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 been volunteering in an emergency department of a Southern Californian community hospital for five years. I clean gurneys, stock shelves, provide support for RNs and EMTs and translate for Spanish-speaking patients. Since my job requires minimal intellectual effort, I’ve had considerable time to observe the staff and contemplate the inspiring work they do.
I’ve watched them perform heroically with sick babies, …
I went to the doctor yesterday, my semi-annual visit, as it were. These days I see a nurse practitioner, a woman. Recently, she and the practice she is a part of moved into a renovated building, state-of-the-art, they are calling it. It almost sparkles in its newness. The practice is owned by one of the large hospital corporations in our city.
Rarely are health care professionals given the opportunity to truly ponder a crucial aspect of patient care; the truth behind what it feels like to lie in a hospital bed, vulnerable, disoriented, and stripped of every basic human dignity. I have spent over 300 days as a patient in hospitals and more than three decades in and out of doctor’s offices and testing facilities. I have a profound respect for …
The harder the conflict, the more glorious the triumph. What we obtain too cheap, we esteem too lightly; it is dearness only that gives everything its value. I love the man that can smile in trouble, that can gather strength from distress and grow.
― Thomas Paine
Dear my oncologist,
This year was my 11th anniversary as a breast cancer survivor. For the past 6 …
Imagine patient-centered care explained as a kind of updated Norman Rockwell painting. What you’d get is a recent PBS documentary, Rx: The Quiet Revolution, which, yes, uses a famous Rockwell image of a kindly family physician (Doctor and Doll) to set the stage for what follows.
Putting patient-centeredness into practice
The 90-minute film, available for viewing online, features four extraordinary stories of inspiring health care providers working in Maine, Mississippi, Alaska …
Spring ushers in major holidays in many faiths and religions. The rites of spring and the vernal equinox, new life and rebirth are springtime themes and touchstones across many cultures. Faith is important to many people and across many cultures and religions. I would assert faith is even important to atheists and agnostics, and those without a formal religious tradition.
“He’s just expired,” said the nurse as I approached Ray’s room in the large inner-city hospital where I work as a patient advocate. “And his wife has just arrived. Why don’t you go in?”
I found Natalie bent over Ray’s body. His hollow cheek was drenched with her tears.
“I’m so sor –”
“I told him yesterday to talk to Jesus,” Natalie interrupted, speaking quickly. “I told him if the two of them …
Managing diabetes is all about control: controlling what you eat, when you eat, and the amount of insulin you give yourself. As someone with type 1 diabetes, I understand how control over one’s blood glucose levels is vital to maintaining a healthy lifestyle. When I was hospitalized due to a car accident, however, I saw how the hospital’s desire to control my care ended up costing my insurance company more …
There are a lot of frustrated and unhappy people out there when it comes to their perception of health care today. The contemporary practice of medicine is changing, rapidly, and those changes have been a challenge for patients and physicians alike. The list of reasons for this is lengthy. Certainly physicians and hospitals are finding it difficult at times to meet all the changes and demands put on them, by …
It’s hard enough to sustain a good relationship when neither partner is facing a health challenge. Illness ranks high on the list of life’s stressful events, so it’s no surprise that it can have a negative impact on a close relationship. Couples may benefit from counseling, one of the principal reasons being that the presence of a neutral party in the room can facilitate more calm and constructive communication.
I have been doing emergency medicine for almost ten years — thirteen if residency counts, and I sure think it does. I face the same issues that cause my work colleagues, physicians and nurses alike, to burnout. I struggle with burnout myself, but I keep coming back. Many days (and nights), I ask myself why I continue to do what I …
I consider myself a pretty savvy and resourceful consumer. I know how to solve problems that come up in the day to day situations we all face. I have navigated my way through more than a few complicated and sensitive financial situations. Add to that my ability to be persistent, and you would think that I could figure out a simple denial of an insurance claim with ease, right? In …
If I could drop our health insurance altogether, I would. With a high deductible of $4,000 for in-network providers, my family of three has yet to reach our collective deductible over the last three years. This means we have to pay out of pocket for medical care until we reach that amount. To make matters worse, our health insurance premiums increased by 10 percent, forcing us to find a less …
Sometime while I was still in high school, my mom began to have trouble breathing. She had never had asthma before; an albuterol inhaler helped for a while. Still, cold season was a nightmare, and later, so was allergy season, and every year seemed to get worse.
After college, I moved back in with my parents. She fought her way through the cold season, dutifully driving 20 miles (and later 40, …
Recently the Mayo Clinic named a patient as a visiting professor for 2015. The patient, Dave deBronkart (otherwise known as “e-Patient Dave”) was chosen by the internal medicine chief residents to fulfill this unique role, where he would have the opportunity to lead grand rounds, give educational talks to medical students, residents and faculty, and truly emphasize the message of patient engagement and empowerment.
As part of the increasing push for health care quality improvement, a lot of energy is being focused on improving our communication with patients and making sure that patient-centered care is more than just a buzz phrase. Gone are the days when the doctor-patient interaction was a wholly paternalistic one, where the doctor’s word was taken as final and absolute, and patients weren’t encouraged …
I assumed many things that morning. For instance, I thought it was likely that Ronald’s fatigue was from lung cancer that had metastasized to the liver. Or that he decided to stay in his room in the nursing facility because the decision to elect hospice had finally taken its toll. I was sure that he was both physically and emotionally spent. I reasoned that I wouldn’t want to get out …
My family and close friends have done so much for me since I became chronically ill in 2001, and I’m deeply grateful to them. I’ve written this piece because there are a few important things I want them to know about how I feel.
Although this piece is personal in nature, I’ve been hanging out online for over a dozen years with other people who are chronically ill (which includes those …
She is a time traveler. She spends an hour with each patient, takes note of each symptom, listens to each emotional concern, takes every call from every worried patient, handles all emergency situations, fills every prescription, handles each every insurance concern, breaks bad news gently, does her hospital rounds, yet is never late to see those in the waiting room.
