November 18th, 2011 by StevenWilkinsMPH in Opinion, Research
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Abraham Verghese, MD, Standford University
My wife has two world-class oncologists who help her manage her Stage 4 Lung Cancer. Both are excellent clinicians. Yet their skills differ in one very important way. Her radiation oncologist physically touches her a lot (in a good way of course!). There are the touches on her arm, a hand on the shoulder, hugs, and of course a thorough hands-on physician exam. Her medical oncologist not so much.
We all recognize the therapeutic value of touch. Dr. Abraham Verghese, a Stanford Physician and Professor, at the 2011 Med2.0 Conference, described the power of touch associated with the physical exam. In the following scenario he describes an interaction with a chronic fatigue patient who came to him after being seen by many other physicians: Read more »
*This blog post was originally published at Mind The Gap*
November 15th, 2011 by EvanFalchukJD in Opinion
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Atul Gawande says that we’re used to doctors working like “cowboys” – rugged individualists who are responsible for making sure your care gets done right. We don’t need cowboys, he says. We need “pit crews” – teams of doctors working together toward a common goal, with each playing their own role.
It’s an appealing idea. Pit crew-like teams work, and work well, in trauma units across the country.
But there’s a problem: if you haven’t just been airlifted to a hospital after a horrible accident, you’re not going to be treated by a pit crew. You’re going to be on your own, shuffled from one 15-minute specialist visit to the next, likely with no one person in charge of your care.
Dr. Gawande knows this, and he picks a heck of an example of the problem: Read more »
*This blog post was originally published at BestDoctors.com: See First Blog*
November 13th, 2011 by Dinah Miller, M.D. in Opinion
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We’ve been having a great discussion over on the post Tell Me…. An Ethical Dilemma. The post talks about a young man who wants to know if he can check “no” to a question about whether he has a psychiatric disorder if his illness is not relevant to the situation. The comments have been fascinating — do read them– and very thought-provoking.
One reader asked, ” If a patient asked if they were boring you, and they were, would you say yes?”
This is a great question, and of course the right thing to do is to explore with the patient what meaning the concern has to him. But is that all? I’m not very good at doing the old psychoanalyst thing of deflecting all questions, and mostly I do answer questions when they are asked of me. This can present a really sticky situation because one can not think of any clinical scenario in which it would be therapeutic to have a therapist tell a patient, ‘Yes, you’re boring, OMG are you boring,’ or ‘No, in fact, I don’t like you.’ And not answering could be viewed as negative response by the patient –if you liked me, you’d tell me, so clearly you don’t like me. So if the exploration of the question doesn’t take care of the issue, and the patient continues to ask, what’s a shrink to do? Read more »
*This blog post was originally published at Shrink Rap*
October 25th, 2011 by Bryan Vartabedian, M.D. in Opinion
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While most of us fail to see it, doctors are changing. We’re changing as a result of the social and technological innovation. In 2050 what we do and how we do it will be very different from what we did at the turn of the century. We’re evolving from analog to digital. I think it’s important to consider the ‘digital physician’ as a concept worthy of attention. The training and support of this emerging prototype has to meet its different needs and workflows. Perhaps the criteria by which we choose medical students should take into consideration the anticipated skill sets and demands of this next generation. And we need hard information about the digital physician and her habits.
Here are some differences between the digital and analog physician:
The digital physician
- Information consumption is web-based
- Rarely uses a pen. Care and correspondence is conducted through an EMR.
- Socially connected. Comfortable with real time dialog at least on a peer-to-peer level. Recognizes Read more »
*This blog post was originally published at 33 Charts*
October 18th, 2011 by Michael Kirsch, M.D. in Opinion
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The blog, Shots, posted a question primer to prepare patients for medical office visits with their doctors. A reaction to this appeared on Glass Hospital, where John Schumann offered his own wry version of the question list. My less wry, and more dry response appears below.
While I agree with Shots that education is power, a closer look at the question list demonstrates that the intent to educate may obfuscate instead.
First, the post is entitled, Ten Questions to Ask Your Doctor, suggesting that patients arrive at their physician’s office Read more »
*This blog post was originally published at MD Whistleblower*
