October 6th, 2010 by StevenWilkinsMPH in Better Health Network, Health Tips, Research, True Stories
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A 69-year-old woman who swims in my master program came back to the pool after a total knee replacement. I asked her how she was doing. She said she is still in a lot of pain because of her physical therapy. She said that her physical therapist was disappointed that she still was still unable to achieve full flexion of 120 degrees. Why 120 degrees? Did you set that goal I asked her? “No,” she said, “the therapist did.”
She went on to tell how she already had more range of motion in her knee than she did before the surgery. My friend was quite satisfied with her progress and wanted to stop physical therapy. The pain from the PT was worse than anything she had experienced before the knee replacement. I knew she and her 80-year-old boy friend were going on a cruise and she didn’t want to still be hobbling around.
It turns out that patients and physicians disagree on quite a few things. We hear a lot about patient-centered care. You know, that’s where the provider is supposed to consider the patient’s needs, preferences, and perspective when diagnosing and treating health problems. But medicine is still very provider-centered. Read more »
*This blog post was originally published at Mind The Gap*
July 13th, 2010 by StevenWilkinsMPH in Better Health Network, Health Policy, News, Opinion, Research
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Anytime you come across a healthcare article that implies that every patient wants access to this or that — i.e. their medical record, patient-centered care, etc. — you can safely assume that the claim is wrong. Why? Patients are not a monolithic group –- they don’t all share the same motivations, preferences, beliefs or experiences when it comes to their health.
But let’s face. If you are trying to push an agenda, just saying some people want this or that is not the same as implying that everyone wants it.
Take the issue of patient access to physician notes in their medical record. Robert Wood Johnson (RWJ) recently announced their OpenNotes study. The OpenNotes project will evaluate the impact on both patients and physicians of sharing, through online medical record portals, the comments and observations made by physicians after each patient encounter. Okay…so far, so good.
Things begin to fall apart, however, when RWJ cites “a recent study“ in the Journal of General Internal Medicine, as part of the basis for the OpenNotes research. According to RWJ, the study found that “most consumers want full access to their medical records.” Since when did six focus groups (64 people) constitute a representative sample, e.g. most people? Read more »
*This blog post was originally published at Mind The Gap*
June 4th, 2010 by Toni Brayer, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research, True Stories
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From Dr. Toni Brayer at Everything Health:
We medical folks have always known that July is the worst time for a patient to be admitted to the hospital. It has nothing to do with nice summer weather or staff vacations. Although it cannot be proven, we think the answer to the mystery of July hospital errors is human — yes, it’s the new interns.
A new study published in the June issue of the Journal of General Internal Medicine looked at all U.S. death certificates from 1979 to 2006. They found that in teaching hospitals, on average deadly medication mistakes surged by 10 percent each July. The good news is they did not find a surge in other medical errors, including surgery or in non-teaching hospitals. Read more »
*This blog post was originally published at ACP Internist*
April 28th, 2010 by Davis Liu, M.D. in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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A recent article found that primary care doctors the United States are providing sub-standard care when it comes to colon cancer screening.
In the Journal of General Internal Medicine, researchers found that 25% of primary care doctors used in-office stool testing to screen for colon cancer. Specifically, doctors do a rectal exam and then swipe the rectal contents off their gloves onto a stool-testing card. A positive test result indicates the presence of blood, which can be invisible to the naked eye. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
