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.
Two things are missing from the bustling conversations on health care reform jamming the Internet highway. First, where among the finger-pointing anecdotes and critical analyses of our “broken” American medical system are the stories and discussions of all that is right? Second, where is our sense of hope?
I’ve experienced American health care from an unusual, yet useful, vantage: that of a physician with chronically recurring cancer. From both sides of …
Read more…
What doctors can learn from patients in the health care reform debate
by Diana Lee
A recent episode of the A&E show Intervention about a woman with occasional migraines and other serious health problems who takes up to 50 Percocet pills a day made me uncomfortable. Maybe Danielle, the woman featured in the episode, really does have migraine attacks. But she is also an addict. One condition really has nothing to do with the other. Many people with acute or chronic pain use …
Read more…
Migraines and the stigma of chronic pain medication use
Originally published in MedPage Today
by Chris Emery, MedPage Today Contributing Writer
Prostate specific antigen (PSA) tests may lead to unnecessary treatment of healthy men for prostate cancer, and there is little evidence supporting the common but controversial test for routine cancer screening, two new studies found.
Measurements of blood concentrations of PSA failed to predict cancer with the accuracy generally …
Read more…
What’s the latest on prostate cancer and the PSA screening test?
by an anonymous NICU nurse
There is a medical controversy brewing over in England that is threatening to invade the United States. Ms. Capewell, a 23-year old British mother, is claiming English doctors let her 21 5/7 week infant die, only because they were following national perinatal guidelines.
If only he was born at 22 weeks, she insists, they would have tried everything to save him and admitted him to the …
Read more…
Should letting a premature infant die be considered health care rationing?
Originally published in MedPage Today
by Michael Smith, MedPage Today North American Correspondent
In unpublished data, Canadian researchers have suggested that seasonal flu vaccination may increase the risk of catching the H1N1 pandemic strain, but such a pattern has not been found in the U.S., the CDC said.
The Canadian data appear to suggest that people who had been vaccinated against …
Read more…
Is the seasonal flu vaccine associated with H1N1 pandemic influenza?
by Michael Kirsch, MD
The concept of medical excess is very difficult for ordinary patients to grasp. The medical community has worked hard for decades teaching them that more medicine meant better medical care. The public has learned these lessons well. Physicians who sent their patients for various diagnostic tests or specialty consultations were regarded as conscientious and thorough. Patients approved of doctors who prescribed antibiotics regularly for colds and other …
Read more…
Does the bulk of excessive medical care happen in the ER?
by an anonymous radiologist
I recently read the article and comments on this link from this post, concerning radiologists, from Musings of a Dinosaur.
I was disturbed to discover the animosity with which this topic is covered. The tenor of the blog is that radiologists are greedy, self-serving and are out to erode the doctor-patient relationship. The suggestion that radiologists would schedule percutaneous breast biopsies for their financial enhancement is both …
Read more…
Radiologists and communicating mammogram results to patients and their doctors
Originally published in MedPage Today
by Kristina Fiore, MedPage Today Staff Writer
Soft drinks and other beverages loaded with sugar should be taxed as a public health hazard, much as cigarettes are, a group of prominent medical researchers says.
Since extensive evidence ties sugary drinks to an epidemic of obesity and related health problems, such as heart disease and diabetes, they …
Read more…
Should soft drinks be taxed and be called a public health hazard?
by Mark Adelman, MD
While diseases like prostate cancer and heart disease have become household concerns, abdominal aortic aneurysms (AAA), the 10th leading cause of death in men age 55 and older, have been overshadowed by more prominent diseases for far too long. It’s time we pull back the curtain and take a closer look at this serious disease and how it can be both detected and prevented.
An AAA, which …
Read more…
How to protect yourself from abdominal aortic aneurysms
Recently I was on a canoe trip in Ontario, Canada with a close friend. As he and I were portaging our gear and canoe between two lakes I was thinking that the uphill path was difficult and wondered how many more steps it would take. The sooner it was done the better.
