March 4th, 2008 by Dr. Val Jones in Medblogger Shout Outs
Tags: Humor, Parenting, Pediatrics, Relationships
No Comments »
Here are some good ones from Mindy Robert’s book, “Mommy Confidential: Adventures from the Wonderbelly of Motherhood“:
***
Son (age 6): “Dad, did you have any friends of your own before you married mom?”
Father: “Of course I did.”
Son: “Well, are they all dead?”
***
Mom: “Will, would you like lunch now?”
Son: “Mom, not only do I want lunch, but I want that fly OUT of here!”
***
[Mother is with daughter at a public restroom]
Daughter (age 4): “Mommy, I need a smaller toilet.”
Mom: “Honey, these are the only ones we have right now.”
Daughter: [Every time she wiggled onto the seat to get into a comfortable position, the automatic flushing mechanism was triggered, scaring the girl nearly to death.] “Mommy, make it stop!”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 4th, 2008 by Dr. Val Jones in Medblogger Shout Outs, News
Tags: Beauty, Complementary And Alternative Medicine, Dermatology, Hospitals, Infectious Disease
2 Comments »
I learned something interesting today from Dr. Benabio’s Derm Blog: bacteria love to grow in skin cream. He said that it was kind of like cream cheese – leaving it out at room temperature would cause it to go bad pretty quickly, were it not for the usual preservatives. He described an outbreak of a deadly bacterial infection in a hospital ICU – caused by nurses using “all natural” European (preservative-free) skin cream on their patients.
So there you have it folks – deadly bacteria are indeed “all natural.”This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
February 3rd, 2008 by Dr. Val Jones in Health Policy, Medblogger Shout Outs
Tags: Finance, Hospitals, News, Research
1 Comment »
One of my favorite healthcare policy blogs is Dr. Rich’s Covert Rationing. In his most recent post he discusses a research study linking New York State’s public report card system to increased heart patient death rates. Doctors’ names are published alongside their procedure-related mortality figures, so if a patient dies while undergoing a risky (though potentially life-saving) procedure, the doctor’s grade suffers.
It’s no surprise that doctors are more hesitant to operate on high risk patients if their professional reputation is on the line. The result is that patients with heart problems in New York State are less likely to receive life saving therapies.
Now here’s where my outrage increased exponentially – Dr. Rich argues that report cards are actively promoted by payers (health insurance companies and the government) under the guise of patient empowerment (they deserve transparency about their doctors’ performance record, right?) But the real truth is that the payers are benefiting financially from the report card system. Fewer procedures mean lower pay outs, and if high risk patients die sooner, then they save even more on care costs.
Man, that’s depressing. So many reforms with “good intentions” result in unanticipated harm. Though strangely I can’t think of too many reforms that harm the payers. Can you?This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
December 8th, 2007 by Dr. Val Jones in Medblogger Shout Outs, True Stories
Tags: Hospitals, Palliative Care, Parenting, Pediatrics
No Comments »
There’s nothing sadder than the death of a child. Young hopes and aspirations are snuffed out long before they can ignite their potential. That’s why the Make-A-Wish Foundation is doing their part to make sick childrens’ dreams a reality – to bring a sense of joy and fulfillment to kids whose days are cut short by illness.
I had the chance to participate in making a child’s wish come true earlier this year. I blogged about it here. It was a really moving experience for me and all involved – we helped a young terminally ill boy fulfill his dream of being President of the United States for a day. Amazingly, the White House even provided a real motorcade to shuttle him around. I got to play the role of paparazzi.
An EMT student blogged about another Make-A-Wish recipient whose dream it was to become a fireman. This story is also very touching. Here’s an excerpt:
There he stood, a father watching his son’s fantasy come to life. Sometimes, the deepest pain brings the greatest happiness.
William is usually outgoing and exuberant. Not Saturday. Saturday, he was awestruck.
Powers gave William a badge and the firefighters lined up to shake his hand. As they finished introducing themselves, William lifted the badge a few inches off his lap.
“He’s showing you to let y’all know he’s a fireman now,” said his mother, Marion Bussey.
Powers reached into a bag, pulled out a hat, and gave it to William. Then he gave the boy a shirt and yellow helmet as the rest of the firefighters looked on.
William leaned toward his mother and smiled. “Mom, I like this,” he whispered.
