January 21st, 2011 by DavedeBronkart in Health Tips, Opinion
Tags: Active Healthcare Participant, Becoming A Savvy Healthcare Consumer, Besty Lehman, Boston Globe, Chemotherapy Overdose, Dana-Farber Cancer Institute, Dave deBronkart, e-Patient Dave, e-Patients.net, Empowered Patients, General Medicine, Health-Savvy Patients, Healthcare Improvement, Hospital Deaths, Institute of Medicine, Medical Error Prevention, Medical Error Reduction, Medicare Deaths, Oncology, Participatory Medicine, Partners In Health, Patient Empowerment, Patient Participation, Patient-Doctor Partnership, Patients As Healthcare Partners, Personal Challenges, Quality Improvement, Realistic Medicine, Responsibility in Healthcare, Responsible Patients, Team-Based Patient Care, Teamwork In Medicine, U.S. Inspector General
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There are several stages in becoming an empowered, engaged, activated patient — a capable, responsible partner in getting good care for yourself, your family, whoever you’re caring for. One ingredient is to know what to expect, so you can tell when things seem right and when they don’t.
Researching a project today, I came across an article* published in 2006: “Key Learning from the Dana-Farber Cancer Institute’s 10-Year Patient Safety Journey.” This table shows the attitude you’ll find in an organization that has realized the challenges of medicine and is dealing with them realistically:
“Errors are everywhere.” “Great care in a high-risk environment.” What kind of attitude is that? It’s accurate.
This work began after the death of Boston Globe health columnist Betsy Lehman. Long-time Bostonians will recall that she was killed in 1994 by an accidental overdose of chemo at Dana-Farber. It shocked us to realize that a savvy patient like her, in one of the best places in the world, could be killed by such an accident. But she was.
Five years later the Institute of Medicine’s report “To Err is Human” documented that such errors are in fact common — 44,000 to 98,000 a year. It hasn’t gotten better: Last November the U.S. Inspector General released new findings that 15,000 Medicare patients are killed in U.S. hospitals every month. That’s one every three minutes. Read more »
*This blog post was originally published at e-Patients.net*
January 21st, 2011 by AnneHansonMD in Better Health Network, Opinion
Tags: BLS, Bureau of Labor Statistics, Census of Fatal Occupational Injuries, Correctional Facilities, Dr. Anne Hanson, Employee Protection, Employee Safety, Healthcare Workers, Hospital Homicide, Hospital Security, Murders in Hospitals, Murders in Prison, My Three Shrinks, Psychiatry and Psychology, Safety At Work, Shrink Rap, Violence and Medicine, Workplace Violence
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There’s been a lot of stories in the news lately about homicides committed in hospitals. Just out of curiosity, I went to the Bureau of Labor Statistics (BLS) website and pulled some data from their Census of Fatal Occupational Injuries. It confirmed what I suspected — that homicides of workers in hospitals have increased at twice the rate as correctional facilities, where worker homicides have remained stable. Here’s the graph I was able to make from the BLS data:
The red bars (hospital murders) are up to six and seven homicides per year while the blue bars (correctional facility murders) have remained stable at about three per year. This is only for the employees who have been murdered, not all murder victims.
When we consider the cost and repercussions of increased hospital security, think about this trend. We people wonder if it’s safe to be a forensic psychiatrist in corrections, and I will bring out these numbers. It does seem to be safer to work in prison than in a hospital.
*This blog post was originally published at Shrink Rap*
January 21st, 2011 by Paul Auerbach, M.D. in Book Reviews, Opinion
Tags: Dr. Paul Auerbach, Heading Outdoors Eventually Leads Within, healthline, hiking, Kathy and Craig Copeland, Medicine for the Outdoors, Outdoor Medicine, Outdoors and Health
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“Heading Outdoors Eventually Leads Within” is a small book written by Kathy and Craig Copeland and published through their company, HikingCamping.com. Here’s a summary from the website:
Everyone walks. What distinguishes hikers is that walking does more than transport us, it transforms us. But nowhere is the thoughtful undercurrent of hiking celebrated. The wisdom we glean from the wilds is a match lit in the rain. That’s why we created this book: to cup our hands around the flame. These journal entries are the mental waypoints we recorded while hiking 30,000 miles / 48,280 km (more than the circumference of the Earth) through wildlands worldwide. Accompanying them are photos of the places (primarily the Canadian Rockies, Utah canyon country, and New Zealand) where we conceived and noted the initial ideas. We hope our words and images compel you to recognize, voice, own and honour the thoughts arising from within while heading outdoors. Doing so will deepen your fulfillment. A truly adventurous life is contemplative as well as vigourous.
