I am smacking myself on the forehead and saying, “Why didn’t I think of this?” Dr. Richard Parker, Medical Director at Beth Israel Deaconess Medical Center, has sent out a list to his physician colleagues of 56 common medical tests and procedures. What is revolutionary is that there are prices next to each item. You non-physicians may be surprised to know that we doctors have no idea what the tests or drugs we order actually cost. Unless we get billed as a patient, we are as clueless as you are.
As I wrote before, the ostrich excuse just won’t fly any more. We all need to be aware of the cost of care and have skin in the game. Some will argue that price can’t be the only driver. I’ve heard physicians say you can’t compare one price to another because “quality” costs more. I say prove it. Read more »
An outcomes article in the January 2011 issue of the Journal of Plastic and Reconstructive Surgery asks the question: “Are patients making high-quality decisions about breast reconstruction after mastectomy?”
The objective of the study was to “measure women’s knowledge about reconstruction and to evaluate the degree to which treatments reflected patients’ goals and preferences.” Their conclusion (bold emphasis is mine):
Women treated with mastectomy in this study were not well-informed about breast reconstruction. Treatments were associated with patients’ goals and concerns, however, and patients were highly involved in their decisions. Knowledge deficits suggest that breast cancer patients would benefit from interventions to support their decision making.
Granted the study was small, but it left me wondering if we the medical community fails to educate these women.
The study involved a cross-sectional survey of early-stage breast cancer survivors from four university medical centers. The survey included measures of knowledge about specific reconstruction facts, personal goals and concerns, and involvement in decision making. Only 84 patients participated (59 percent response rate). Participants answered only 37.9 percent of knowledge questions correctly. Read more »
You can’t be well-empowered if you hear advice wrong. That’s why in a participatory relationship, an essential skill is accurate handoff of information.
The Foundation for Informed Medical Decision Making (FIMDM), catchily pronounced “fimdim,” has been working for years to improve patients’ knowledge of options and alternatives. In [the September 20th] Boston Globe Liz Cooney talks with people from FIMDM about the issue. An excerpt:
What doctors explain and what patients understand might be two very different things, recent research suggests.
Ideally, patients talk with their doctors about the pros and cons of a particular treatment, weighing the risks and benefits, exploring alternatives — including doing nothing — and then come to a conclusion. That’s the goal of the informed consent process, best known by the paperwork patients sign at the end saying they heard doctors describe what they may be getting into.
A Boston non-profit, FIMDM is the force behind Gary Schwitzer’s excellent Health News Review service, which analyzes health news in the media, teaching e-patients and policy people to sift the gold from the garbage.
Today [Aug 28] I’m participating in the workshop “Engaging Minority Communities in Safer Healthcare” organized by MITSS (Medically Induced Trauma Support Services), a Boston non-profit I’ve written about before.
The current speaker is Lisa O’Connor, VP of Nursing at Boston Medical Center. She just showed this four-minute safety awareness video, produced by Quantros. Much of its content will be familiar to our readers here (the frequency of medical errors and hospital acquired infections), but I’m posting it because of its good, concrete, specific actions every patient should know.
The part with specific actions for patients starts around 2:30. (My highlights are below.) Read more »
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…
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…
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…
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…
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…