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’ve struggled almost my whole life with food. During my late teens I was obsessed with dieting and calorie-counting, which turned into compulsive eating and a powerful addiction to sugary, fatty foods in my 20’s and 30’s – even though I had both a medical degree and a degree in dietetics (human nutrition).
Obviously, having scientific knowledge about food and health isn’t enough to help someone control their uncontrollable behavior around …
So said Dr. Susan Pinker, psychologist and author. This perfectly articulated truth puts into perspective popular thinking: To make a decision, the most important thing is evidence-based information: all you need is science. To this I say, that’s a bunch of hooey. Science tells us nothing about the individual. Thank you Dr. Pinker.
Creating the expectation that health decisions are entirely based on evidence-based information …
A doctor at Sloan-Kettering Cancer Center recently advised that I submit to genetic testing without ever having met me. It turns out I may harbor a gene that increases my risk of developing prostate cancer.
This unsolicited advice was delivered via National Public Radio after a story on the JAMA study of preventive breast and ovarian surgery in women with BRCA1 or BRCA2 genes. Dr. …
Mark Perry provides an interesting inference from two news stories: a WSJ article that suggests consumers are using less health care and another that reports a big jump in MinuteClinic volumes.
Consumers aren’t necessarily consuming less health care like the WSJ suggests; rather, they are shifting their demand for health care away from expensive, conventional physician offices with limited hours to affordable and convenient retail clinics. Especially …
Recently, a press release from Mount Sinai School of Medicine in New York City landed in my e-mail inbox. “Students with Humanities Background Equally Successful in Medical School as Traditional Students”, the headline read.
The press release summarized the findings of a study published in the August issue of Academic Medicine. David Muller, MD, and Nathan Kase, MD, reviewed data on the Mount Sinai …
I’m having a weird, visceral reaction to all of the recent brouhaha surrounding the term “e-patient.”
For some reason, semantically speaking, the term is slipping in to derogatorium. Up there with “cyberchondriac,” which definitely is derogatory. It’s kind of like research—one day, omigod, it’s Mecca; the next day, it’s the scab on a rotting wound.
Whatever.
I have a chronic condition—I’m not dying, it’s not …
Every once in a while, there’s a magazine piece that so encapsulates the key moral issues — and irrationality — of 21st Century medicine that it warrants designation as mandatory reading for anyone who interacts with patients. Atul Gawande has written some of these; so too has Slate medical columnist, Darshak Sangavi.
[Physician blogger John] Schumann was worried, too. He lived nearly a thousand miles away — too far to come and see his friend. Besides, the patient was posting all his test …
Health Affairs reports on a study that finds Evidence That Consumers Are Skeptical About Evidence-Based Health Care.
According to the abstract,
We found many of these consumers’ beliefs, values, and knowledge to be at odds with what policy makers prescribe as evidence-based health care. Few consumers understood terms such as “medical evidence” or “quality guidelines.” Most believed that more care meant higher-quality, better care. The gaps in …
Psychotherapy appointments have traditionally lasted 50 minutes with 10 minutes for paperwork. This has lead to the expression, “the 50-minute hour”.
More recently there has been talk of incorporating psychotherapy techniques in brief visits in primary care. The provoking title “The Fifteen Minute Hour” is from a book about addressing the emotional aspects of disease in primary care during brief appointments. The title and the concept seem relevant to much of …
Speaking to the senior staff of the National Library of Medicine recently was like going before the best kind of murder board.
Picture it: 30 of the nation’s smartest health information mavens around a polished conference room table, asking me sharp questions, suggesting new lines of inquiry, and offering their own insights. In other words, heaven.
Our jumping-off point was the Pew Internet Project’s latest research on internet penetration, mobile use, and …
Most of the resources I’ve read about how to prepare for a doctor’s appointment recommend bringing a loved one with you so that person can help you remember what the doctor said and make sure you get your questions and concerns addressed.
But when I read Paula Kamen’s book All in My Head: An Epic Quest to Cure an Unrelenting, Totally Unreasonable and …
The Alzheimer’s Association sponsors a journal titled Alzheimer’s & Dementia. In the March 2010 issue, they provide a report on facts and figures related to Alzheimer’s disease (AD).
I’m a sucker for data so I spent some time going through the manuscript and here are some of the things that stood out to me:
Ninety (90) drugs are under investigation using human volunteers in the U.S. to slow or stop …
If you had asked me what I thought forgiveness was when I was a young adult, I probably would have said that it is something you do for others—others who have wronged you in some way, to give them a break and let them know that you are no longer angry or upset with them.
As I’ve matured emotionally over the years, my view of forgiveness has evolved significantly. Some of …
A long time ago — when managed care-style employee healthcare benefits were a new thing — we worker bees learned we might have to throw our old family doc under the bus.
We were given a booklet of providers on the network panel, and if the faithful retainer who had served our family for years wasn’t on that list, it was sayonara — unless we …
Care more particularly for the individual patient than for the especial features of the disease.
— William Osler
We enter medical school eager to help the sick and the dying. Over the years this golden objective is transmuted into the base lead of disease-specific diagnostics and therapeutics. Our absorption in the strangeness of the manifestations of a remarkable pathophysiological process may distract us from its impact on …
One of the most common excuses for not wanting to use CPAP is that “I travel a lot.” Even after I explain that many people travel just fine with their CPAP machines, some people are stll reluctant.
With advances in technology and increased awareness by the lay public, government officials and medical professionals about the importance of using CPAP for obstructive sleep apnea, traveling with CPAP, although initially a challenge, can be …
I walked into Room 22 to find a very interesting patient who presented to our ER with complaints of abdominal pain and associated nausea and vomiting.
The patient sat on her cot with her pant legs rolled up above her knees, refusing, according to her nurse, Gwen, to put on a treatment gown. Her left leg hung in the air, her ankle crossed over the knee of her right leg. Her …
Setting: Ouesso, Congo
Position: Timber consortium medical expert
We landed in Brazzaville and took a private jet to Pointe Noire where we spent the night. The next day, the group is assigned six 4×4 Toyotas to take through the Mayombe Mountains, Brazzaville and the plateau to reach Ouesso near the Cameroon border.
The journey is eventful, particularly when I drove the pickup truck into a river from a bridge to avoid children …
Recently, the New York Times reported of the movement in Washington State to officially do something about prescription opioid abuse, coming on the heels of course of the FDA rejecting the current risk evaluation and mitigation strategy plan as, essentially, not going far enough.
The article basically discusses the discussion in Washington about what to do; no formal new plans have been …
