September 23rd, 2011 by Lucy Hornstein, M.D. in True Stories
Tags: Breach, Confidentiality, Electronic Medical Records, Emergency Department, EMR, ER, Facebook, HIPAA, Medical, Security, Social Networking, Status Updates, Voicemail
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Got a call from a long-time patient over the weekend. Hearing a not overly alarming story but one that was not terribly reassuring either, I suggested she go to the Emergency Department.
Later that morning, sitting at an internet cafe with DSS eating breakfast, each of us surfing on our respective laptops, he says conversationally, “So I see Miss LTP is in the ER.”
My heart stopped and my stomach dropped. Had he managed to access the voicemail program I use for after hours calls? My EMR? Had I left shortcuts up to any patient-related materials on that machine? When had I last used it anyway? My mind was racing. I wasn’t all that concerned specifically about him knowing that a particular person was in the ER, since he understands confidentiality. But if he was able to access confidential patient information, did that mean I had a security breach?
“How do you know that?” I asked him carefully, after a very long pause, during which all of the above ran through my head. Read more »
*This blog post was originally published at Musings of a Dinosaur*
September 22nd, 2011 by HarvardHealth in Health Tips, True Stories
Tags: Blockages, Blood Clot, Cardiac Catheterization, Cardiac Rehabilitation, Cardiology, Cholesterol-clogged arteries, Coronary Artery Bypass Surgery, Coronary Artery Disease, Harvard Medical School, Health, Heart Attack, Heart Burn, Heart Disease, Heart Health, Plaque, Shortness of Breath
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Most people are pretty good judges of what’s going on with their own bodies. But telling a heart attack from other causes of chest pain is tough stuff—even, it turns out, for highly trained doctors. That’s why I thought this personal story, written by a Harvard doctor who has heart disease, would make an interesting read. It’s an excerpt—the full version can be found in Heart Disease: A guide to preventing and treating coronary artery disease, an updated Special Health Report from Harvard Medical School.
Early one spring, I noticed a burning sensation high in my abdomen whenever I walked up a hill or worked out on the treadmill. I felt perfectly healthy otherwise. I had lots of energy and could do high-level exercise on the treadmill—once the burning sensation went away—without becoming short of breath. I thought it was just heartburn, so I started taking powerful acid-suppressing pills. They didn’t help.
Sometimes when I would feel the burning in my chest, I would remember an old saying to the effect that “A doctor who takes care of himself has a fool for a patient.” Still, I hesitated; I didn’t want to waste the time of a cardiologist if all I had was heartburn.
But one morning as I walked across the street from the garage to my office in the hospital, Read more »
*This blog post was originally published at Harvard Health Blog*
September 19th, 2011 by KennyLinMD in Health Policy, True Stories
Tags: Abnormal Tests, Adverse Effects, Ageism, Blood Test, Consequences, Early Detection, Government-sponsored euthanasia, Literature Review, Meta-Analysis, Physical Damage, Prostate Cancer, Prostate Specific Antigen, PSA, Psychological Damage, Recommendations, Screening, U.S. Preventive Services Task Force, USPSTF
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Flashback to summer of 2008. I’m looking forward to August 5–the day that I’ll no longer be a faceless bureaucrat. The day that the US Preventive Services Task Force (USPSTF) will issue its new recommendations on screening for prostate cancer–recommendations I’ve labored on as a federal employee for the past year and a half.
For much of 2007 I combed the medical literature for every study I could find on the benefits and harms of prostate cancer screening. In November of that year I presented my findings to the USPSTF, a widely respected, independent panel of primary care experts. They discussed and debated what the evidence showed and then voted unanimously to draft new recommendations. I didn’t get to vote, but it has been my job in 2008 to shepherd the draft statement and literature review through an intensive vetting process and to finalize both.
As August 5 approaches, my colleagues in public relations warn me that the last time the USPSTF said anything about prostate cancer screening, the phones started ringing off the hook. I’m not so secretly hoping that the same will happen this time.
And I’m not disappointed! After we release the statement, Read more »
*This blog post was originally published at Common Sense Family Doctor*
September 18th, 2011 by Linda Burke-Galloway, M.D. in True Stories
Tags: Barbara Tate, cellulitis infection, Congestive Heart Failure, Diabetes, Dr. Linda Burke-Galloway, Healthy Start Program, High Blood Pressure, High Risk Pregnancy, Infertility, Miracle, Near-Miss Pregnancy, Non-cancerous tumor, Pregnancy, Premature Labor, Slipped Disk
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There are some patients that keep you humbled. Barbara Tate was one of those patients. With a shopping list of chronic conditions a mile long, she was told she could never carry a baby because she had miscarried two during her early 20’s. She suffered the hammer blows of diabetes, high blood pressure, congestive heart failure and asthma. And it doesn’t stop there. Tate also had a history of two slipped disks, a cellulitis infection and a non-cancerous tumor on her adrenal gland. In fact she was scheduled to have surgery until she discovered she was pregnant at the age of 43. She was strongly encouraged to terminate the pregnancy because of her multiple medical conditions but she didn’t. Tate viewed her pregnancy as a miracle and for all intent purposes, it was. After age 37, there is a rapid decline in the ability to conceive although not impossible.
Her baby was born three months early and it appears that she was unaware of the classic signs of premature labor. On the day of her child’s birth, Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
September 17th, 2011 by Bongi in True Stories
Tags: Beliefs, Culture, Evil Spirits, Gunshot Wound, Hygienic, Protection, Ribbons, Sangoma, South Africa, String, Tassel, Waist
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In quite a few of the cultures in south africa people tie ribbons, strings and tassels around their own and their children’s wrists and waists. These tassels are imbibed with power to keep evil spirits at bay, I am told. If these tassels come off then the patient is completely unprotected from any and all marauding evil spirits that may be lurking around. Of course, not wanting to be responsible for the unopposed assault by multiple evil spirits, most people are fairly reticent to remove these things. I saw it slightly differently.
As a student I took my lead from my senior. If he removed the tassels then I would be ok with it. If he felt that we should respect the culture of the patient and sort of try to move the tassels out of the way of the operating area or even operate around them, despite the increased infection risk, I sort of reasoned it was his patient and even if I medically didn’t agree with him, the reasoning of respecting the patient’s culture surely held some water at least and I didn’t argue. The fact of the matter was that a number of the sisters would become quite aggressive with the doctor if they thought he was going to remove the tassels and strip the patient of his evil spirit protection, and I think some of the doctors were scared. Then one day something happened that cemented my views and actions for the future. Read more »
*This blog post was originally published at other things amanzi*
