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When A Doctor Is “Spent”

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“I need you to do me a favor,” my nurse asked me at the end of our day on Friday.

“Sure,” I answered. “What do you want?”

“Please have a better week next week,” she said with a pained expression. “I don’t think I can handle another one like this week.”

It was a bad week. There was cancer, there was anxiety, there were family fights, there were very sick children. It’s not that it’s unusual to see tough things (I am a doctor), but the grouping of them had all of us trudging home drained of energy. Spent.

I think this is one of the toughest thing about being a doctor (and nurse, by my nurse’s question): The spending of emotional reserves. I’m not physically active at work, yet I come home tired. I don’t have to be busy to feel drained. It’s not the patients’ fault that I feel tired. They are coming to me to get the service I offer to them, and I think I do that job well. The real problem is in me. The real problem is that I care. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Is It Bad Patient Behavior Or Poor Doctor-Patient Communication?

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It seem like everyone these days is focused on changing some aspect of patient health behavior. You know — getting patients to get a mammogram or PSA test, exercise more, take medications as prescribed, or simply becoming more engaged in their healthcare. If only we could change unhealthy patient health behaviors, the world would be a better place.
 
I agree with the sentiment, but I think that patients and their health behavior often get a “bad rap” from healthcare professionals. I would even go so far as to say that much (not all) of what we attribute to poor patient behavior is more correctly attributable to ineffective doctor communications with patients.

In my last post I talked about the link between strong physician advocacy, e.g., I recommend, and desirable health outcomes, i.e., patients getting more preventive screening.
 
Here’s what I mean. Mammography studies have consistently shown that screening mammograms rates would be much high if more physicians “strongly recommended” that women get screened, e.g., “I recommend” you get a mammogram. In studies where physicians advocated for screening, mammography screening rates were always higher compared to physicians that did not advocate for them. The same phenomenon can be found in studies dealing with exercise, weight loss, colorectal cancer screening, HVP immunization, and patient participation in clinical trials. Read more »

*This blog post was originally published at Mind The Gap*

An Animated Look At The Future Of Healthcare

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Mrs. Happy and I just returned from Disney World for our Happy family vacation. (It was either that or a Parkinson’s Cruise.) While at Disney’s Epcot Center, Mama and Papa Happy discovered what the future of healthcare in America will look like, and it has nothing to do with insurance.

You’ve all seen that giant Epcot ball. Inside that ball is a slow-moving ride that takes you through thousands of years of history. At the end you choose your own future. I present to you this video showing the future of healthcare in America, courtesy of the Epcot Spaceship Earth and Mama and Papa Happy:

A couple words of mention. They still think there will be doctors in the future, unless their reference to doctors was reference to future nurse practitioners known as Dr. Nurse. That’s quite possible. Maybe that’s why the future of healthcare has nothing to do with medical care or insurance and has everything to do with healthy lifestyle. You don’t need to be a nurse for that, you just have to accept the truth of healthy living. And you don’t need a medical school education or even nursing education requirements to make that happen.

*This blog post was originally published at The Happy Hospitalist*

May We All Die So Well

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Everyone liked him. Though his later years (the only ones in which I knew him) took away his ability to do most things, and though he was in great pain every day, it was easy to see the mischief in his eyes. The subtle humor was still there, coming out of a man who was weak, in pain, dying.

She lived for him. She was always telling me of his pain, frustrated with the fact that he didn’t tell me enough. She was anxious about each complaint of his, wondering if this was the one that would take him away from her. Many of her problems were driven by this anxiety and fears, and she spent many hours in my office giving witness to them through her tears.

As his health failed, I wondered about her future. He was the center of her life, the source of her energy, joy, purpose. How could she manage life without him? How could she, who had so much lived off of the care of this wonderful man, find meaning and purpose in a life without his calming presence?

Then he died. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

Healthcare Improvement Via An Imperfect Solution

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My professional organization recently asked me to participate in an interesting meeting at the state capitol talking about healthcare payment reform and how to improve the healthcare delivery system. This was sponsored by the state of Ohio and their Health Care Coverage and Quality Council.

It was the first meeting that I’ve been to where there were physicians, hospitals, insurance companies, and patients — all trying to put our heads together — present our points of view and try to come to consensus. Did we come to consensus on solutions? Not really, only that we will continue the conversation. There is no perfect solution that will make everyone happy, but we will strive to try to get to that best imperfect solution.

When is comes to healthcare delivery and healthcare payment, there was a lot of discussion on physicians and hospitals — meaning healthcare providers. The motivating factor in these cases uses terms like payment, lack of payment, incentives, bonuses, and penalties. Read more »

*This blog post was originally published at Doctor Anonymous*

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