November 10th, 2009 by Happy Hospitalist in Better Health Network, Opinion
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When a patient decides they are leaving against medical advice what responsibility does the physician have to their care? When I was a resident in training, and even early on in my position as a hospitalist, I would get a call from the nurse that Mrs Smith was demanding to leave the hospital against medical advice. I would tell the nurse “Fine. Let her go. I’m not her father.” I would tell the nurse to discharge Mrs Smith with no medications and leave it up to them to find follow up.
I would suspect this is a prevalent attitude for many hospital and emergency based physicians. I’ve seen it over and over again. And I still see it today. Many doctors and nurses feel obliged to let grown men and women make poor decisions. However, being a grown man or woman able to make poor decisions is apparently not enough to keep a doctor for being sued and losing that lawsuit because a patient chose to make poor decisions. Read more »
*This blog post was originally published at A Happy Hospitalist*
November 9th, 2009 by DrRob in Better Health Network, Humor
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Top 10 lists are back!
I forgot about this kind of post, and a reminder by a reader is bringing them back. They are really a fun and easy kind of post to write, so you may see a fair number of them (read: Rob is getting lazy). I thought I’d start back with some suggestions for disgruntled patients (or gruntled ones, for that matter) to make their doctor’s day much worse.
1. Require the doctor to keep things secret from your child or your elderly parent. Insist that they can’t know about their cancer, depression, ADD, or foot fungus. Call the medication the doctor prescribes “vitamins.” Alternatively, you can threaten your child by saying that if they don’t behave better, the doctor will give them a shot. Read more »
*This blog post was originally published at Musings of a Distractible Mind*
November 4th, 2009 by Happy Hospitalist in Better Health Network, True Stories
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When a patient comes in with an infection related diagnoses, efforts are often undertaken to keep that pathogen from spreading to other patient rooms. In British hospitals they’ve banned ties and long sleeves. At Happy’s hospital we place a dedicated stethoscope in the patient’s room which is then shared by all health care workers caring for the patient. And that stethoscope shall remain forever in that patient’s room.
At Happy’s hospital, the dedicated stethoscopes look like they were made in a Chinese toy factory. Read more »
*This blog post was originally published at A Happy Hospitalist*
October 29th, 2009 by RamonaBatesMD in Better Health Network, Health Tips
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Flipping through the 1908 textbook, A Text-Book of Minor Surgery by Edward Milton Foote, MD I found at an antique store last month, I came across the section on ingrown toenails. The causes of ingrown toenails were much the same as one hundred years.
This is a condition in which the edge of the nail, usually of the great toe, by its too close contact with the flesh beneath causes irritation, ulceration, or suppuration. There has been much discussion as to whether the nail or the flesh is the more at fault. This discussion is without profit. It is much better to study the normal conditions, and see what can be done to restore them. Read more »
*This blog post was originally published at Suture for a Living*
October 26th, 2009 by EvanFalchukJD in Better Health Network, Health Policy, Opinion
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In my post yesterday about lessons we can learn from Israel’s health care system I wrote:
So, yes, the focus on health insurance reform will lead to many changes, and more complexity. And some day, years from now, someone will be explaining the American system to an audience, and people will wonder, how did anyone ever create a system such as this?
In response, a friend of mine challenged me: if the system is too complicated, how should we simplify it?
I wish more policy-makers were asking this question.
For me, the answer is clear: Primary care. Time was, your primary care doctor was able to serve as the hub of your medical activity. He or she could spend all the time needed to figure out what was wrong and to coordinate with your specialists. It’s not true anymore. Patients are left on their own trying to navigate the system. In many ways they end up acting almost as their own primary care doctors. Patients try to pick their specialists, find out what to do about their condition, decide on good treatment choices. Read more »
*This blog post was originally published at See First Blog*
