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Caregiver Burden

It was a straightforward phone message (names changed): “Hey Dr. S., this is Bobbie Jones, April Dixon’s granddaughter. I was calling to inform you that April passed away today at City Hospital. They said she was bleeding in her stomach or something. I’m not quite what sure what happened, but she got real sick. But she’s gone, so, thanks so much. You’ve been a real neat doctor, and it’s been good working with you through the years taking care of my grandmother. Take care. Bye.”

Bobbie Jones is a saint. Pure and simple. She took care of her 88-year-old grandmother with tender, loving care. I am certain if left to the vagaries of the “healthcare system” that her grandmother would have died at least three years ago, maybe earlier.

Ms. Jones will get no recognition. No income. No honors, save this blog post which she’ll never see. She will get a letter from me, expressing my condolences and appreciation for the love and care that she provided her grandma. She singlehandedly advocated for an octogenarian with advanced dementia and probable cancer (we were never able to get a definitive diagnosis of it) and gave her a quality of life that I would want were I in her grandma’s shoes. Read more »

*This blog post was originally published at ACP Internist*

Top 10 Tips On How To Treat Your Patients

This is a guest post from Carolyn Thomas:

An Open Letter To All Hospital Staff

Dear hospital employees,

After a particularly bizarre experience undergoing a treadmill stress echocardiogram at your hospital recently, I decided to do something that I have never done before: I called the manager of the cardiology department to complain about her staff. (Incidentally, a recent opinion survey of international tourists found that Canadians were #1 in only one category: “Least likely to complain when things go wrong” — so you can appreciate that lodging an official complaint is a fairly big deal here!)

In my best PR fashion, I told the manager how distressing the appointment had been because of the behaviour of the two cardiac technicians in the room. It’s not so much that they were openly rude, but it was their insufferable lack of people skills that had pushed me over the edge. No introductions, no eye contact, no consideration of how awkward this test can be, no explanation of  the test procedures or even the flimsiest effort at polite conversation. To them, I was merely the 1:00 o’clock appointment, the obstacle between them and their next coffee break, just a piece of meat on a slab — but worse, an invisible piece of meat. Read more »

Tweets From Doc Gurley In Haiti

She’s tweeting her medical mission in Haiti. So tragic are the unmet medical needs of these people. From Doc Gurley:

Saw an alone 9-month-pregnant 19 yr old. No birth kit, no string for the cord, no plan for who would be with her. Gave supplies+discussed how to ask helper to wash hands. Nothing sharp&clean for cord so gave scalpel. Acted out birth, w/handwashing.

Also saw woman with overwhelming postpartum uterus infection. Someone used hands at delivery to pull out pieces of placenta.

Saw 14yrold girl w/months of excruciating pain, mass in her lower belly, wasting. Ruptured appy? Tumor? Left her w/ narcotics, antibiotics.

Also, women do not have menstrual protection supplies:

I’ve been asked, if there are no pads, what do women use? In the cases I saw, one used a page of a magazine & another a dinner napkin.

God bless you, Doc Gurley, and the members of your team for all you’re doing. What can we do to help?

*This blog post was originally published at tbtam*

Fixing Up Primary Care: Is Anyone “Home?”

love Don't live here anymore... by Robb North via Flickr

By John Henning Schumann, M.D.

The Patient Protection and Affordable Care Act (aka “Health Care Reform”) signed by President Obama in March will revolutionize primary care in the United States. By 2014 tens of millions of uninsured people will “enter” the system by being granted insurance, either through expansion of the Medicaid program or through mandated purchasing of insurance via state pools or the private market.

This alone will have a profound impact, straining the capacity of our already frayed system. Therefore, embedded in the law are funds to encourage growth and improvement in primary care: Incentives to encourage graduates to enter primary care fields (family medicine, internal medicine, and pediatrics) and practice in underserved areas (through scholarships and loan forgiveness), and money to re-format the way that primary care is practiced and paid for. Read more »

*This blog post was originally published at ACP Internist*

Waterbirth: What’s In The Water?

By Dr. Amy Tuteur

Waterbirth has been touted as an alternative form of pain relief in childbirth. Indeed, it is often recommended as the method of choice for pain relief in “natural” childbirth. It’s hardly natural, though. In fact, it is completely unnatural. No primates give birth in water, because primates initiate breathing almost immediately after birth and the entire notion of waterbirth was made up only 200 years ago. Not surprisingly, waterbirth appears to increase the risk of neonatal death. Read more »

*This blog post was originally published at Science-Based Medicine*

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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