March 1st, 2011 by DavedeBronkart in Health Policy, Opinion
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ABCNews.com has posted a great new piece by Dr. Roni Zeiger entitled, “The Biggest Wasted Resource in Health Care? You.” Subtitle: “How Your Internet Research Can Help Your Relationship With Your Doctor.” It’s well reasoned and clearly written, and continues the trend we cited a month ago, when Time posted Dr. Zack Meisel’s article saying that patients who Google can help doctors.
Related notes:
— Dr. Zeiger’s article title parallels what Dr. Charles Safran told the House Ways & Means Subcommittee on Health in 2004: Patients are “the most under-utilitized resource.” He was talking about health IT, quoting his colleague Dr. Warner Slack, who had said it many years earlier. I often quote it in my speeches for the Society for Participatory Medicine, asserting that it applies not just to IT but to all of healthcare.
— Dr. Zeiger is on the editorial board of our Journal of Participatory Medicine and is Chief Health Strategist at Google. He gets the power of patient engagement deeply and clearly. Last fall he posted a prediction that in the future it might be malpractice for doctors not to prescribe a patient community to help you help yourself with your conditions.
Prediction: Googling and patient networks will become essential as we move toward the practice of shared medical decision making (SMDM). I know firsthand that the information my kidney cancer community gave me about coping with treatments went well beyond what my excellent clinicians could offer. (We’re starting a series on SMDM. The first entry was in December.)
*This blog post was originally published at e-Patients.net*
February 28th, 2011 by EvanFalchukJD in Health Policy, Opinion, True Stories
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Media reports on misdiagnosis continue to mount. A recent study on patients with Alzheimer’s found that half had been misdiagnosed. Half.
Another headline blared “4 out of 10 patients being misdiagnosed.” The article encouraged patients to “see another doctor” if they are worried about their diagnosis.
You know what it makes me think about? Starbucks. Why? Because the way Starbucks revolutionized coffee drinking shows a way forward for healthcare.
Starbucks realized that since our lives focus on two places — home and work — most of us don’t have a “third place” to go. A place where we can be free of everyday distractions and take care of ourselves. Starbucks set out to create that “third place” by making its shops comfortable, inviting places. It works. “Third place” makes customers’ lives better — and Starbucks has almost 20,000 shops to prove it.
It’s time for a kind of “third place” in healthcare. Healthcare focuses on two places, too: The doctor’s office and the hospital. Both places are difficult for patients. Patients complain of not getting enough time from their overworked doctors, and studies of things that go wrong in hospitals are equally disturbing.
There really isn’t a “third place” to go to in healthcare. Somewhere that you can step outside of the difficult process of being sick. Somewhere you can get a quiet, clear perspective of what is going on.
Now, some people are lucky and can turn to relatives or friends who are doctors to provide some of that “third place” experience. But most people can’t. At Best Doctors, we’re creating the experience of a healthcare “third place.” We do it by taking the time to review each case, have doctors think about what’s happening, consult with experts, and share advice. Read more »
*This blog post was originally published at See First Blog*
February 28th, 2011 by DrCharles in Opinion, Research
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After the computer known as Watson easily dispatched of the best two human Jeopardy! contestants in history, IBM announced that one of the first applications of their artificial intelligence technology would be in the medical field. We should soon expect virtual physician assistants in the exam room. At least one of my friends even speculated that the days of human doctors are numbered.
Is it possible that machines will replace humans in the doctor-patient relationship? I doubt it. According to a study done by the Mayo Clinic in 2006, the most important characteristics patients feel a good doctor must possess are entirely human. According to the study, the ideal physician is confident, empathetic, humane, personal, forthright, respectful, and thorough. Watson may have proved his cognitive superiority, but can a computer ever be taught these human attributes needed to negotiate through patient fear, anxiety, and confusion? Could such a computer ever come across as sincere?
