor. Oh sure, we know all about patient-doctor relationships and its importance. There are …
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The art of medicine and mastering relationships
When is an ice cream label a health literacy tool?
When Dr. Barry Weiss decided to use an ice cream label as a tool to asses whether we (patients) are able to understand medical instructions. Funded by Pfizer-backed Clear Health Communication initiative, Weiss’s research resulted in the creation of “The Newest Vital Sign.”
A health literacy assessment tool, with findings published in the Annals of Family Medicine.
However, the document, Why …
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An ice cream label as a health literacy tool
Several years ago, I spoke at Baylor College of Medicine in Houston, where Michael DeBakey, the legendary heart surgeon, was master of the universe for nearly half a century.
I heard lots of DeBakey stories during my visit, but one in particular really stuck with me. “A few years back,” someone told me in a voice of hushed reverence usually reserved for descriptions of flawless beach days and single …
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Why physicians ignore fatigue
by Mary Lynn Summer
I am a nurse. Like most medical practitioners, I am afraid of malpractice attorneys and view them as a threat to my nursing license. Every hospital has a system in place to deal with medical errors and patient complaints. I used to think they worked, but now I don’t.
My mother, in her late 80s, recently broke her hip. She has dementia so is unable to appropriately express …
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A nurse and the system to deal with medical errors
At “Background On The ‘Ecosystem’ of Commercial Healthcare IT” I wrote:
… In reading about HIT difficulties it is important to understand the “ecosystem” of commercial health IT, that is, the identity and nature of the principal constituents and stakeholders, and their interrelationships. Familiarity with this environment is useful in order to place the social and organizational issues affecting HIT diffusion in the proper context.
By implication, I made the case that the …
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The commercial health IT ecosystem and its implications for patients
The waiting area in Bellevue Hospital was full. Every chair was taken. But the people kept streaming in. More chairs had to be brought in. It wasn’t clear if the room could accommodate everyone.
This wasn’t the emergency room or the clinic waiting area, however. It was the scene of the Bellevue Literary Review poetry and prose reading. More than 100 people poured into Bellevue Hospital on a Sunday evening to …
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A poetry reading at Bellevue Hospital
by Paul M. Cinciripini, PhD
If you smoke, quitting the habit is the best New Year’s resolution you could make — and keep — in 2011. That’s true even if you’re just a social smoker.
A new report from the Surgeon General shows that even occasional smoking and secondhand smoke cause immediate damage to the body.
The good news is that people who stop smoking before age 50 cut their risk of dying …
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Quit smoking in 2011: 5 steps you need to know
About 60% of patients suffering from depression do not find any benefit from their first antidepressant. Up to 20% of patients find depression impossible to overcome even after 1 year. Assertive treatment of depression from the get go is essential to helping recover from depression.
Psychiatrists don’t have a shared definition of treatment resistant depression. However, most would agree that your depression may be treatment resistant if it has not resolved …
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Solving treatment resistant depression
Being a physician always has been a busy job.
This is especially true for primary care physicians who set as their goal the delivery and coordination of comprehensive care for patients. Achieving such a goal requires availability, a broad spectrum of medical knowledge, effective use of the local health care system, and attention to both the “big picture” and the details of a patient’s life and …
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Physician time should be considered a resource