Tears formed in Bussey’s eyes and rolled down her cheeks.
“William is our hero and you guys are his hero,” she said to the firefighters. “He doesn’t have to say he wants to be a fireman anymore.”
What happened next wasn’t scripted. Maybe it was coincidence. Maybe no explanation exists.
William’s parents and the dozen firefighters looked at William and said the same words at the same time: “You are a fireman.”
William lifted his right hand and placed it on his forehead.
“I am William McKay,” he said, “and I’m an official fireman. Thank you.”
Then he saluted.
The firefighters looked at each other, tears welling in their eyes. They began crying. Some left the room. Others dabbed their eyes with tissues. William’s family began crying. Hospital staff began crying. Almost everyone began crying.
But not William. He had no reason to cry. He was the happiest boy in the world.
This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
December 4th, 2007 by Dr. Val Jones in Medblogger Shout Outs, Opinion
Tags: Hospitals, Pediatrics, Quality, Relationships, Research
No Comments »
I have witnessed various disappointing doctor-patient interactions over the years. Sometimes the doctor is insensitive, other times he or she doesn’t listen to the patient – and errors can result. Young physicians are more prone to inappropriate patient and family interactions when they are feeling inadequate and insecure. A fellow blogger describes just this kind of problem with a young pediatrics resident:
A meek lady with a white lab coat
walks in and just starts asking medical questions. So
my answer to her first question was “Who are you?” She apologized and
said she was the pediatrics resident and asked a bunch of questions
that didn’t seem to us to have much bearing on the situation at hand.
We asked about why my son was making unusual gasping breaths ever since
he woke up and she said it was because he was crying. We said that he
was making these breaths before he started crying. She then said it was
probably hiccups. My wife, who is a registered nurse, said there was no
way it was hiccups because she felt him pressed against her body and
could tell. The resident then said that it was probably due to the
anesthesia. I could tell she was just giving that answer to say
something but really had no clue what was going on. So I challenged her
on it and said “Have you ever seen this after anesthesia before?” She
paused and said, “Maybe once.”
Although this is not the wost example of an unsatisfying doctor-patient interaction (read the rest of the post to get the full story), it is pretty typical for inexperienced physicians to “make up” explanations for symptoms or problems that they don’t understand. This can be dangerous or even life threatening if certain symptoms are ignored.So how do we protect ourselves against this kind of potential error? Sadly, the current quality assurance programs are rather ineffective. In his recent blog post about ensuring physician quality, Dr. Scalpel published a letter he recently received from his hospital. The letter was prepared as part of the Joint Commission quality assurance program. They actually require doctors to get a letter of recommendation from someone (who doesn’t work with them) to ensure that they’re practicing good medicine… It’s like asking a stranger to grade your work competence.
Dear Dr. Scalpel:
In
accordance with Joint Commission regulations, we are required to
request an evaluation of your clinical performance. The Credentialing
Committee now requires the completion of an evaluation form by a peer in your specialty who is not a member of your group practice.
Attached,
you will find a letter and accompanying evaluation form which you
should forward to a peer of your choice for completion. In order to
proceed with the processing of your reappointment application, it is
necessary that you ensure that the required evaluation form is
forwarded to a peer and returned to us in a timely manner. A return
envelope is provided for this purpose. Please note that the evaluation
form must be returned to us by the person completing the form. If we do
not receive the evaluation form before ________, your clinical
privileges may be interrupted.
Sincerely,
An Unnamed Bureaucrat
So, how do you ensure that you’re getting good medical care? It’s not easy, and you can’t necessarily depend on oversight committees to come up with sensible safeguards. Being an informed patient is part of being an empowered patient – you should do what you can to research your doctor’s and hospital’s credentials and reputation (you can do that right here with Revolution Health’s ratings tool), you should read about your diagnosis or condition on reputable websites like Revolution Health, and you should advocate for yourself or loved one at the hospital when necessary. You have the right to reasonable explanations for care decisions – and if you’re concerned about a symptom, you should ask about it.
Unfortunately, there’s no way to guarantee quality medical care. However, perhaps the most important thing you can do (besides advocate for yourself and become educated about your condition) is to develop a close relationship with a primary care physician. Establishing a medical home with a good primary care physician can go a long way towards helping you to navigate the system. They can be your best advocate in this broken system.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
