Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

It’s Important To Discuss Side Effects With Your Health Care Providers

Prepared Patient Publication Logo Talking About Side Effects With Your Health Care Team

Side effects may occur with any new treatment, including new medications, placement of a new medical device, surgery, or even physical or occupational therapy. We usually think of side effects when we begin to experience bad changes —when the treatment introduces new worrisome symptoms or problems. Most treatments have some sort of side effect associated with them, and many of us may wonder if side effects are simply the price we must pay for a necessary treatment.

But side effects shouldn’t be taken lightly, for a number of reasons. At their most extreme, side effects raise the alarm when you are having harmful and even potentially fatal treatment reactions. Even somewhat mild side effects like a dry mouth, sleepiness, or minor muscle aches may still interfere with your daily life. Sometimes side effects bother some people so much that they skip doses or give up a treatment altogether, which can derail care and put them at risk for both short- and long-term complications.

Before treatment begins, here are a few questions you can discuss with your health care team: Read more »

*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*

Changing The Behavior Of Doctors: Is It The Key To Engaging Patients?

I may not know how to tell the difference between an empowered patient, an engaged patient, or an activated patient.  But I do know that the fastest way to disempower, disengage, and de-activate any patient is a trip to the doctor’s office or the hospital. A visit to an average primary care physician (or specialist) is to an empowered/activated/engaged patient what Kryptonite is to Superman.  It will stop all but the strongest willed patients dead in their tracks.

We patients have been socialized that way.   Think about your earliest memories of “going to the doctor.”  For me, I remember my Mom taking me to the Pediatrician.  Early on I learned by watching the interaction between my Mom and the doctor that they each had a role.  The doctor’s role was that of expert – he spoke and my Mom listened.  I was there just to have one or more extremities twisted and prodded.  And oh the medicinal smell…

Things haven’t changed much in the 40 years since I was a kid sitting in Dr. Adam’s office. Read more »

*This blog post was originally published at Mind The Gap*

Earning Patient Trust Through The Power Of Touch

Abraham Verghese, MD, Standford University

My wife has two world-class oncologists who help her manage her Stage 4 Lung Cancer.  Both are excellent clinicians.  Yet their skills differ in one very important way.  Her radiation oncologist physically touches her a lot (in a good way of course!).  There are the touches on her arm, a hand on the shoulder, hugs, and of course a thorough hands-on physician exam.  Her medical oncologist not so much.

We all recognize the therapeutic value of touch.  Dr. Abraham Verghese, a Stanford Physician and Professor, at the 2011 Med2.0 Conference, described the power of touch associated with the physical exam.  In the following scenario he describes an interaction with a chronic fatigue patient who came to him after being seen by many other physicians: Read more »

*This blog post was originally published at Mind The Gap*

Sometimes Little Changes Can Add Up: The Extra Work Of The EMR

“I estimate these changes to your charting work flow will take only five minutes.”

Five minutes is fine if it happens for only one patient. But when it is multiplied by as many as forty patients in a day, the multiples get impressive. Five minutes x forty patients = 200 minutes (more than 1.5 hours a day).

Minor five-minute changes to administrative charting requirements aren’t so minor, especially when you add more time for quality assurance reporting or pay-for-performance initiatives. Suddenly huge swaths of time from a doctor’s opportunity to take care of their patients. We need more care time and less data entry time. Doctors must insist that we not become data entry clerks.

Increasingly, I see the data entry burdens of regulatory health care documentation requirements falling on doctors. On first blush, this seems logical because only doctors (or very capable, highly trained surrogates) understand the nuances required to make potentially life-altering adjustments to the electronic medical record. But when new administrative documentation requirements are added to doctors and other care providers, it Read more »

*This blog post was originally published at Dr. Wes*

Changing The Feel Of The Physical Exam

I suffer with herniated lumbar disks.  L4-L5 bulges and ruptures on occasion.  If you catch me on the wrong day I have a little curvature to my back representing the spasm that makes me miserable.

I saw an extremely well-referenced orthopedic surgeon in consultation recently.  But through the course of my visit he never touched me.  We spent an extraordinary amount of time examining my MRI.  Together in front of a large monitor we looked at every angle of my spine with me asking questions.  I could see first hand what had been keeping me up at night.  I could understand why certain positions make me comfortable.  What we drew from those images could never be determined with human hands.  In my experience as a patient, I consider it Read more »

*This blog post was originally published at 33 Charts*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »