I discuss some common sense tips doctors should follow while using Twitter:
1. Patient privacy is paramount. Do not discuss individual cases or provide patient advice via Twitter.
2. Use Twitter to point your patients to trustworthy online health information sources.
3. Use Twitter as a tool to promote your practice’s brand. More and more patients are using Twitter; those who do are likely to feel positive about their physicians using it as well. More than just a fad, Pho says that Twitter is here to stay and offers tremendous potential.
4. Remind your patients using Twitter: Be careful whom you follow. Anyone can sign up for Twitter claiming to be a physician. Read more »
*This blog post was originally published at KevinMD.com*
Empowered health consumers know how to take charge of their health and are proactive in their care.
Whether they’re surfing the web for health information, visiting their doctor or health care professional, or a patient in the hospital; empowered health consumers know how to question and communicate.
This blog is a continuation of the “He Said, She Said” post where I promised to give you tips about how to be an empowered health consumer.
Sabriya Rice, CNN Medical Producer had a similar idea.
Here are my 3 tips to help you become an empowered health consumer: Read more »
*This blog post was originally published at Health in 30*
I forgot about this kind of post, and a reminder by a reader is bringing them back. They are really a fun and easy kind of post to write, so you may see a fair number of them (read: Rob is getting lazy). I thought I’d start back with some suggestions for disgruntled patients (or gruntled ones, for that matter) to make their doctor’s day much worse.
1. Require the doctor to keep things secret from your child or your elderly parent. Insist that they can’t know about their cancer, depression, ADD, or foot fungus. Call the medication the doctor prescribes “vitamins.” Alternatively, you can threaten your child by saying that if they don’t behave better, the doctor will give them a shot. Read more »
I recently had the opportunity to spend five days with seven amazing teen women doing community service at the Howling Acres Wolf Sanctuary in Oregon. My eldest daughter has arranged this annual camping trip since she was in middle school and I tag along to drive, cook, provide first aid, reminders about bug spray and sunscreen, and do a lot of dishes.
This year I also gave some feedback to a couple of new teens that was not well-received and the experience set me to thinking about the role of adult mentors in the lives of teens. I think as adults, it is easier to just watch teens, make our own judgments about their behavior, but unless they are our own, refrain from helping them reflect on those behaviors.
Sadly, I think this lack of feedback from adults does not benefit youth. I am of the mind that teachers, doctors, counselors, and actually all adults spending time with teens are ethically responsible for giving them feedback about their behavior – to provide an opportunity for them to reflect on a person’s perception of their behavior and his or her response to it.
The flip side of this is hearing the feedback given back, so yes, I heard when I was “snippy” and did have to apologize several times for losing patience – but it is all good and we are never too old to “engage” in relationships.
Teens really are blessed if they spend time with adult who will talk with them honestly and give them feedback, but the teen has to make the decision to hear the feedback and not just feel criticized and withdraw – which is the hard part of honest relationships. This group of girls was a new group, with four new members, and a wide age range – 12 to 17 – so there were several mini-lectures about judgment and being self-centered, which of course were translated into “she does not like me.”
I have to say it is hard to have conversations with teens who do not want to hear, but if they can hear that the feedback is about being perceived as the type of person they want to be, then there is hope. For example, if a teen says something negative about a person we pass or interact with in the community, I am likely to say, “whoa, that is really judgmental – are you sure you want to judge her without knowing more about her?” Or, maybe, “I hope you do not judge me solely on my appearance,” and if focused, I might add that people tend to shy away from people who are negative or judgmental, which is usually not what we want, which is to attract people.
Reactions range from silent sullen and angry to a brief nod and maybe “I am sorry,” but I think the process is the important part. Teens are going to be adults soon, and then feedback gets really rare except from friends, family, and bosses (which have consequences attached), so it is important to give the feedback and help teens hear it.
For this week’s CBS Doc Dot Com segment, I thought I’d cover something completely non-controversial: what can weekend warriors learn from elite athletes? But I’m starting to believe that in this era of evidence-based medicine, nothing may be truly knowable. I went to the studios of the world famous Ballet Hispanico in New York City and spoke to athletic trainer Megan Richardson. She took me through the motions, emphasizing the importance of warming up and stretching in preventing injury. It sounded good and it felt good. But proving in the medical literature that it’s effective is another thing. An online search quickly produced multiple conflicting reports and advice: stretching definitely works, stretching definitely doesn’t work; stretching only works if you do it my way. Click here for a sampling:
My friend and CBS colleague, Richard Schlesinger, offered his solution. ”I get around it by neither stretching nor exercising.” Had I listened to Richard, my blog post would have ended right here. But I figured I needed at least one more paragraph so I contacted a true expert on the subject, Ian Shrier MD, PhD, a specialist in sports medicine and Associate Professor at McGill University. He has a PhD in physiology and is Past-President, Canadian Academy of Sport Medicine. He’s not a huge fan of stretching right before exercise.
“First, the stretching, whether with or without warmup, does not improve performance. It makes you run slower, jump not as high, and makes you weaker.” And “stretching definitely can hurt people if you overstretch; people do it all the time if they force the stretch.”
He added, “I don’t think it hurts you in general if you do it properly but it doesn’t prevent injury.” He’s more supportive of stretching at other times, including after exercise, saying, “Regular stretching at other times is beneficial. It makes you stronger, jump higher, etc, and there are three studies suggesting it reduces injuries as well, although the results were only significant in one.” He adds that “stretching is analgesic; it allows you to put your muscle through a wider range of motion without feeling tension. And that may be why ballerinas say that stretching helps them.” Dr. Shrier spells out his take on the subject in detail in a chapter called
“Does stretching help prevent injuries?”
For me, Dr. Shrier’s most interesting advice, especially for weekend warriors, was about the importance of warming up. He explained that muscles need energy to function properly. Energy is mainly produced inside of cells in structures called mitochondria. When you are resting, your mitochondria power down. During exercise, it takes awhile for the cell to rev up the enzymes needed for breaking down fat and carbohydrates for fuel and for using oxygen to make energy from that fuel. If you start running at full speed without warming up, your body will produce lactic acid. Lactic acid can impair muscle function for awhile, preventing you from sprinting efficiently at the end of the race.
So Dr. Shrier suggests gradually warming up. He estimated it takes about 3 to 5 minutes to efficiently go from one level of exercise to the next – for example, going from rest to a ten minute mile or going from a ten minute mile to a seven minute mile. If you go for a jog, “you walk, then jog slowly, and then pick it up. Elite marathoners might go for a fifteen to twenty minute jog before they run a marathon. That allows them to run faster at the beginning of the race. They run the second half of the marathon faster than the first.”
In summary – and I suspect that I am the first person today to tell you this – don’t outpace your mitochondria.
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