November 13th, 2011 by Dinah Miller, M.D. in Opinion
Tags: Dilemma, Doctor Patient Relationship, Ethics, Honest, Lies, Lying, Psychiatric Disorders, Psychiatry, Psychology, Psychotherapy, Shrink, Therapy, Truth
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We’ve been having a great discussion over on the post Tell Me…. An Ethical Dilemma. The post talks about a young man who wants to know if he can check “no” to a question about whether he has a psychiatric disorder if his illness is not relevant to the situation. The comments have been fascinating — do read them– and very thought-provoking.
One reader asked, ” If a patient asked if they were boring you, and they were, would you say yes?”
This is a great question, and of course the right thing to do is to explore with the patient what meaning the concern has to him. But is that all? I’m not very good at doing the old psychoanalyst thing of deflecting all questions, and mostly I do answer questions when they are asked of me. This can present a really sticky situation because one can not think of any clinical scenario in which it would be therapeutic to have a therapist tell a patient, ‘Yes, you’re boring, OMG are you boring,’ or ‘No, in fact, I don’t like you.’ And not answering could be viewed as negative response by the patient –if you liked me, you’d tell me, so clearly you don’t like me. So if the exploration of the question doesn’t take care of the issue, and the patient continues to ask, what’s a shrink to do? Read more »
*This blog post was originally published at Shrink Rap*
November 13th, 2011 by John Mandrola, M.D. in Opinion, Research
Tags: Cardiology, Diet, Exercise, Fat, Fitness, Health, Heart Health, Junk Food, Lifestyle Changes, Medications, Nutrition, Obesity, Overweight, Research, Studies
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There was a very controversial presentation made at a recent meeting of heart doctors in Canada. I’ve been stewing about what to say about it for a week.
The title speaks to its inflammation:
Fat, unfit, unmotivated: Cardiologist, heal thyself
The presenter that made the stir, pediatric cardiologist, and IronPerson, Dr. Brian McCrindle (Toronto) argued that overweight, unfit doctors are doing their patients a disservice. His bottom line: cardiologists are acting like the rest of Western society. They are not living a healthy lifestyle.
He made three major points. (in-depth coverage can be viewed here, on TheHeart.org)
*This blog post was originally published at Dr John M*
November 12th, 2011 by DrWes in Opinion
Tags: administrative work, Data-entry, Doctor-Patient Communication, Documentation, EHR, Electronic Health Record, Electronic Medical Record, EMR, extra work, Five minutes, Paperwork, Records
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“I estimate these changes to your charting work flow will take only five minutes.”
Five minutes is fine if it happens for only one patient. But when it is multiplied by as many as forty patients in a day, the multiples get impressive. Five minutes x forty patients = 200 minutes (more than 1.5 hours a day).
Minor five-minute changes to administrative charting requirements aren’t so minor, especially when you add more time for quality assurance reporting or pay-for-performance initiatives. Suddenly huge swaths of time from a doctor’s opportunity to take care of their patients. We need more care time and less data entry time. Doctors must insist that we not become data entry clerks.
Increasingly, I see the data entry burdens of regulatory health care documentation requirements falling on doctors. On first blush, this seems logical because only doctors (or very capable, highly trained surrogates) understand the nuances required to make potentially life-altering adjustments to the electronic medical record. But when new administrative documentation requirements are added to doctors and other care providers, it Read more »
*This blog post was originally published at Dr. Wes*
November 12th, 2011 by GarySchwitzer in Opinion
Tags: arms race, Cancer, Construction projects, Evidence Based Medicine, Health Care Costs, HealthLeaders Media, Medical Devices, Scripps Health, UC San Diego Medical Center
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I have written many times on this blog about one shining example of the medical arms race – the slow (some would say not so slow), steady, proliferation of huge and hugely expensive proton beam radiation facilities in medical centers in the US. I have written about how the proliferation never seems to occur in single units – rarely just one per town – but almost always two simultaneously – the medical arms race among health care institutions and providers at play.
The latest chapter is playing out in San Diego, as captured by HealthLeaders Media Online senior editor Cheryl Clark.
Excerpts:
“As members of the debt reduction “super committee” wrestle to slice $400 billion from Medicare over 10 years, I wonder what they might say about the $430 million proton beam center war now being waged a few miles from my home in San Diego.
This nearly half a billion dollar investment in proton therapy is a big part of Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
November 12th, 2011 by AndrewSchorr in Opinion
Tags: Cancer, Chronic Lymphocytic Leukemia, Chronic Myelogenous Leukemia, CML, family members, Human Connection, Meet-ups, Multiple Myeloma, Patients, Seattle Cancer Care Alliance, summit meeting
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Remember when people in the waiting room at a doctor’s office were all reading magazines? It was quiet as each person waited for their name to be called. Even if you went to a specialist’s office, no one dared say “I’m here for _____. What brings you here to see Dr. ____?” No one “shared” even if, just maybe, they had a very similar health concern to the person next to them. Makes sense, health is a private matter, right? Well many people I know don’t feel that way. They feel the benefits of connecting with other patients far outweigh the risks.
The other day I was in Atlanta where 30 or so patients attended an educational “summit” for people with a rare form of leukemia, chronic myelogenous leukemia or CML.While the people who came wanted to be informed and hear the latest from medical experts and an oncology social worker, they also wanted to meet others facing the same diagnosis. Particularly in rare conditions like this one, many patients have never met someone else with the diagnosis – and they very much want to make that connection. They want to hear the stories of others and see if they are like their own.
I found that to be true when Read more »
*This blog post was originally published at Andrew's Blog*
