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.
Dr. Paul Grundy is on a mission — a mission to promote the patient-centered medical home model that he has been instrumental in developing and rolling out, in his dual role as Director of Healthcare, Technology and Strategic initiatives for IBM Global Wellbeing Services and Health Benefits, and President of the Patient-Centered Primary Care Collaborative.
I had the opportunity to speak with him last month (here’s the transcript and …
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How the patient-centered medical home can improve our health care system
by Daniel A. Graubert, MD
Medicine has changed so dramatically since I graduated medical school in the 1980’s, that it is hardly recognizable.
Certainly, there has been an enormous growth in knowledge which is often beneficial, but has often led us down the wrong path. For example, when advanced imaging techniques such as CT scans and MRIs became available, we were able to see the inside of large numbers of patients …
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Doctors need to fix the health care system that they had a hand in breaking
Originally published in MedPage Today
by Todd Neale, MedPage Today Staff Writer
Here’s a case where texting may actually improve a teenager’s health: Text message reminders appear to be effective in getting young liver transplant patients to take their immunosuppressive medications, a small study showed.
In 41 patients with a median age of 15, there was a significant improvement in medication compliance …
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Texting young liver transplant patients to take their medications
As Bob Dylan sang so long ago, The Times They Are A-Changin’. Some like change; some do not.
Consider these change scenarios:
* One of the important scenes of change for health care providers is the national debate on health care coverage currently playing out in Washington D.C. Some are very vocal in their support. The media covers many of the vocal opponents. Certainly some sort of change will come out of …
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Embracing the change coming to our health care system
Originally published in MedPage Today
by Todd Neale, MedPage Today Staff Writer
Most patients who underwent extracorporeal membrane oxygenation (ECMO) for respiratory failure survived their struggle with pandemic H1N1 flu, according to a study by researchers from Australia and New Zealand.
Of the 68 patients treated with ECMO during the Southern Hemisphere’s winter, 54 were still alive as of Sept. 7, according to …
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One way to treat patients with severe H1N1 flu
by Phil Sefton
Writers and editors rushing to meet deadlines know the feeling. The effects of stress, a few too many cups of coffee, and perhaps a candy bar or bag of chips in place of a meal can conspire to make the most steely-nerved wordsmith feel a tad nauseated. Or is it nauseous? And what of that stress, that coffee, that ill-chosen meal replacement—are its effects nauseating or nauseous?
Grammarians with …
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Should medical journals use the term nauseous, nauseated, or nauseating?
Originally published in MedPage Today
by Michael Smith, MedPage Today North American Correspondent
The winter wave of the pandemic H1N1 flu hit intensive care units in Australia and New Zealand hard, researchers said, and may offer lessons for doctors bracing for the pandemic’s return to the Northern Hemisphere.
All told, 722 people with confirmed pandemic flu were admitted to one of the …
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How H1N1 pandemic flu will affect intensive care units
Originally published in MedPage Today
by John Gever, MedPage Today Senior Editor
Many African-Americans in California enrolled in health maintenance organizations (HMOs) appear to prefer getting medical treatment in emergency rooms, researchers said.
One-quarter of African-Americans enrolled in Kaiser Permanente or other commercial HMOs in California, who would therefore have a range of treatment options, sought treatment in emergency rooms in 2007, …
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Do HMOs drive blacks to the emergency room?
by Michael Kirsch, MD
This is a less controversial issue than patients ‘friending’ their doctors on Facebook, which I oppose. Although most physicians’ offices are not e-mailing with patients, perhaps they should. There are several obvious advantages.
* Decompress phone lines, which are suffocating nearly every medical practice in America.
* Relieve patients of the cruel and unusual punishment of languishing on ‘hold’ listening to elevator music or dead air.
* Allow office staff …
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Should doctors be paid to e-mail their patients?
Originally published in MedPage Today
by Ed Susman, MedPage Today Contributing Writer
Cruising down the highway in a sleek convertible, with the wind blowing in your hair, may sound like the ideal road trip — but it could harm your hearing, British scientists said.
In a study conducted on the high-speed motorways of the U.K., doctors found that at highway speeds, …
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Will riding in a convertible harm your hearing?
Max Baucus’ decision to release his solo album—subtitled the Senate Finance Committee’s proposal on health reform—was timed with the precision of a 4th grade marching band.
Physicians could live with that, but the bill contained gornisht on tort reform and not much more than that on Medicare reimbursement. Upon seeing that, the Long White Coats reacted as if they’d seen earwax on their stethoscopes.
“The feeling of most doctors is that …
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Does the Max Baucus health reform plan do enough for doctors?
One of the many questions asked in the health-care reform debate is ‘how do we keep people out of emergency departments in order to reduce costs?’ Simply put, we probably can’t. And 16 years into my emergency medicine practice, I think I know why.
Having taken my own children to the emergency department, even I have been surprised at the charges generated. But we should step back and remember that emergency …
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Will more primary care doctors keep patients out of the ER?
Everything old is new again and that is certainly true in the world of “alternative” health. One of the axiomatic premises of contemporary “alternative” health puts its believers behind the times … by approximately 500 years.
A fundamental premise held by believers in “alternative” health is that we are swimming in a world of “toxins” and those “toxins” are causing disease. Like most premises in “alternative” health it has no basis …
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The alternative, complementary, and integrative health obsession with toxins
Originally published in MedPage Today
by Michael Smith, MedPage Today North American Correspondent
A vaccine against cocaine was effective in nearly 40% of users of the drug, researchers said.
In a randomized, placebo-controlled study, volunteers who reached a high level of antibodies after vaccination used less cocaine than those whose response was lower, according to Thomas Kosten, MD, of Baylor College …
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Is a cocaine abuse vaccine coming soon?
Originally published in MedPage Today
by Kristina Fiore, MedPage Today Staff Writer
Contrary to information that led the FDA and other regulatory agencies to release warnings about varenicline (Chantix), a new study has found “no clear evidence” of a relationship between the risk of suicide and the smoking-cessation drug.
Both varenicline and bupropion (Zyban), another drug used in smoking cessation programs, were …
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Does Chantix increase suicide risk?
by Esther Buddenhagen, MSW
I write as a lay person concerned about the gap between what many people should receive and what they actually receive. The question of good medical care for ordinary people is being buried not only by insurance issues but by failure to come to terms with what primary care should be about.
Even Atul Gawande, who is particularly good at making distinctions between good and …
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What the United States health care system can learn from Mexico
The doctor-patient relationship must remain the central focus of good health care. Diminish or hinder that relationship, and no technological advance, funding system, or government intervention in the world will be able to compensate. Many complaints about present health care systems can be seen as evidence of relationship dysfunction, not in the least due to the interference of third parties, administrators, payers and insurers, who wield the financial clout. Transparency …
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Informed consent is central to the doctor-patient relationship
Recently, a former staff medical writer at a MECC (Medical Education Communication Company) anonymously alerted me to a particularly sleazy advertising tactic used by a medical writing company. This person had worked as a pharma-supported medical writer for several years, but recently quit because, “I really couldn’t stomach the ethical problems associated with writing for the pharma industry.” Recently, looking for medical writing jobs, this writer came across a company …
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Medical ghost-writing influences doctors to prescribe more drugs
