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.
Doctors, both generalists and specialists, have constraints on their time. New practices and new approaches need to happen in order to maximize everyone’s time. In addition to bringing your co-payment, you should “invest” in the visit and do your part, so that by the time the visit has ended, a successful plan of care is developed.
Here are some helpful tips to make the most of your medical appointments.
When I ran into Paul S. not knowing he had cancer, I barely recognized him and struggled with what to say. “What happened?” didn’t seem appropriate, although it was my initial reaction. I believe I said, “I barely recognized you,” which was true. I’ve been in many situations where I wasn’t sure what to say to someone who was ill or in distress; I wanted to be supportive …
It’s widely rumored that a health IT industry executive was unhappy about suggestions that systems have to be usable in the eyes of employees who use them while caring for us. (Us. The patients. Your mother.)
According to the rumor, the exec said, “Over my dead body.” As if he ran the agency.
Whether or not the rumor’s true it’s not funny. So when I was asked to represent the patient perspective …
Here’s a question. It’s not a 5¢ or $5 question that anybody can solve on their own without much thought or effort. It’s a $100 ask-an-expert or think-about-it-for-a-second question.
What’s the point of patient empowerment?
Much of the current discussion of empowerment deals with patients who for one reason or another have had to fight for their care. CNN’s Elizabeth Cohen opens her book, …
Grandmother Pat LaColla, 82, was lured by the hype—”get in shape without setting foot in a gym”—when she bought a pair of Skechers last year, wincing at the $100 price tag. Toning shoes like those she bought are the newest craze in athletic footwear, projected to grow 500 percent to become a $1.5 billion market this year.
Although the designs vary, toners typically have strongly curved, thickened soles. From the moment …
Jennifer Goodman Linn, 39, has been through five surgeries and six rounds of chemotherapy since 2004, trying to control the sarcoma that keeps growing in her abdomen.
Goodman Linn has what her doctors call a rare form of a rare cancer — an MFH sarcoma, also known as an undifferentiated high grade pleiomorphic sarcoma. It’s remained confined to her retroperitoneal …
An excerpt from Treat Me, Not My Age: A Doctor’s Guide to Getting the Best Care as You or a Loved One Gets Older.
by Mark Lachs, MD
Over my twenty-five-year medical career, the route by which people are admitted to the hospital for an overnight stay has subtly evolved in ways that most patients (and even many doctors) may not realize. Specifically, the proportion of patients who …
My father passed away about two weeks ago after battling a brain tumor for some time.
Initially diagnosed with an extensive inoperable mass one and one-half years ago, upon presenting with a focal seizure, he did well with only one medication for seizure control for about ten months. Around Christmas of 2009, however, he landed in the hospital in status epilepticus that took three days to control. After these days of …
We say we exchange words when we meet. What we exchange is souls.
-Minot J. Savage
It was Monday evening. The shelves in the electronics department overflowed with different styles, prices, and brands of headphones, all displayed in sealed plastic cases. I was in the mood to buy but was baffled by the array of options in front of me. This was not going to be as simple as I had thought.
Skin cancer is the most common form of cancer diagnosed in the United States.
There are three major types: basal cell, squamous cell and melanoma. Of those, basal cell and squamous cell are most common, accounting for about 3.5 million cases in the United States per year. Although, these types typically do not metastasize, they can be quite disfiguring, particularly after resection when they occur on the face. On a population …
You probably saw the July press reports: balmy tropical breezes, azure surf, cerebral plaques and tangles, and new criteria for Alzheimer’s.
Who could deny an opportunity to spend some time at the best non-oil-spoiled beaches for those who toil at the benches and bedsides for Alzheimer’s victims — and on taxpayer money yet.
It seems to me like, just as human hip and knee joints and premolars and molars are not preprogrammed …
Social anxiety refers to the fear of being around people due to the threat of embarrassment.
People who are socially anxious frequently freeze and are unable to seek the very company their hearts desire. They may make adaptations: they may decide that they “hate” being around people; they may isolate and play video games; they may absorb themselves in their work, but no matter what they do, this anxiety always exists …
Here is an unfortunate, but almost daily not-so-secret occurrence in my practice:
I am in the midst of an intricate follow-up visit with a rather complicated patient with diabetes, high cholesterol, and high blood pressure. I am feeling as though I am a CIA agent in a rather mission impossible assignment: she is here for lab results, is complaining of low back pain, and presents with an elevated blood pressure of …
I need help. In dealing with obesity as a medical problem, that is.
I am pretty solid at arrhythmia management, but as an obesity doctor, not so much. If I was the teacher, and my obese patients were the students, I would surely be fired for poor student test performance. At least, if the core measure was the patient’s BMI.
If a student does poorly on an achievement test, is it the student’s …
In April, an independent panel established by the National Institutes of Health came to the disheartening conclusion that currently, there is nothing to prevent or delay the progress of Alzheimer’s disease in those of us who are destined to join the 5 million Americans currently suffering from this dreaded ailment.
The panel found that: “Although numerous interventions have been suggested to delay Alzheimer’s disease, the evidence is inadequate to conclude that …
Radiation is emitted in various forms. Recently, CT scan radiation has preoccupied (or “absorbed”) the attention of the public and media. As explained: “X rays, γ rays, and neutron beams are considered ionizing radiation. Ionizing radiation may break molecules into pieces, creating ionic free radicals that can be very damaging to tissue.”
For this reason, it is imperative that the use of radiation is only by highly trained personnel and that …
It is a curious fact, seldom remarked upon, that all diseases purportedly caused by vaccination share certain common characteristics. Chief among these characteristics is that the cause of the disease purportedly caused by vaccination is presently unknown.
Vaccine rejectionists never claim that a particular vaccine causes heart disease, gall bladder disease, bone abnormalities or any of the myriad diseases for which causes are already known. Vaccine rejectionists always insist that vaccines …
There are things we (the providers) do to health care that are hurtful. We make protocols and rules that divide us from our patients. Protocols that sometimes make patients feel alone, distant, and disconnected from their doctors. I don’t mean algorithms of care (safe, standardized ways of how and why to treat pneumonia, for example), I mean clinic rules for helping patients schedule and get in to see doctors appropriately.
Thus sprach Phil Fontanarosa and me in a 1998 JAMA editorial in the famous theme issue dedicated to Complementary and Alternative Medicine.
So I went to Mr. Google in 2010 and entered … Alternative Medicine … and clicked — 41,200,000 results; entered Complementary and Alternative Medicine, click — 3,210,000 results; entered CAM, click — 191,000,000 results, but that’s not fair; CAM can stand for many unrelated topics.
In addition to providing those incentive dollars for meaningful use of a certified EHR, the Health Information Technology for Economic and Clinical Health Act (HITECH) significantly strengthened aspects of the HIPAA security rule, including the penalties imposed under HHS and the Office of Civil Rights.
If you are a “Covered Entity” (CE) or “Business Associate” (BA) it’s time to get serious, the deadline to be fully compliant with these final HIPAA …
