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Latest Posts

Should You Find A New Doctor?

Come  on people… you know what I am talking about.  Sure you are comfortable with your current doctor… after all you are still alive and kicking.  Besides it has taken you years to figure out what you can safely tell your doctor and when it’s ok to speak up.  Yes the fact that your doctor is often late and never seems to listen to you bothers you just a little.  But you aren’t displeased enough to stop giving your doctor high satisfaction scores.  After all who wants to upset their doctor?   But admit it; you have wondered if there isn’t a doctor out there that would be a better fit with you.   I know I have.

Doctors probably feel the same way about many of their patients.   It can’t be easy everyday trying to help patients that don’t seem to want to help themselves… or who want a quick fix from a bottle of pills.   Not to mention patients who habitually miss their appointments and are generally non-compliant.

How Would Changing Doctor’s Help? Read more »

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

The Boundaries Between Doctor And Patient

This post from Kelly Young on Howard Luks’ blog asks when patients cross the line with respect to their own advocacy.  It’s worth a peek.

The question of boundaries between doctor and patient is interesting.  All of my patients are empowered in some way.  The extent and level of that empowerment is personal.  On our own there are few lines and little with respect to boundaries.  We have effectively unlimited access to information and resources.  And how far we go to look after ourselves and our kids has few limits.

But when we enter into a relationship with a provider, we’re no longer alone.  It’s unreasonable for a provider to tell a patient Read more »

*This blog post was originally published at 33 Charts*

Where Does The Patient’s Responsibility For Their Health Begin?

When you or I visit an accountant, a lawyer or car mechanic, we know what our role is and have a pretty clear understanding of what the ” expert” is supposed to do. But when it comes to a trip to the doctor these days the roles and responsibilities of patients and physicians have become blurred and unpredictable…and the patient seems to generally be on the losing end.

Take my Mom’s case. My Mom who was 89 years old and evidently had severe osteoarthritis. She never knew that even though she was been seen every couple of months by her Internist for years and years. It’s too bad…because my Mom died last week from complications due to a compression fracture of her spine. Turns out her spine was very fragile according to her consulting Neurosurgeon but no one ever told her.

The first question that entered my mind when I heard of her condition was why didn’t her primary care physician “pick up” on the severity of her condition before she fell and fractured her spine? Read more »

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

How e-Patients Find Answers And Each Other Online

NPR logo[Recently] NPR’s popular program “Talk of the Nation” covered something we discuss often: How e-patients find information and find each other online. Featured guests were Pat Furlong, mother of two boys with a rare disease who started an online community, and Susannah Fox of the Pew Internet and American Life Project, a frequent contributor here. The audio is here.

It’s a good combination: Pat speaks from the heart about her own experience and her passion for community, and Susannah, as usual, speaks as an “internet geologist” — as she once put it, “A geologist doesn’t have opinions about the rocks, she just observes and describes them.” Susannah spoke about her newly-released report “Peer-To-Peer Healthcare,” about which she recently wrote here.

Listener comments begin around 13:00. Examples:

— A woman describes how she started a Facebook group for her painful chronic condition (ankylosing spondylitis) and it’s grown into a website, HurtingButHelpful.org. (Spoonies, take note!) What drove her to create a patient community? “There’s no one else who can understand what I’m talking about.”

— The mother of a newborn with a heart defect found similar parents online. Hearing their stories — and even seeing an upsetting photo — helped her prepare for the surgery.

— On the downside, the daughter of an ovarian cancer patient said her now-cured mom keeps going online to patient communities and getting scared by what she reads. (Host Neal Conan’s observation: “There other parts of the computer that can be addictive, and I guess this one can, too.”)

It’s heartening to hear coverage of online patient communities, including the risks and challenges, in a respected outlet like NPR. (Time covered it, too, a year ago.) And there’s no equal for the reality check of Pew’s data. Some patient activists suggest (and some people fear) that the Internet “frees” patients from doctors, but Pew says that’s not what people are doing. Read more »

*This blog post was originally published at e-Patients.net*

Selecting Targeted Therapies Online: The Future Of Personalized Cancer Treatment?

The word cancer comes from the greek word for crab “karkinos,” so named by Hippocrates who visualized the tumor and its surrounding vessels looking like a crab, dug stubbornly into the sand with its legs. We know far more about cancer today than the ancient Greeks, but the vision of an entrenched opponent, almost impossible to extract whole, appears to be vividly prescient.

What we have realized over the last half century is that removal of the visible tumor is not enough. Even as we learned how to do bigger and more destructive surgeries, the cancer still managed to sneak back in, growing later at different locations. The crab’s legs are still embedded in the patient.

Thus the discovery that certain chemicals could extinguish these rogue cells opened the modern era of cancer therapy and led to the first “cures” from cancer. Many of these compounds were exquisitely toxic. Early experimenters even used nitrogen mustard, quite literally a poison, as Siddhartha Mukherjee tells in his excellent history of cancer, “The Emperor of All Maladies.”

To many, the battle looked grim. For the founder of CollabRx, who himself was living in the shadow of advanced melanoma, this was the signal to take his expertise in internet information technologies and apply it to cancer. Thus a “biomedical software company” was founded, with the mission:

…to save lives by using information technology to personalize cancer treatments and accelerate research.

The rapid proliferation of knowledge about the molecular underpinnings of different cancers, has brought hope for a new age of “targeted” therapies. These drugs are designed to find and destroy cells with aberrant biochemical pathways, while bypassing the normal body tissues. Immense hopes rest on them. Read more »

*This blog post was originally published at iMedicalApps*

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…

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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…

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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…

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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…

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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…

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