How many times have you started a new exercise program and been determined that this time would be different? You’d actually keep it up. You wouldn’t quit. But, a few weeks or months later, you’re back to your old ways. You’re busy, and you have lots of “legitimate” excuses for skipping a fitness routine.
I think most people who have tried to make regular exercise a part of their lives have …
3 tips to stick with an exercise program
by Charles Bankhead
My oldest sister died recently. She spent the last three years of her life in a nursing home, trying to hold on to reality and her dignity as her mind and body betrayed her.
Barely five feet tall, my sister Peggy had a big heart and a vibrant personality that made her seem much taller. I have a lot of fond memories of her, many of which involve her …
Laughter and humor heals the soul in life’s most difficult times
What is the purpose of the note in the patient chart?
Depends who you’re asking.
The best guidance I ever received on how to write a good note came from my residency program director, who told us that a note needn’t be encyclopedic to be excellent; in fact, he urged us to get away from the “second-year medical student” style, which typically includes absolutely everything.
Instead, he urged us to write, as concisely …
Notes in the chart are helping patients less
A guest column by the American Board of Internal Medicine, exclusive to KevinMD.com.
The concept of patient-centered care was catapulted into the mainstream by the publication in 2001 of the seminal Institute of Medicine report Crossing the Quality Chasm: A New Health System for the 21st Century. This report identified six aims of improvement for the U.S. …
ABIM: Patient centered care is crucial in health reform
by Emily P. Walker
The number of obese adults in the U.S. continues to rise, despite a growing number of federal anti-obesity initiatives in the past two years, according to a new report.
The seventh annual “F as in Fat” report, released Tuesday by the nonprofit Trust for America’s Health and the Robert Wood Johnson Foundation, found that obesity rates continued to rise in 28 states from 2007 through 2009.
Nationally, two-thirds of …
Obesity in American children and adults continues to grow
A while back I did in a post where I asked the question, What can patients really expect from their physicians today? In that post, I wondered at the fact that many patients still have a high degree of trust in their physician in spite of the quality and safety problems attributed to physicians in the press.
For example:
Is patient adherence responsible for health quality and safety?
Death is not the enemy. We all die.
The enemies of patients and physicians are premature death, disease, disability, pain, human suffering.
I believe that all people deserve a death with dignity and without pain. Palliative care is the right mode for as many as 80% of all Americans who will die of chronic progressive incurable diseases. Eighty percent of those state that they do not want to die in a hospital …
Every patient deserves a death with dignity and without pain
by Michael Smith
Clinicians treating dying patients did well in managing pain but fell short on communicating with patients and their loved ones, researchers said.
The findings, from a single-institution study, suggest that those who care for terminal patients also often failed to assess shortness of breath in a dying patient whose mechanical ventilation was withdrawn, according to Anne Walling, MD, of the University of California Los Angeles, and colleagues.
But overall those …
Caring for dying patients needs better physician communication
An excerpt from Stroke Diaries.
by Olajide Williams, MD
The man who did not take his medicine
Pedro was lying on the bathroom floor next to the toilet bowl. Water was still running from rusty faucet, overflowing the sink, and pooling around his body as he lay limp on wet porcelain tiles. Lucy was standing over him and whining. The young black Labrador retriever had not left …
What does a TIA feel like? A Stroke Diaries excerpt
by Nancy Walsh
Both maternal and paternal cigarette smoking can contribute to adverse chronic conditions — physical and psychological — in children, two large studies found.
Writing in the July issue of Pediatrics, Marie-Jo Brion, PhD, of the University of Bristol in England, and colleagues reported that children in two cohorts whose mothers smoked were more likely to have conduct/externalizing behavior problems than were those who had no prenatal tobacco exposure:
* British …
How adult smoking affects behavior in children
Most people enter the healing arts with a genuine desire to serve others.
The long educational journey and the realities of both the workaday world and the various business models of health care often strain our abilities to act in an empathic manner.
We have to pay the bills, after all.
“No money, no mission,” is a refrain I’ve often heard in the non-profit corners of the health care world, justifying business decisions …
Empathy is needed for better relationships with patients
Gordon Gekko is wrong. Greed is not good. Not when it comes to health care providers.
The socioeconomic study of what motivates people is a fascinating field of study, not the least of which is because of how counter-intuitive it is. For example, it seems normal to assume that the more someone is rewarded for their efforts, the more effort they will put forth toward those rewards.
These rewards (increasing salary, bonuses, …
Greed is not good when it comes to doctors, patients and medicine
The news that Dr. Marcus Conant has quit practicing medicine is a blow to healthcare here in the Bay Area.
And a sad symbol of all that is wrong with healthcare – and in particularly, the way we treat primary care practitioners – in America today. It would be hard to find a doctor more symbolic of the best of medicine than Marcus Conant – a man willing to devote …
What to do if your doctor quits and leaves medicine
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One currently popular folk remedy, kombucha tea, is …
Kombucha tea can be dangerous to your health
Say the words, “Patient-centered medical home,” and you’re bound to get a variety of opinions.
On this blog alone, there are a variety of guest pieces critical of the effort, saying it does not increase patient satisfaction, nor does it save money.
And that’s not good news for its advocates, who are pinning primary care’s last hopes on the model.
Medical homes hit the …
Why patients are wary of the primary care medical home
by Kate Atkinson, MD
Six years ago, I organized a group of female healthcare practitioners for a women’s medical journal club. A multidisciplinary team of doctors and NPs from primary care and sub-specialties regularly attended monthly dinners. Invited speakers presented on a variety of topics and over the course of a meeting we exchanged insights while challenging each other on how best to manage our challenging patients.
Our group grew …
How the Massachusetts gift ban hurts primary care doctors
I recently received a call from a mother that made me both want to cry and scream out in frustration.
Several months ago I wrote a post entitled Drugs for Children May Silence Stories, in which I described a young boy who had suffered severe neglect as an infant. His adoptive parents had sought help from me when he was four, but when I recommended intervention for the whole family …
ADHD and how drugs impede meaningful help for children
Medical school trains us to deal with a wide range of medical problems.
No matter what our current practice or specialty, at some point during medical school we will have had to study and demonstrate our knowledge and competency in dealing with common disorders like diabetes, hypertension, depression, chronic pain and countless other ailments. In addition, we will have spent hours poring over much rarer disorders, conditions that many of us …
Obesity should not require specialists to manage
Everybody knows politics is a balancing act. One must balance promises against reality.
For example, how does government keep Medicare intact for seniors while cutting $500 billion out of Medicare when government has no track record of cutting entitlement spending?
And how one do it without losing the vote of seniors, who hold the key to the balance of power?
The Obama administration and the Democrats hope to keep power by winning the …
How seniors will accept cuts in Medicare from health reform
“You know, what Mr. HD really needs is for his mom or somebody to chain herself to him…” [the ICU team laughs] …
“But seriously, he needs to be watched over, he needs to be talked to. He needs someone to give him his medications, someone to take him to his appointments, someone to take care of him. With that somebody he can live for years to come. Without that somebody …
Chronic illness needs to be managed at home, not at the hospital
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