November 16th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy, Opinion, True Stories
Tags: 33 Charts, Doctor Patient Relationship, Doctors and Social Media, Dr. Bryan Vartabedian, General Medicine, Healthcare and the Internet, Healthcare Social Media, Interacting With Patients Online, Patients and Social Media, Pediatrics, Physicians On Twitter, Social Media In Medicine
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When perusing my Twitter feed [one] morning, I stumbled onto this post directed to me:
Patients reaching me in public social spaces is becoming a regular thing. I’ve discussed this in the past, but I think it bears repeating. So here’s what I did:
I understood the mom’s needs. Patients resort to “nontraditional” means of communication when the traditional channels fail to meet their needs. Recognize that these patients (or parents in my case) are simply advocating for themselves. My specialty struggles with a shortage of physicians, so we’re dependent upon phone triage to sort out the really sick from the less-than-sick. It’s an imperfect system and consequently parents find themselves having to speak up when the gravity of their child’s condition hasn’t been properly appreciated.
I took the conversation offline. I don’t discuss patient problems in places where others can see, so my first order of business in this case was to get the conversation to a place where it can be private. I called the mom, found out what was going on, and rearranged her appointment to a time appropriate to the child’s problem. Read more »
*This blog post was originally published at 33 Charts*
November 16th, 2010 by admin in Better Health Network, Opinion, True Stories
Tags: ACP Internist, Alzheimer's Disease, American College Of Physicians, At-Home Caregiving, Caregiver Burden, Dementia, Dr. John Schumann, Family Caregivers, Family Medicine, General Medicine, Geriatrics, GlassHospital, Home Health Care, Hospital Medicine, Internal Medicine, Primary Care
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It was a straightforward phone message (names changed): “Hey Dr. S., this is Bobbie Jones, April Dixon’s granddaughter. I was calling to inform you that April passed away today at City Hospital. They said she was bleeding in her stomach or something. I’m not quite what sure what happened, but she got real sick. But she’s gone, so, thanks so much. You’ve been a real neat doctor, and it’s been good working with you through the years taking care of my grandmother. Take care. Bye.”
Bobbie Jones is a saint. Pure and simple. She took care of her 88-year-old grandmother with tender, loving care. I am certain if left to the vagaries of the “healthcare system” that her grandmother would have died at least three years ago, maybe earlier.
Ms. Jones will get no recognition. No income. No honors, save this blog post which she’ll never see. She will get a letter from me, expressing my condolences and appreciation for the love and care that she provided her grandma. She singlehandedly advocated for an octogenarian with advanced dementia and probable cancer (we were never able to get a definitive diagnosis of it) and gave her a quality of life that I would want were I in her grandma’s shoes. Read more »
*This blog post was originally published at ACP Internist*
November 15th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, Opinion, True Stories
Tags: Charity Care, Dr. Lucy Hornstein, Family Practice Residency Programs, General Medicine, Government-Funded Care, Government-run Healthcare, Healthcare Economics, Healthcare Infrastructure, Healthcare reform, Medical Schools, More Primary Care Doctors, Musings of a Dinosaur, National Healthcare System, New U.S. Healthcare System, Private Medical Practice, Public Healthcare Clinics, Public Healthcare System, VA, Veterans Administration
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A friend who works with the unemployed called me up the other day huffing with indignation. The local charity clinic, apparently overwhelmed, had changed its policies so that her unemployed uninsured would no longer be able to seek care there.
“Someone has to do something!”
Um, what exactly would that be? I’d love to help, but I have bills to pay (as do charity clinics) so I can hardly provide medical care without seeking payment. I understand her desperation (and that of the people she so valiantly helps) but who, exactly, is supposed to do what, precisely?
Things are going to get worse before they get better, I fear. The unemployment issue goes way beyond a devastating economic downturn. It’s a reflection of the most basic economic principle of supply and demand. Wages are the “price” of labor — prices go down when supply goes up. In the case of labor, it’s when you have large numbers of people willing to accept lower wages. Can you say “outsourcing?” Watch as the jobs flow overseas while we’re still left with all these people, but not enough jobs to support themselves. In the meantime they all still need healthcare, but can’t pay for it.
Someone has to do something!
Guess what? It just so happens that we really do have a healthcare infrastructure in this country. Between the Veterans Administration (VA) and public healthcare clinics, we have rather a good start at building a truly national healthcare system. Perhaps now is the time to expand it. Read more »
*This blog post was originally published at Musings of a Dinosaur*
November 14th, 2010 by Edwin Leap, M.D. in Better Health Network, Opinion, True Stories
Tags: Dr. Edwin Leap, General Medicine, Hospital Auxiliary Association, Hospital Volunteers, Medical Volunteer Efforts, Patient Care, Retirees, Volunteerism
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Here is a talk I gave last week to our hospital auxiliary association, mostly made up of retired volunteers. They give us so much, and this is my tribute to them.
Capacity, utility and volunteers
Thank you for letting me speak to you tonight. It is an honor. I have today been at two different ends of the medical world . Today at lunch, I spoke to a Christian Medical Student’s association at USC in Columbia, SC. And now, I am honored to speak to you, who do so much to keep the hospital functioning by your gift of volunteerism.
Tonight I want to talk about capacity and functionality. About utility and usefulness. In preparing to do so, I began to think about how I became the way I am, and my mind wandered to ancestry. I suppose that ancestry has much to do with who we are, though I doubt it is the sole determinant. Read more »
*This blog post was originally published at edwinleap.com*
November 13th, 2010 by Shadowfax in Better Health Network, True Stories
Tags: Chemical Dependency, Doctor's Story, Doctors Threatened By Patients, Drug Addiction, ED, Emergency Department, Emergency Medicine, Emergency Room, ER, ER Doctor, Inappropriate Professional Behavior, Movin' Meat, Prescription Drug Abuse, Saying no to drug seekers, Shadowfax
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I wish I could say that every patient encounter worked out well, that all my patients went home happy and satisfied. It would be nice, but unfortunately that is not true at all.
There are many patients who present with unrealistic expectations or an agenda which is non-therapeutic, and I am relatively straightforward and unapologetic about correcting patient’s misconceptions about the care that is or is not appropriate in the ED. Unsurprisingly, this often though not always involves narcotic medications.
Which is not to say that I am a jerk. I try to be compassionate, and I try to find alternative solutions, and I have been told that I can turn away a drug seeker more nicely than any other doctor in the department. But when it is time to say “no,” I say “no” firmly and without evasions or excuses. People don’t like to hear that, and all the more so in this “the consumer is king” environment of customer-service culture we foster in the medical industry these days.
So when I do say “no,” as nice as I try to be, some people get upset. Sometimes they escalate. They hurl insults, spit, throw themselves on the floor and throw a fit or feign unconsciousness. Read more »
*This blog post was originally published at Movin' Meat*
