Unlike some of my classmates in medical school, diseases themselves are not something I often feel a passion to study. I find philosophy, theology, politics, literature, history, psychology, and so many other subjects much more interesting. But when I see a person suffering and looking for answers and relief, I am motivated to learn all that I can to help.
So while the topic of allergies is not something that really …
Tips to manage your seasonal allergies
This is a speech I gave recently at our local hospital when I was given a “physician of the year” award for my work managing medical detox in our community for 20 years.
At first, when I was told about this honor, I was really unsure why my clinical work in medical detox would warrant “physician of the year.”
I am not as skilled a diagnostician as many of you. I’m not …
Managing medical detox: A speech about compost
Overheard in the gym:
“Yeah, but I heard that ____ can be dangerous.”
“Oh, they wouldn’t let us buy it if it was.”
Lately, the public’s faith in the safety of prescription and over-the-counter drugs has been making me uneasy. Advances in drug development mean that many of us truly can live better lives through their wise use. But are we adequately guided and protected by a) regulators, b) our clinicians, c) a …
Patients need to take an active role in their medications
There is a dark cloud of discouragement, dejection, disheartenment, and all other synonyms of despair, hanging over the medical profession. It’s not that all physicians live in constant gloom and doom, although quite a few do, particularly those still in private practice, but the profession itself seems to be losing its luster.
Some doctors seem content to pragmatically adapt to the new and duller definition of their old profession, but in …
When doctors complain: How to resonate with the public
Now that consumers can generally make an efficient health insurance purchase at Healthcare.gov and most of the state-run exchanges, we can finally get to the real question.
Are the healthy uninsured going to buy it?
The big health insurance changes Obamacare made to the individual and small group market were arguably done in order to get everyone, sick and healthy, covered in a more equitable system.
To be clear, no one I know …
What if the uninsured don’t buy Obamacare?
It is no secret that one of the best ways towards better health management is a good physician-patient relationship. There needs to be buy in from both participants to shared decision-making. One might object to the title of this post, stating that it puts the biggest burden on the patient, however when examining how this is achieved, you will, I hope, feel differently.
1. Establish a relationship. This might sound trite, but the first few …
5 ways to change patient behavior
One year ago, my book, When Doctors Don’t Listen: How to Avoid Misdiagnoses and Unnecessary Tests, was published. My goal in this last year has been to travel around the country and talk about the book and its message of advocating to improve your health. I planned a 48-city itinerary where I’d crisscross the U.S. from Massachusetts to California and back. I’d speak at bookstores, libraries, nursing homes, universities, and community …
Learning from patients on a speaking tour
As a scientist with a brain naturally inclined to skepticism and analysis, I suppose my spiritualism may be best captured by: Keep the faith, but get the data. While some of my fellow skeptalytics, if I may coin such a term to catalog us, may be inclined to renounce that first clause altogether, thinking there is no need for faith, I am obliged to disagree.
We are all a mass of electrons …
Keep the faith, but get the data
As we address the issue of quality in healthcare, there is much to be learned from other industries. I believe our current approach, though, is a dangerous one, one that won’t yield the desired results. Thus far, we’ve approached quality assurance as if healing were an industrial process, a process similar to those that yield cars, air conditioners, or even cheeseburgers.
But in an age where science, technology, and health policy …
Let’s learn from No Child Left Behind: Measuring quality in healthcare
Meet Damien, my Facebook friend, photographer, and IT guy.
This morning, he messages me: “I would like to make an appointment.”
I reply: “For?”
“High blood pressure.”
I offer to see him, but he never comes in. Weeks later, he writes, “I got busy Pam. How are you? High blood pressure pills keep making me sick. I am doing the best I can. On bad …
The unidentified cause of one man’s hypertension: Racism
Here we go again. There is yet another round of evidence of how the physician workforce hole we’ve dug for ourselves keeps getting deeper, but there has been still no substantive payment reform on the government side (Medicare/Medicaid) or the private payer side.
One recent study appeared in Academic Medicine. Clese Erikson and colleagues surveyed a random sample of 4th-year medical students in 2010. Only 13% of the students stated they …
Balancing the physician work force: It takes more than money
Here are a few words some physicians and medical professionals have used to describe patients who have turned to Dr. Google for information and advice on their medical conditions: irritating, suspicious, distrustful and challenging.
Perhaps frustrated with physicians’ continued resistance to Internet-empowered patients, Dr. Kevin Pho urged them to “deal with” the fact that patients “Google their symptoms.”
But, we all know the Internet-informed patient is old news. I’m here with …
Beyond Dr. Google: How new technologies will affect patient-provider relationship
I recently struggled with an interesting patient care issue related to my illness. I had to cancel several weeks of clinical sessions, which I realize is a hardship for my patients.
A few weeks ago, when seeing a long-time patient of mine — a warm woman with several chronic conditions — I …
Physician self-disclosure about illness
ADVERTISEMENT
In 1950 Ernst Wynder, MD and colleagues began to produce convincing data that cigarette smoking caused lung cancer. Over the ensuing many years evidence has arisen linking cigarette smoking to many different cancers, chronic lung disease and heart attacks.
In 1964 the surgeon general reported that cigarette smoking was the most important risk factor for development of lung cancer and that quitting smoking reduced that risk. Since that time a concerted …
Reflecting on the history of smoking cessation
When it comes to the health care of a frail older person, families really need a good personal health record (PHR) system. So I am once again preparing to take a look at what’s available, in hopes of finding something that I can more confidently recommend to the families I work with. (To see what medical info I urge families to track, see this Geriatrics for Caregivers post.)
I have …
What I’m looking for in a personal health record system
In recent months, news reports focused on the number of new enrollees as a key test of the law. Although the troubled performance of the Healthcare.gov website during October and November delayed enrollment for hundreds of thousands of potential subscribers, Obama administration officials and congressional Democrats hailed a surge in enrollment at the end of the year as proof that the law would fulfill its promise of providing affordable coverage to …
How should we define the success of the Affordable Care Act?
Several years ago, a young woman I’d been seeing in clinic weekly for about a month to initiate treatment for depression called late Friday afternoon to cancel an upcoming appointment for the following Monday and did not reschedule. The receptionist sent me a message as is our policy for patients who cancel and do not reschedule. It gave me a bad feeling that she was not following through on her treatment plan and …
A gracious note, letting a doctor know she made a difference
A guest column by the American College of Physicians, exclusive to KevinMD.com.
A few months ago, I attended a social event and ran into a few colleagues whom I had not seen in a long time. In the interest of privacy, I won’t reveal their specialties but I will note that I was the only primary care specialist in the group. As …
How I changed my private practice glass from half empty to half full
Radical change often happens suddenly, the result of a single decision or event.
The fall of the Berlin Wall and the dissolution of the USSR stand out as two dramatic political examples. In a social context, Supreme Court decisions in Brown v. Board of Education or Roe v. Wade both radically changed our society.
Then there’s the U.S. health care system. We know it can take 17 years for a new, proven treatment to …
4 scenarios that would dramatically improve health care
A recent research article in the Journal of General Internal Medicine, and the gap between its findings and the real world, helps point up the usefulness and limitations of research. The article, by Susan H. McDaniel, PhD, and coauthors, set out to determine how often doctors speak about their colleagues in supportive or critical ways.
Their method is one widely used in the field: simulated patients, actors, were prepared with lifelike …
When doctors disagree: What should you tell patients?
Get free updates delivered free to your inbox.
