Patients

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.

How comfortable are compression stockings for post-surgical thromboprophylaxis?

Crystal Phend

Patient

September 14, 2009

by Crystal Phend, MedPage Today

“Every 10 years a doctor should be the patient,” said my doctor, squeezing me into pair of compression stockings that would make a sausage casing seem spacious by comparison.

“Seems like a good idea,” I thought, as I lay there on the table feeling optimistic about the opportunity for first-hand experience.

It was my first minor …

AMA: How to prepare for seasonal and H1N1 influenza

Kevin

Conditions and Diseases

September 10, 2009

The following is part of a series of original guest columns by the American Medical Association.

by Nancy H. Nielsen, MD

This year’s flu season promises to be different than in years past. With the potential of both seasonal and H1N1 influenza circulating this year, it is more critical than ever that health care professionals proactively talk to their patients about influenza.

Many patients will be confused about who needs the H1N1 …

Family caregivers are the unsung heroes of our health system

Ken Covinsky, MD

Patient

September 9, 2009

Long term care is a hot topic. When people talk about long term care, they are generally talking about nursing homes. Policy makers put a lot of attention on nursing homes because they cost so much money. About half of nursing home care is paid out of public dollars. In California, in the setting of our state budget fiasco, the high cost of nursing home care to the state has …

Does counseling kids to lose weight and increase exercise work?

MedPage Today

Patient

September 9, 2009

by Todd Neale, Staff Writer, MedPage Today

Overweight and obese children who received counseling from a family doctor did not lose more weight or get more exercise than youngsters who did not receive counseling, Melissa Wake, MD, of Royal Children’s Hospital in Melbourne, and colleagues reported online in the British Medical Journal.

Because the screening and counseling are so expensive, …

The ultrasound that saved a baby girl’s life

Kevin

Patient

September 3, 2009

by Linda Lee, MD

Bob Hebert, in his column in The New York Times, recently wrote that, “Life in the United States is mind-bogglingly violent. But we should take particular notice of the staggering amounts of violence brought down on the nation’s women and girls each and every day for no other reason than who they are. They are attacked because they are female.”

As a family physician I can …

Is alternative health a form of fundamentalism?

Amy Tuteur, MD

Physician

September 1, 2009

There once was a time when all food was organic and no pesticides were used. Health problems were treated with folk wisdom and natural remedies. There was no obesity, and people got lots of exercise. And in that time gone by, the average lifespan was … 35!

That’s right. For most of human existence, according to fossil and anthropological data, the average human lifespan was 35 years. As recently as 1900, …

How a wealth of information takes attention away from the patient

Kevin

Patient

August 31, 2009

by Abraham Verghese, MD

This month I am the attending physician overseeing an internal medicine team, one of four such teams that admit patients to my teaching hospital. It’s a great time to be an attending physician. I have seasoned interns who in just a few weeks will be junior residents, and I have even more seasoned senior residents on their way to entering practice or entering subspecialty training. The team …

Why following a delayed vaccine schedule may be dangerous

Kevin

Conditions and Diseases

August 29, 2009

by Steve Perry, MD

I recently read a post by Dr. Bob Sears which listed several “Vaccine Friendly Doctors” in Colorado and across the nation.

As a pediatrician and vaccine advocate, I thought I’d be on this list. I am “vaccine-friendly doctor” who works with moms and dads to find the best health care plan for their babies. I read the information on both sides of the issue and weighed the science …

Increasing radiation exposure to patients from CT scans and other imaging tests

Kristina Fiore

Conditions and Diseases

August 28, 2009

by Kristina Fiore, Staff Writer, MedPage Today

Imaging procedures can expose patients to high cumulative doses of radiation, researchers say.

In a large study, 193.8 people per 1,000 were exposed to moderate doses of radiation each year, while 18.6 per 1,000 were exposed to high doses, and 1.9 per 1,000 received very high doses, according to Reza Fazel, MD, of …

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

Kevin

Conditions and Diseases

August 26, 2009

Caster Semenya is the South African track and field star who recently was engulfed in controversy at the recently concluded World Track and Field Championships.

Turns out, there are some who are questioning her gender, and subsequently, tests are being conducted to see if she is really a woman.