I’m afraid some major calibrations might be needed to substitute artificial intelligence for an “ideal” physician. What do you think? Here’s an artist’s conception (read: farce) of how such an application in the examining room might play out. Click HERE to watch the medical cartoon.
*This blog post was originally published at The Examining Room of Dr. Charles*
February 16th, 2011 by Elaine Schattner, M.D. in Better Health Network, Opinion
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Over the weekend I went to see “The King’s Speech.” So far the film, featuring Colin Firth as a soon-to-be-king-of-England with a speech impediment, and Geoffrey Rush as his ill-credentialed but trusted speech therapist, has earned top critics’ awards and 12 Oscar nominations. This is a movie that’s hard not to like for one reason or another, at least most of the way through. It uplifts, it draws on history, it depends on solid acting.
What I liked best, though, is the work’s rare depiction of a complex relationship between two imperfect, brave, and dedicated men. At some level, this is a movie about guys who communicate without fixating on cars, football (either kind), or women’s physical features. Great! (Dear Hollywood moguls: Can we have more like this, please?)
The film’s medical aspects are four, at least: The stuttering, the attitude of physicians toward smoking, a closeted sibling who had epilepsy and died at an early age (just mentioned in passing), and the king’s trusted practitioner’s lack of credentials.
At the start, Prince Albert (young King George VI) has a severe speech impediment. It’s said that he stutters, and on film Firth does so in an embarrassingly, seemingly extreme and compromising degree. He’s the second of George V’s sons, and might or might not succeed to the throne depending on events in history, his older brother’s behavior, and his capacity to serve the Empire at the brink of war. Being effective as the king of England in 1936, and especially at the start of war in 1939, entails speaking confidently.
Prince Albert’s been through the mill with doctors who’ve tried to help him talk. Some recommend he smoke cigarettes — these, they advise, would help him to relax because they’re good for the nerves, they say. One asks him to speak with a mouthful of marbles, on which this doctor watching the film worried he might choke. Eventually Albert’s wife, Elizabeth (Queen Mother to be), finds a speech therapist in London, Lionel Logue, who uses unorthodox approaches with, by rumor, exceptional results. Eventually Prince Albert — or “Bertie” as the therapist insists on calling him — trusts and accepts help from this peculiar Australian who, it turns out, developed his methods of assisting stutterers through his work with shell-shocked soldiers in WWI. Read more »
*This blog post was originally published at Medical Lessons*
February 13th, 2011 by Bryan Vartabedian, M.D. in Opinion, True Stories
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It was sometime in the mid-nineties that parents started showing up in my office with reams of paper. Inkjet printouts of independently unearthed information pulled from AltaVista and Excite. Google didn’t exist. In the earliest days of the Web, information was occasionally leveraged by families as a type of newfound control.
A young father and his inkjet printer
One case sticks clearly in my mind. It was that of a toddler with medically unresponsive acid reflux and chronic lung disease. After following the child for some time, the discussion with the family finally moved to the option of a fundoplication (anti-reflux surgery). On a follow-up visit the father had done his diligence and appeared in the office with a banker box brimming with printed information. He had done his homework and his volume of paper was a credible show of force.
At the time in Houston, the Nissen and Thal fundoplication were the accepted fundoplication procedures in children. Deep from the bottom of one of the boxes, the father produced a freshly-reported method of fundoplication from Germany. He had compared the potential complications with other types of fundoplication and this was the procedure he wanted.
What he didn’t understand was that an experimental technique used on a limited numbers of adults didn’t necessarily represent the best option for his toddler. I gave it everything I had but didn’t get very far. The tenor of his argument was slightly antagonistic. Ultimately there was nothing more I could do. I deferred the remainder of the discussion to one of our best “talking” surgeons, but knew the father wouldn’t get the time and consideration that I had offered.
I never saw the child again. As they say, the father voted with his feet. Read more »
*This blog post was originally published at 33 Charts*
