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A Doctor’s Letter To Patients With Chronic Disease

Dear Patients:

You have it very hard — much harder than most people understand. Having sat for 16 years listening to the stories, seeing the tiredness in your eyes, hearing you try to describe the indescribable, I have come to understand that I, too, can’t understand what your lives are like. How do you answer the question, “How do you feel?” when you’ve forgotten what “normal” feels like? How do you deal with all of the people who think you are exaggerating your pain, your emotions, your fatigue? How do you decide when to believe them or when to trust your own body? How do you cope with living a life that won’t let you forget about your frailty, your limits, your mortality?

I can’t imagine.

But I do bring something to the table that you may not know. I do have information that you can’t really understand because of your unique perspective, your battered world. There is something that you need to understand that, while it won’t undo your pain, make your fatigue go away, or lift your emotions, it will help you. It’s information without which you bring yourself more pain than you need suffer. It’s a truth that is a key to getting the help you need much easier than you have in the past. It may not seem important, but trust me — it is. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

If Doctors Billed Like Lawyers

From a discussion thread on Medscape (registration required) posted in response to comments on my earlier post entitled “If Lawyers Billed Like Doctors:”

Mr. Clark, it appears quite likely you are having a heart attack and will require my services. I will need a retainer of $1,500 via either cash or cashier’s check. This does not cover any treatment, but merely retains me as your physician.

Then you will need to deposit $5,000 into an escrow account. I will bill this account for services rendered. My charges are $400 an hour and I bill in 15-minute increments. Which means if it takes me 5 minutes to review your EKG, I still bill for 15 minutes.

When the escrow account reaches $1,000 you will need to deposit an additional $4,000 into the account or I will cease to be your physician and you forfeit the money in the escrow as well as the retainer, and if you continue to require my care you will need to retain me again.

Would you like me to treat your heart attack?

Ouch.

-WesMusings of a cardiologist and cardiac electrophysiologist.

*This blog post was originally published at Dr. Wes*

Paramedic Rap

The Sudden Cardiac Arrest Foundation has held a “You Can Save a Life” video awareness contest, in which participants were invited to submit videos that raise awareness of cardiopulmonary resuscitation (CPR) and automated external defibrillators (AEDs). The 2010 grand prize winner is “Paramedic Rap” by 911 Emergency ROCKsponse, a college team that uses humor to get your attention about sudden cardiac arrest:

For more videos of contestants and previous competition winners, head over to the foundation’s YouTube channel.

*This blog post was originally published at Medgadget*

Unease About Blogging And Social Media In Medicine

Although it happened a few weeks ago, I only recently learned of the “retirement” of the blog called “Medic999” by EMS social media superstar Mark Glencourse who works in the United Kingdom. I only learned of Mark and his blog (which was recognized as the 2009 Fire/EMS Blog of the Year) in the past few months in association with the hugely popular Chronicles of EMS project (see the first episode on video here).

In stating why he was stopping his blog, unfortunately, I find similar thoughts being shared by the medical colleagues I know about why people either stop blogging or don’t ever start in the first place:

I find it a shame that the reason for this blog ending is the general lack of understanding of blogging and social media. I feel that I have promoted best practice, shared my passion for the job that I do, and hopefully have shown all readers what it is that makes EMS and those that devote their lives to it so special.

However, there still remains a general unease about social media and blogging in the health service. Read more »

*This blog post was originally published at Doctor Anonymous*

Heart Attacks Are Killing Fewer People: Why?

Heart attack mortality fell by nearly a half a percent last year at 4,500 hospitals that treat Medicare patients. And, facilities with the lowest and highest death rates saw similar declines, according to a new hospital report card by the U.S. Centers for Medicare and Medicaid Services (CMS). 

Heart attack mortality fell from a national average of 16.6 percent last year to 16.2 percent, with a range among all facilities from 14.5 percent to 17.9 percent. CMS released the data as part of its hospital report card effort to spur better quality and outcomes through public reporting of recommended treatments. The agency added heart attack and heart failure mortality to the report card three years ago.

At issue now is what’s driving the figures: public reporting of hospital data driving improvement, or faster door-to-balloon-treatment times. Areas that do need to improve include lowering readmissions and getting people to the hospital faster when they have a heart attack. (USA Today)

*This blog post was originally published at ACP Hospitalist*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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