I often find myself counting steps during my daily activities as I know that the fewer physical steps it …
Read more…
How eliminating waste and taking fewer steps can improve patient care
by Michael Smith, North American Correspondent, MedPage Today
A minimum of 3.4 million doses of vaccine against H1N1 pandemic flu will be available in the first week of October, the CDC said.
Those doses — all in the form of a live attenuated nasal spray vaccine — may be supplemented by some injectable vaccine, according to Jay Butler, MD, the …
Read more…
How will the H1N1 vaccine be distributed to patients?
What makes a good doctor?
There are two important characteristics. The first is clinical skill: the ability to find a pattern in the patient’s signs and symptoms, the ability to identify the pattern, and the judicious use of medical tests to fill in the blanks of the pattern. The second characteristic is compassion: the ability to care about the patient and empathize with his or her situation.
Many doctors have one or …
Read more…
Is an efficient physician necessarily a good doctor?
by Monte Ladner, MD
The August 17, 2009 issue of TIME magazine ran a cover story entitled “The Myth About Exercise” with a subtitle claiming it won’t make you lose weight. The author of the article cherry picked bits of data from several scientific studies to make the case that exercise won’t help with weight loss, and might even lead to weight gain by causing people to eat more.
The TIME …
Read more…
Is the obesity epidemic caused by too much exercise?
The Obama healthcare plan hinges on savings achieved through the implementation of electronic medical records (EMRs) and pays doctors $44,000 over 5 years for hardware and software to embrace this evolving technology. Let us not forget however, that garbage in produces garbage out, for instance, information not suitable for medical decision making.
In reality, data entry is daunting and by far the most expensive aspect of converting to electronic records. Huge …
Read more…
Data entry in EMRs, and why doctors are slow to adopt information technology
by Susan H
1. I acknowledge and believe that I will die someday. Everyone I love will also die. That inevitable outcome will be factored into all my personal health care decisions.
2. I acknowledge that just because a paid professional might be found to assert that he would have performed differently under similar circumstances, doesn’t mean a doctor or nurse committed malpractice. Judges who are overturned on appeal ought to …
Read more…
The Patients’ Bill of Responsibilities
by Jeff Brandt
There is much confusion about Personal Health Record (PHR) in the market today.
PHRs are divided into three groups; Mobile SmartPhone (mPHR), Cloud Apps, and other devices such as USB and Smartcards. Each type of PHR serves a different purpose and provides a useful and needed service. I will speak to the strengths and weaknesses of each of them.
Web Apps/Cloud PHR
These are browser based systems that need to be …
Read more…
A personal health record and using the PHR on a mobile smartphone
by Michael Smith, North American Correspondent, MedPage Today
People infected with the H1N1 pandemic flu strain continue to shed virus after the point where current recommendations say they can go back to work or school, two studies here suggested.
The question, experts said, is whether those people are still contagious and whether a longer stay-at-home period would prevent enough additional …
Read more…
How long are you contagious after being infected with H1N1 influenza?
by Kumud B. Jindal, MD, MPH
Many patients and self-appointed health care experts view medical services as commodities, and openly express frustration with seemingly opaque pricing for a visit to the doctor’s office. “Doctors should publish their fees so we know what we’re paying!” The idea that this matters significantly with regard to health care costs is a terrible myth, one that deserves much closer scrutiny.
The health insurance industry and …
Read more…
Why price transparency won’t affect health care costs
by Cole Petrochko, Staff Writer, MedPage Today
Don’t wait for the pandemic H1N1 vaccine to become available before getting an inoculation for seasonal flu, the National Foundation for Infectious Diseases warned.
Putting off routine flu shots in hopes of one-stop-shopping would defeat the primary line of defense against a proven threat, according to a panel representing some of the nation’s …
Read more…
Don’t wait for the H1N1 vaccine before you get your flu shot
by Michael Kirsch, MD
Consider this hypothetical vignette. Tiger Woods accepts my challenge to play 18 holes. Obviously, the gallery would be packed with golf enthusiasts who would cancel job interviews, vacations and even worship services in order to witness this historic competition. Spectators would be permitted to place bets at even money. Perhaps, my mother would bet on me, but no other sane person would. They would properly conclude that …
Read more…
What does Tiger Woods have to do with medical futility and end-of-life care?
