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.
In its current listing of online social networks, Wikipedia presents 156 major, active websites. A neighboring link to view “now-defunct” sites accompanies the listing — a subtle reminder of the Internet’s competitive and volatile environment where promising endeavors rise and fall overnight.
But although the popularity of a specific website may fade with time, the practice of online social networking is here to stay.
In its simplest form, online social networking is …
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Social networking impact on patients, doctors, and non-profits
by Mike Himowitz
When you’re advocating for a health cause, can good news be bad news?
It’s entirely possible — when science threatens fund-raising, and at the worst possible time.
Consider a study of worldwide maternal death rates by a team from the University of Washington that appeared online recently in The Lancet.
The group, led by Christopher Murray, of the school’s Institute for …
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Maternal death rates improve but hurts fund raising
Last week my wife and best friend, Elaine, had massive abdominal surgery. We fully expected her to be an inpatient for a week, but she was home in four and half days. To watch her recover was to see what happens when everything converges: the deep knowledge and skills of excellent, humane physicians; a capable, caring clinical staff; wonderful new technologies; and a lifetime of eating right, being fit and …
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Quality hospital care deserves to be celebrated
by Crystal Phend
Lack of insurance and financial concerns keep patients from treating a heart attack like the emergency it is, researchers affirmed.
A delay in getting to the hospital for treatment of acute MI was 38% more likely among the uninsured and 21% more likely among insured patients with financial concerns, reported Paul S. Chan, MD, MSc, Mid America Heart Institute in Kansas City, Mo., and colleagues.
More than two in every …
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Money prevents patients from seeking timely heart care
by Diana E. Lee
The cost of therapy and medication for underinsured people are common barriers keeping people from getting treatment for a mental health problem.
Although there are community mental health centers that provide treatment for many people, their resources are stretched far too thin to help everyone who needs treatment on the level someone with a more serious issue may need. One of the most positive changes that will arise …
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How health care reform will affect mental health
Free is good, right? If you have to pay out of pocket for medicines, free prescription drug samples from your doctor’s office might seem like a godsend. But nine times out of ten, these free samples end up costing you more money. Here’s how.
First of all, pharmaceutical reps only get paid to give out brand new medicines that their companies are trying to promote. They are giving out these drugs …
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Free prescription drug samples cost patients more money
I had an interesting juxtaposition of events. While waiting in Peets, a coffee shop in Lexington Center, I watched the friendly discussions between the baristas and customers.
I then went to a doctor’s appointment, where a nurse stood typing at a laptop asking me a series of questions, including “Are you in pain?” and “Do you feel safe at home?” She didn’t look at me once as she read and typed.
Eye Contact …
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Doctors need more eye contact with patients, not computers
by Charles R. D’Agostino, MD
We’ve all seen the headlines –- “Primary Care Physicians Becoming a Scarce Breed”, “Wait Times for Appointments Increasing”, “Primary Care in Crisis” –- and have heard the pundits pontificating on the deteriorating state of primary care.
But rarely do we hear what’s happening from physicians on the front lines, those actually seeing patients. Consequently, with direct access to the primary care trenches, replete with an overworked …
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Primary care is burdened by excessive paperwork
by Toni Bigby
Our Federal Government is investing in a consumer education campaign called, “Questions are the Answer.” The idea is to encourage people to watch out for themselves a little better and be their own advocate by asking their doctors questions like, “Why do I need this surgery?” and “Are there any side effects from this drug?”
Why are we as health care consumers, who collectively spend trillions of dollars each …
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Questions for doctors are powerful patient tools
Working in the hospital this month, my team has been caring for Mr. M. He was here when we started on service at the beginning of the month, and unless his planned transfer to another facility goes through, he’ll be here when we sign off to the next team at the end of the month.
Mr. M is in his fifties. He speaks Spanish. He is an undocumented immigrant from Central …
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Undocumented individuals make hospital discharge difficult
I consider my most successful cases to be the ones that do not seem me any more. Not that they are “better”, but they and their families have come to realize the full complexity of the problems they are struggling with, and are getting appropriate help.
I inherited my “ADHD practice” from another pediatrician. He was wonderful man, a larger than life, toss babies in the air pediatrician with a hearty …
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ADHD needs more than drugs to appropriately treat
by Todd Neale
The greater burden of colorectal cancer in the black community appears to be related to healthcare utilization, and not biology, researchers found.
Similar proportions of black and white patients had polyps or masses detected by flexible sigmoidoscopy, but black patients were less likely than whites to have the recommended follow-up colonoscopy (62.6% versus 72.4%), according to Adeyinka Laiyemo, MD, MPH, of Howard University in Washington, and colleagues.
After adjustment for …
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Colorectal cancer in blacks is affected by healthcare utilization
Dr. Desiree Pardi was the palliative care medical director at Weill Cornell Medical Center in New York. She died of metastatic breast cancer in 2009 at the age of 41.
Her story provides palliative care clinicians an opportunity to reflect on how our own personal mortality interacts with our professional lives.
I did not personally know Dr. Pardi. I write this post knowing that many readers did indeed know her, some …
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Palliative care physicians confronting their own mortality
by Emily P. Walker
My grandfather recently died of pancreatic cancer.
My grandpa was a WWII veteran, a nature enthusiast, an animal-lover, a chiropractor until the 1980s, and a firm believer in natural medicine. He helped my grandmother give birth to five children in her bed, and neither of them had ever taken any drugs except when both were hospitalized one winter with pneumonia.
As someone with a major respect for medical doctors …
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Dementia affects the entire family
Patient satisfaction, as I wrote previously, is being increasingly focused upon.
Doctors are often pressed for time, and appear rushed — which can potentially lead to unhappy patients.
I saw this small study showing that the simple act of sitting down while talking to patients can have a profound effect. Many doctors I know already do this, but now there’s some data to support sitting.
According to the study, performed at …
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Patient satisfaction scores improve when doctors sit
When her gynecologist told her she had high blood pressure, Marie had a simple solution: switch doctors. After all, she had gone to him for a different problem, and this was the first time he had ever checked her blood pressure.
“He said, ‘Oh my God, you’re like a bomb waiting to explode.’ I said, ‘I didn’t come here for that, I came here for something else,’” she explained.
Two years later, …
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High blood pressure treatment that patients need to know
by Kristina Fiore
If you’re surrounded by heavy drinkers, you’re more likely to become one, new research shows.
An analysis of data on alcohol consumption and social networks found that people are 50% more likely to drink heavily if someone they’re directly connected to does so, Nicholas Christakis, MD, PhD, of Harvard University, and colleagues reported in the Annals of Internal Medicine.
“We’ve found that the influence of your friends and people you …
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Social networks affect alcohol drinking patterns
Illness might be the most isolating and alienating experience a person can know. Lots of well people simply have no clue how to relate to someone with a chronic and catastrophic illness. That sort of thing is scary even just to witness. They hope (or assume) you’ll get better, and then they won’t have to deal with whatever you’re going through – but when that takes too long, they drift …
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Sick friends could use your help
I was consulted recently about an elderly woman who refused surgery for a large bowel obstruction from a colonic mass, likely cancer. The inpatient team asked me to help with the transition to hospice and to help make her comfortable.
I went to see her. She had a nasogastric tube sucking up brown material from her stomach. Her abdomen was swollen and uncomfortable. Her primary goal was to return to walking …
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Palliative care needs a simple and consistent message
