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.
There’s an interesting video from WCVB in Boston about doctors getting kick backs from the insurance company to switch patients from branded medications to generic medications: New Rules To Protect Prescription Drug Customers.
If people were concerned about undue influence when drug companies used to give physicians pens and other novelties (now currently banned by most companies), they should really be concerned about actual monetary payments.
Actually, she was nobody’s patient, she was just a wife; she was “the family.” She was a rough, stern looking woman, and with good reason as she had weathered many difficult times. Her husband had been severely demented for many years; however, it was only in the past few months that he required such intensive inpatient care.
I’ve been hearing and reading a lot lately about how the doctor-patient relationship is under siege. There are many reasons for this, ranging from care decisions increasingly being made by insurers to the shortage of primary care physicians, to patient empowerment. I didn’t quite understand how patient empowerment could be a threat, until I started thinking about the recent perceptual shift from patients to health-care consumers.
They start out by asking open-ended questions, and unless patients get too far off-track, they don’t typically interrupt them. Despite having limited time for appointments, they have an unhurried manner. They make eye contact with their patients and do not bury their heads in charts and computer screens. Their patients leave their appointments feeling respected and heard.
Recently, the 21 percent cut in Medicare physician reimbursements was replaced with a 2.2 percent pay hike.
Later this year, Congress will have to consider the matter once again, just as it has ever year since 2003. This is the third time this year that Congress has averted Draconian cuts to physician’s payments. What, you might wonder, is going on?
Here is the back-story. In 1997, Congress enacted a so-called “sustainable growth …
Since the subtext of the natural childbirth and attachment parenting movements is the notion of the good mother, it’s worth asking what makes a good mother. My whole approach to writing about childbirth and mothering choices is based my rejection of currently popular beliefs about good mothering.
Simply put, I believe that good mothering is about choosing mothering and not about mothering …
I often find, when I talk with patients and families about hospice care, there is a palpable sense of relief; relief that there is another option when facing a terminal diagnosis or end stage disease process.
Families who have participated in caring for their loved one at the end of life are grateful for the guidance provided in hospice care. Patients in turn are grateful to spend their last days at …
I was in a room full of Family Doctors – who call themselves everything but Family Docs: Family Physicians (FPs) Primary Care Physicians (PCPs) General Practitioners (GPs). It was the Society of Teachers of Family Medicine (STFM) Spring Conference, at a session entitled: “Language Matters: Women-centered talk during pelvic exams.”
Two men amongst 20 women, all interested in learning more about being Politically Correct (PC) whilst conducting a pelvic exam. Session leaders Drs …
In diagnosing areas of chronic pain for adult pain management, I have come across a helpful test which I have unable to peer review.
It is the Draw a Person test. Pain management physicians have not used this easily identifiable test to evaluate the subconscious of the patient. This is done by asking the patient to draw a male and a female, with …
Summer has already begun, and LeeAnn has already had enough of mosquitoes. She wants to know, “Does taking Vitamin B1 really help keep mosquitoes from biting? How much is safe for children?”
I remember a trip to the Florida Everglades as a child with school—surrounded by mosquitoes, alligators, and miles of swamp, our teachers told us that mosquitoes are a vital part of the food chain, and essential to the ecosystem.
“Avoiding those twin traps of overtreatment and therapeutic nihilism”
Recognize this phrase? It’s from our Hippocratic Oath, the one I took, standing beside my newly assigned cadaver, in my second year of medical school.
“What Broke My Father’s Heart“, recently in the New York Times Magazine, is an exquisitely painful story of medicine and our Oath gone awry in the United States. I urge you to read it.
Did you ever see the Seinfeld episode where Elaine gets into trouble at the doctor’s office? While she’s waiting in the examining room, she sneaks a peek at her chart and notices that it says she’s “difficult.” When the doctor comes in, he whips the chart out of her hands.
So-called cyberbullies share many of the psychosocial features as their victims — and in fact many bullies were also victims themselves, researchers from Finland said.
A population-based cross-sectional study surveyed more than 2,000 seventh- and ninth-graders in two Finnish communities and found that cyberbullies had higher than average rates of self-perceived difficulties in life, headache, feeling unsafe at school, and perceiving teachers as uncaring, among other problems, reported Andre …
It has been 10 years since the landmark Institute of Medicine report “To Err is Human” uncovered disturbing deficiencies in the quality of our nation’s medical care.
Progress in correcting these deficiencies remains frustratingly slow, and it has become clear that achieving the quality and safety improvements we seek will require us to examine our approach to medical education.
Although today’s newly minted physicians are well prepared in the science of medicine …
Last month Dave deBronkart, known on the internet as “e-Patient Dave,” released his first book, Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer (and what healthcare can learn from it)(www.LaughSingBook.com).
It’s his personal cancer story – excerpts from the journal he kept …
Regina Holliday’s husband, Fred, age 39, died of cancer in June 2009 leaving his wife, and his two young, beautiful children behind. During their journey through the healthcare system to try to get Fred the help he needed, too many hurdles were put in their way. Their story makes you want to scream.
Among the horrors of their journey was the fact that Fred was transferred …
People often seem to think that members of the medical world are excessively preoccupied with, defined according to, and ruled by a status-oriented system.
That may have been an accurate perception a generation ago, but I’ve seen enough surgeons sweeping O.R. floors, attending physicians socializing with interns, and doctors having deep conversations with custodians to believe that “medical people” have matured a little past the old caste systems that governed the …
Last year, People published an interview with Cindy McCain, wife of U.S. Senator John McCain of Arizona.
She revealed she has dealt with excruciating migraine attacks for about 15 years, including during her husband’s presidential campaign. Though she has never discussed them publicly before, she has chosen to talk about her situation now to help bring awareness to this disabling condition and all the people going through what …
Someone going by the name “Darthmed” recently posted a comment that stopped me in my tracks:
… The remaining 95% of “patients” out there are not motivated to become informed, or invest the time/energy/money in using any of these tools. These are the folks that know that fast food isn’t healthy, but are just too tired to choose differently. Some (emphasis on some) will do a standard Google search when they …
I’ve been interested in the role of testosterone in physical performance, depression and aging for many years. While at the University of Iowa, I was involved in research to detect testosterone doping, the psychological effects of testosterone and the potential for testosterone to alleviate depression in older men.
One of the difficult questions facing clinicians is when is testosterone too low in older men.
