HRT: No Wonder Women Are Confused
Confused about hormone replacement therapy (HRT)? I can’t imagine why…
*This blog post was originally published at tbtam*
Latest Posts
Judge Rules Healthcare Reform “Unconstitutional”
A federal judge in Virginia has ruled that healthcare reform is unconstitutional and expects the Obama administration to honor that ruling while it’s being appealed. But states and private companies are continuing to plan and budget for it nonetheless.
The court ruled that Congress exceeded its constitutional powers in compelling Americans to buy health insurance. Judges elsewhere have ruled the law is valid or dismissed the cases on procedural grounds, while a judge in Florida will hear another case later this week.
In the meantime, though, employers and healthcare companies have to continue adjusting to the reform law’s many provisions. States will continue to set up their health insurance exchanges, and they’ve already budgeted for the additional 16 million people who will qualify for Medicaid under the law. And the Obama administration is unlikely to stop what it’s doing, since many of the provisions won’t take effect until 2014.
A key of the lawsuit is “economic inactivity.” The ruling says that while Congress can regulate interstate commerce, it can’t regulate…well, non-commerce, in this case the decision not to buy health insurance. The judge’s decision is online. (Politico, Wall Street Journal, Associated Press, MSNBC)
*This blog post was originally published at ACP Internist*
A Patient’s Contagious Confidence And Endless Possibilities
In a recent post I wrote why patients are the most important part of the medical team, and my colleagues, Elizabeth Cohen, Kevin Pho, MD, Donna Cryer, JD, and Carl R. Sullivan, MD, shared their insights as well. Today, Ginger Vieira, a patient living with type 1 diabetes and celiac disease, says:
“You, as the patient, are the most important part of the medical team because you are the one who makes the daily decisions, who balances your disease around dinners, soccer games, long hours at work without enough time to check your blood sugar and eat lunch. You are the one who takes the knowledge you learn from your doctor and fits it into your everyday life. That’s a huge role, and it’s never easy.”
Ginger Vieira shares her story about the challenges and how her positive attitude is allowing her to lead a life she thought was off limits.
Contagious Confidence, Endless Possibilities
By Ginger Vieira
“Don’t let anyone tell you that you can’t do something.” My twin brother, Pete, said this to me several months ago. I wrote it down on an index card and taped it to my bathroom mirror. Funny thing is, it’s never been other people telling me I can or cannot do something. The loudest voice I hear is my own.
When I was diagnosed with type 1 diabetes in the seventh grade over eleven years ago, the first list that ran through my head was the list of things I probably couldn’t do anymore. I couldn’t eat ice cream without first counting the grams of carbohydrates in the bowl and determining how much insulin I needed. I couldn’t play basketball anymore (at least, that’s what I thought). I couldn’t buy candy and popcorn with my friends when we go to the movies without feeling overwhelmingly guilty about eating such diabetic-off-limits food. The list of foods, activities, dreams and goals I thought were off-limits seemed endless. Read more »
*This blog post was originally published at Health in 30*
Blood Print: “Am I, The Doctor, Bleeding?”
I’m diligently writing a detailed note in the patient’s chart as he speaks of his multiple concerns — severe depression, headaches, and dizziness. I’m not making good eye contact. Often this is effective because I can resist the allure of passively following his narrative to its own diagnostic suspicions. Instead I can record his intuitive guesses without persuasion, formulating my own independent ideas even as I value his. Except that as I write in his chart I notice streaks of red blood appearing among the black script. Am I hallucinating? Am I capable of making paper bleed? Am I, the doctor, bleeding?
With closer inspection I notice three small cuts on my chapped knuckles and fingers, products of the incessant and obsessive handwashing compelled by modern medicine. We are obliged to wash our hands before and after each patient contact, which leads to about 60 hand washings per day. In the dry winter air this can become punishing to the integrity of the skin barrier.
I apologize to the patient for marring his chart, yet it almost seems symbolic — physician blood spilled upon a script of human affliction. I know I should tear the page out of his chart and write a clean new one, yet the scrawls of black ink and stripes of red blood look like art. It is a poem, punctuated with living iron and crimson flourish. Despite having made poor eye contact in an attempt to distance and strengthen my consideration of his symptoms, ironically I see the commonality of our bleeding.
*This blog post was originally published at The Examining Room of Dr. Charles*
The Illusion Of Healthcare Reform
The greatest minds are assembled to discern the answer in healthcare reform. Powerful interest groups are aligned to design solutions to protect their turf. Rubrics, formulas, slogans and taglines get designed, spun, pitched and thrown out. The burden of finding alignment, an answer, a plan that suits everyone seems insurmountable — unless we don’t.
The idea of a fit for all is an illusion. Justice and equity are seen differently. We imagine some public consensus at our own peril. But honesty has been in short supply. To paraphrase Oprah: What do we know for sure?
Some people want a relationship with a trusted doctor who knows them well. They want to pick the doctor, the neighborhood and the hospital they attend. Others want immediate access and have little trust or interest in a personal relationship with a doctor.
Some people want interchangeable access to medical care in the most convenient venue — they care little if it occurs at Walgreens, doc-in-a-box, by a nurse practitioner or by a newly-minted resident — it is about access that fits their lifestyle, which may be at a late hour and may be chosen by shortest waiting time at an ER. To others, this type of medical care is anathema. Read more »
*This blog post was originally published at Dr. Wes*