It’s not as cut and dry as it appears.

Consider the possibility of Read more…

Is Caster Semenya a woman, and the issues surrounding androgen insensitivity syndrome

Will nurses solve the primary care crisis?

Kevin

Physician

August 23, 2009

by Derek Mazique

Between “death panels,” a NICE-style cost effective analysis board, and Obama’s slowly graying hair, one conspicuously absent part of reform are reimbursement rates. Medicare and private insurance typically reimburse for expensive procedures, which ultimately rewards procedure-heavy specialists while discourage those cognitive-heavy services like primary care docs.

The result? As a recent Baltimore Sun op-ed and this very blog pointed out, a combination of pay and burn-out are encouraging …

Do patients really need their complete lab and radiology reports?

Kevin

Conditions and Diseases

August 21, 2009

Most prefer the bottom line, sparing them the raw data.

Primary care physician Rob Lamberts asks that exact question, and reprints sample reports of lab tests and an echocardiogram, demonstrating the wealth of information they contain.

So, borrowing this image from Dr. Rob, I’m not sure how useful something like this would be to patients (sorry for the small type, but you get the idea):

The consequences of doing everything in end-of-life-care

Marya Zilberberg, MD, MPH

Physician

August 19, 2009

Fear-mongering about health care reform killing grandma really burns me: I have delivered “everything”, I know what “everything” looks like. I know its dark side. I also know that these deliberate and self-serving lies will ultimately hurt not only grandma, but the rest of us too. Here is what I mean.

When I was in practice I cared for critically ill patients. I loved the ICU for its complex physiology and …

Op-ed: Wikipedia isn’t really the patient’s friend

Kevin

Patient

August 8, 2009

The following op-ed was published on July 15th, 2009 in the USA Today.

“I researched my condition on Wikipedia.” That’s what more doctors, myself included, are hearing from patients every day.

Wikipedia is the Web’s most popular online encyclopedia. Its more than 13 million articles cover almost every topic imaginable. It is among the most visited sites primarily because its articles routinely show up near the top of search engine results, like …

Health Care Reform: Putting Patients First, medical bloggers at Washington, DC

Kevin

Health Policy

July 20, 2009

Well, that was fun.

This past Friday, I participated in Health Care Reform: Putting Patients First, an event put together by Better Health’s Dr. Val Jones. It was an impeccably organized gathering, and provided medical bloggers a valuable opportunity to discuss health care reform. Great timing too, given the fact that two major reform bills were introduced earlier …

How soon should patients receive their test results?

Kevin

Conditions and Diseases

July 9, 2009

And should you assume that no news is good news?

The answer is no. According to a study in the Archives of Internal Medicine, 7 percent of abnormal test results from primary care offices were never reported to the patient. And in a large, unnamed, academic medical center, that number ballooned to 23 percent.

That’s almost a quarter of abnormal test results from that center that patients were never …

ACR: Reducing medical imaging costs requires a short term investment

Kevin

Health Policy

July 9, 2009

The following is a guest post from the American College of Radiology.

by James H. Thrall, M.D.

Health care reform cannot be approached with a “one size fits all” cost-cutting mentality. Reducing costs in the long term often requires an investment in the short term — particularly, in regard to medical imaging.

Medical imaging saves lives. Imaging also saves dollars through earlier disease diagnosis, less invasive medical procedures, shorter hospital stays, and …

Reader take: Moral hazard, and whether patients should consider cost in their health care decisions

Kevin

Patient

June 30, 2009

The following is a reader take by an anonymous medical student.

One of the ideas that comes up in the search for explanations of high healthcare costs is the so-called “Moral Hazard”—the idea that insured patients are more likely to agree to unnecessary procedures because they don’t pay for them directly. Not everyone thinks it is real—does a patient have the medical knowledge to make an informed decision? …

Did Demerol cause Michael Jackson’s cardiac arrest and death?

Kevin

Conditions and Diseases

June 26, 2009

Michael Jackson’s death continues to consume the news cycle.

There is currently no clear explanation. Some have speculated that it may be related to the narcotic pain drug, Demerol. According to this report from the UK’s The Sun, “An Emergency Room source at UCLA hospital said Jackson aides told medics he had collapsed after an injection of potent Demerol …