May 5th, 2010 by Edwin Leap, M.D. in Better Health Network, Opinion, True Stories
Tags: Dehumanized, Doctors, Exhaustion, Family Medicine, Fatigue, Human, Patient Immunity, Personal Life, Physicians, Physics, Physiologic Phenomena, Primary Care, Stress, The Practice of Medicine
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It’s all too easy to try and quantify everything in medicine. We are, after all, under the widely held delusion that medicine is like physics. A thing that follows fixed, predictable mathematical models. A thing reproducible if only algorithm A is followed for this disease and algorithm B is followed for that disease.
This belief is also held by the government, which doesn’t want to pay for readmissions or mistakes. Because it is believed that all things in medicine can be known from an exam, some labs, some tests, and some studies.
Nevertheless, things happen. Disease are transmitted in public or by families. Medications don’t always work. Bodies change. Bodies age. Humans are non-compliant. Humans are suffering from physiologic phenomena we can’t yet comprehend. Viruses are synergistic with other diseases.
The immunity of our patients is affected by their happiness, their diet, their work history, their family. The algorithms necessary to make medicine anything like physics would be mathematically beyond comprehension. Read more »
*This blog post was originally published at edwinleap.com*
May 5th, 2010 by KevinMD in Better Health Network, Health Policy, Opinion, Research
Tags: Communication Disconnect, Defensive Lack of Documentation, Defensive Medicine, Direct Reports from Patients, Dismisses a Symptom, Doctor-Patient Communication, Downgrade Symptoms, Dr. Ethan Basch, Family Medicine, General Medicine, Internal Medicine, Life-Threatening Diagnosis, Medical Liability, Medical Malpractice, New England Journal of Medicine, New York Times, Nurses, Patient Comments, Patient Complaints, Primary Care
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Doctors often have a communication disconnect with their patients. A recent piece from the New York Times encapsulates the issue, citing a recent New England Journal of Medicine perspective.
According to oncologist Ethan Basch, “Direct reports from patients are rarely used during drug approval or in clinical trials. If patients’ comments are sought at all, they are usually filtered through doctors and nurses, who write their own impressions of what the patients are feeling.”
There are a variety of reasons for this. Some doctors feel they have a better sense of the patient’s symptoms than the patient himself. Biases can affect how doctors and nurses perceive symptoms. Read more »
*This blog post was originally published at KevinMD.com*
May 5th, 2010 by DrRob in Better Health Network, Health Policy, Opinion, True Stories
Tags: Defensive Medicine, Doctor-Patient Connection, Doctor-Patient Responsibility, Family Doctor, Family Medicine, Friends, Genuine Personal Investment, Getting Older, Getting Sick, Long-Term Patients, Medicare Cuts, Mid-Level Healthcare Providers, Patient-Doctor Relationship, Personal Stake in Health, Primary Care Medicine, Relational Medicine, The Joy of Primary Care, To Know and Be Known, Walgreens
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I was happy when I looked at [the day’s] schedule. Two husband-and-wife pairs were on my schedule, both of whom have been seeing me for over 10 years. Their visits are comfortable for me — we talk about life and they are genuinely interested in how my family is doing. They remember that I have a son in college, and want to know how my blog and podcast are doing. I can tell that they not only like me as a doctor — they see me, to some degree, as a friend.
Another patient on the schedule is a woman from South America. She has also been seeing me for over 10 years. I helped her through her husband’s sudden death in an accident. She brings me gifts whenever she goes on her trips, and also brings very tasteful gifts for my wife. Today she brought me a Panama hat.
I know these people well. I know about their past illnesses and those of their children. I know about their grandchildren, having hospitalized one of them over the past year for an infection. I know about the trauma in their lives as well as what they take joy in. They tell me about their trips and tell me their opinions about the healthcare reform bill.
I spend a large part of their visits being social. I can do this because I know their medical situation so well. I am their doctor and have an immediate grasp of the context of any new problems in a way that nobody else can. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
May 5th, 2010 by JessicaBerthold in Better Health Network, Health Policy, Opinion
Tags: Brochure, Dates of Care, Doctor Ratings, Doctor-Patient Encounter, Doctors Who Sit, Doctors Who Stand, ED, Emergency Department, FAQs, Happy Patients, Hospitalist, Hospitalist Medicine, Internal Medicine, Nancy Mihevc, Open-Ended Question, Patient Discharge, Patient Satisfaction, Patient Surveys, Patient-Doctor Relationship, Patient's Condition, PCP, Personal Letter, Post-Discharge, Primary Care Medicine, Primary Care Physician, Real Postage Stamp, Review Patient's Chart, SHM, Sitting Down, Society of Hospital Medicine, Winthrop Whitcomb
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Some interesting points were raised at a recent Society of Hospital Medicine (SHM) session by Winthrop Whitcomb and Nancy Mihevc on patient satisfaction. To improve satisfaction scores:
1. Review the patient’s chart before you go in the room. It makes a big difference if the patient perceives you know what’s going on without having to bury your face in a chart.
2. Patients are often confused about who they are supposed to see after discharge. This, of course, is a safety issue as well as one that affects patient satisfaction.
3. Sit down when you are visiting a patient. Patients are happiest when they perceive you’ve spent enough time with them, and they are more likely to perceive this if you are sitting than standing with your hand on the doorknob. Read more »
*This blog post was originally published at ACP Hospitalist*
May 5th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy, Opinion, True Stories
Tags: Disappointment, Disconnected Physician, Doctor-Patient Connection, Ethical Obligation, Family Medicine, Forgotten Piece of Medical History, General Medicine, Heartbreaking, Internal Medicine, Lost Generation of Medicine, Medical Profession, Older Doctors, Online Conversation, Paradigm of Care, Paternalism, Patient Advocacy, Patient Empowerment, Patient-Doctor Relationship, Personal Boundaries, Physician Control, Primary Care, Quality of Care, Social Health Media, Social Media Platform, Transparency, Younger MDs
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I [recently] visited a small town in west Texas to address a local medical society on the emerging role of social media in healthcare.
My presentation involves social media and the evolving relationship that patients share with doctors. I discuss challenges and opportunities -– especially as it relates to transparency, personal boundaries, and even the ethical obligation to participate in the online conversation. I target the disconnected physician and offer education as well as a compelling argument for involvement.
When I arrived at the venue I found that the meeting was attended predominantly by physicians much older than myself. While waiting to speak, I was concerned that my message of connection and changing relationships would elicit pushback. After all, isn’t it this era of physicians we hold accountable for paternalism and control in dealing with patients? That’s what I’d been lead to believe. Read more »
*This blog post was originally published at 33 Charts*