It is important for me to state at the outset that my opinions, like those expressed in most book reviews, are highly personal. What I write about “Heading Outdoors Eventually Leads Within” are my impressions, and you may not agree with them. I am beginning with this comment because I truly had mixed feelings about the book. There were parts that seemed right on target, for me personally, and parts that seemed to miss the mark. I am certain that the authors have great pride in their work, and they are to be congratulated for their efforts. Read more »
This post, Book Review: Heading Outdoors Eventually Leads Within, was originally published on
Healthine.com by Paul Auerbach, M.D..
January 21st, 2011 by KevinMD in Better Health Network, Opinion
Tags: Accurate Health Information, Consumer Health Information, Cyberchondria, Doctor-Patient Communication, Doctor-Patient Encounter, Dr. Kevin Pho, Dr. Zachary Meisel, Evidence-Based, Health Information on the Web, Internet-Based Health Information, KevinMD, Online Health Information, Online Symptom Searches, Patients Who Google Symptoms, Peer-Reviewed, Pew Internet & American Life Project, Possible Medical Conditions, Researching Online, Searching For Health Information On The Internet, Self-Diagnosis, Symptom Checkers, TIME.com, Trusted Health Information, YouTube
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Many doctors roll their eyes whenever patients bring in a stack of research they printed out, stemming from a Google search of their symptoms. A piece by Dr. Zachary Meisel on TIME.com describes a familiar scenario:
The medical intern started her presentation with an eye roll. “The patient in Room 3 had some blood in the toilet bowl this morning and is here with a pile of Internet printouts listing all the crazy things she thinks she might have.”
The intern continued, “I think she has a hemorrhoid.”
“Another case of cyberchondria,” added the nurse behind me.
It’s time to stop debating whether patients should research their own symptoms. It’s happening already, and the medical profession would be better served to handle this new reality.
According to the Pew Internet and American Life Project, 61 percent of patients turn to the web to research health information. That number is from 2009, so presumably it’s higher today. Health information online is akin to the Wild, Wild West. Stories from questionable sites come up on Google as high — or higher — than information from reputable institutions. Read more »
*This blog post was originally published at KevinMD.com*
January 20th, 2011 by Harriet Hall, M.D. in Better Health Network, Opinion
Tags: American Family Physician, Dr. Harriett Hall, Encyclopedia Britannica, Encyclopedia of Public Health, Healthcare Language, Library Index, Medical Terminology, Preventive Health, Preventive Medicine, Primary Prevention, Science Based Medicine, Secondary Prevention, Stedman's Medical Dictionary, Tertiary Prevention, U.S. Preventive Services Task Force, USPSTF
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A November letter to the editor in American Family Physician chastises that publication for misusing the term “secondary prevention,” even using it in the title of an article that was actually about tertiary prevention.
I am guilty of the same sin. I had been influenced by simplistic explanations that distinguished only two kinds of prevention: Primary and secondary. I thought primary prevention was for those who didn’t yet have a disease, and secondary prevention was for those who already had the disease, to prevent recurrence or exacerbation. For example, vaccinations would be primary prevention and treatment of risk factors to prevent a second myocardial infarct would be secondary prevention.
No, there are three kinds of prevention: Primary, secondary and tertiary. Primary prevention aims to prevent disease from developing in the first place. Secondary prevention aims to detect and treat disease that has not yet become symptomatic. Tertiary prevention is directed at those who already have symptomatic disease, in an attempt to prevent further deterioration, recurrent symptoms and subsequent events.
Some have suggested a fourth kind, quaternary prevention, to describe “… the set of health activities that mitigate or avoid the consequences of unnecessary or excessive interventions in the health system.” Another version is “Action taken to identify patient at risk of overmedicalisation, to protect him from new medical invasion, and to suggest to him interventions, which are ethically acceptable.” But this is not a generally accepted category. Read more »
*This blog post was originally published at Science-Based Medicine*
