January 7th, 2011 by Bryan Vartabedian, M.D. in Better Health Network, Humor, Opinion, True Stories
No Comments »
In the movie “The Sixth Sense,” there was that kid who saw dead people. I’m like that. But I see patients and their parents instead. They’re all around me.
They’re watching at the grocery store when my kids act up. We meet during anniversary dinners, at Christmas Eve service, and on the treadmill at the Y. I bump into parents when buying personal effects and even during the early morning coffee run in my oldest sweats. I see patients.
The follow-up dialog between the parents might go something like this:
Dad: “Marge, don’t you think Billy’s colitis might be better managed by a doctor capable of pulling himself together?”
Mom: “Don’t be ridiculous, Frank. DrV’s bedhead has nothing to do with his ability to care for Billy. And besides, I’ve heard that he can intubate the terminal ileum in under 10 minutes.”
It’s not that I necessarily mind being seen in the wild. I’m pretty comfortable in my own skin, even when it’s glistening after a workout. I’m bothered more by the fact that patients may be repulsed by my occasional bedraggled appearance. If I knew they were good with it, I might be less caught up with the whole matter. Read more »
*This blog post was originally published at 33 Charts*
December 29th, 2010 by eDocAmerica in Better Health Network, Opinion
No Comments »
Recently, I was involved in a discussion on an email list serve and decided to takes some of my comments on patient autonomy and blog about them. This arose following a debate about whether the term “patient” engendered a sense of passivity and, therefore, whether the term should be dropped in favor of something else, like “client” or something similar.
Having participated in the preparation and dissemination of the white paper on e-patients, I don’t see the need for “factions” or disagreements in the service of advancing Participatory Medicine. As Alan Greene aptly stated: “This is a big tent, with room for all.”
I want all of my patients to be as autonomous as possible. In my view, their autonomy is independent of the doctor-patient relationship that I have with them. They make the choice to enter into, or to activate or deactivate, the relationship with me. They may ignore my input, seek a second opinion, or fire me and seek the care of another physician at any time. They truly are in control in that sense. The only thing I have control over and am responsible for is trying to provide the best advice or consultation I can. Read more »
*This blog post was originally published at eDocAmerica*
December 26th, 2010 by JenniferKearneyStrouse in Better Health Network, News, Research
3 Comments »
Placebos helped ease symptoms of irritable bowel syndrome (IBS) even when patients knew that was what they were taking, a new study reports.
Researchers randomly assigned 80 patients with IBS to receive placebo pills (openly labeled as such) or no treatment over a three-week period. Patients taking placebos had significantly higher mean scores on the IBS Global Improvement Scale at 11 and 21 days, and also reported significant improvements in symptom severity and relief. The results of the study, which was funded by the National Center for Complementary and Alternative Medicine, were published online Dec. 22 by PLoS ONE.
Anthony Lembo, M.D., a study coauthor, said in a press release that he didn’t expect the placebo to work. “I felt awkward asking patients to literally take a placebo. But to my surprise, it seemed to work for many of them,” he said.
Ted Kaptchuk, O.M.D., the study’s lead author, told the LA Times that a larger study needs to be done to confirm the findings, and said that he didn’t believe such effects would be possible “without a positive doctor-patient relationship.”
ACP Internist looked at placebos’ place in clinical practice in a 2009 article. (PLoS ONE, Public Library of Science, LA Times, ACP Internist)
*This blog post was originally published at ACP Internist*
November 22nd, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Health Policy, News
No Comments »
A new policy on professionalism in the use of social media was [recently] adopted by the American Medical Association (AMA). The AMA Office of Media Relations was kind enough to share a copy of the policy:
The Internet has created the ability for medical students and physicians to communicate and share information quickly and to reach millions of people easily. Participating in social networking and other similar Internet opportunities can support physicians’ personal expression, enable individual physicians to have a professional presence online, foster collegiality and camaraderie within the profession, provide opportunity to widely disseminate public health messages and other health communication. Social networks, blogs, and other forms of communication online also create new challenges to the patient-physician relationship. Physicians should weigh a number of considerations when maintaining a presence online:
(a) Physicians should be cognizant of standards of patient privacy and confidentiality that must be maintained in all environments, including online, and must refrain from posting identifiable patient information online.
(b) When using the Internet for social networking, physicians should use privacy settings to safeguard personal information and content to the extent possible, but should realize that privacy settings are not absolute and that once on the Internet, content is likely there permanently. Thus, physicians should routinely monitor their own Internet presence to ensure that the personal and professional information on their own sites and, to the extent possible, content posted about them by others, is accurate and appropriate. Read more »
*This blog post was originally published at 33 Charts*
November 20th, 2010 by KevinMD in Better Health Network, Health Policy, News, Research
No Comments »
Hospitals have recently been stepping up their infection control procedures, in the wake of news about iatrogenic infections afflicting patients when they are admitted. Doctors are increasingly wearing a variety of protective garb — gowns, gloves, and masks — while seeing patients.
In an interesting New York Times column, Pauline Chen wonders how this affects the doctor-patient relationship. She cites a study from the Annals of Family Medicine, which concluded that,
fear of contagion among physicians, studies have shown, can compromise the quality of care delivered. When compared with patients not in isolation, those individuals on contact precautions have fewer interactions with clinicians, more delays in care, decreased satisfaction and greater incidences of depression and anxiety. These differences translate into more noninfectious complications like falls and pressure ulcers and an increase of as much at 100 percent in the overall incidence of adverse events.
Hospitals are in a no-win situation here. On one hand, they have to do all they can to minimize the risk of healthcare-acquired infections, but on the other, doctors need to strive for a closer bond with patients — which protective garb sometimes can impede. Read more »
*This blog post was originally published at KevinMD.com*
In the movie “The Sixth Sense,” there was that kid who saw dead people. I’m like that. But I see patients and their parents instead. They’re all around me.
