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What Makes A Conversation “Psychotherapy?”

Years ago I had a student who repeatedly asked me how psychotherapy works. “How is it different than a conversation?”

When I think of psychotherapy, I think in terms of the talking itself as being the aspect that helps — and yes, of course it can be used in conjunction with medications. I think of it as being structured — in terms of time and place and frequency — and being all about the patient. And whether or not it’s actually discussed, some of what works is about the relationship — most people don’t get better talking to someone they despise, and the warmth, empathy, feeling listened to and cared for, well, they’re all important. And I also think of it as being a process over time. These are all parts of my definition, however, and they may not be parts of yours. Read more »

*This blog post was originally published at Shrink Rap*

Fear Of Death Can Motivate Patients To Take Their Medicines

As a hospitalist I sometimes come across patients who, for what ever reason, refuse to take the medications prescribed by their in-patient doctors.  Some patients refuse out of fear.  Some doctor told them years ago that taking medication X would make them worse.  Some patients refuse out of ignorance of their disease process.  Most of the time however, they just don’t understand why the medication is necessary.  Some patients just refuse out of stubbornness.  And some patients refuse because they have a really good reason.

However, when you’re dealing with critical illness and the only thing that’s going to save your patient’s life is a treatment plan they are refusing, sometimes you have to be in their face with reality.  So how do I handle situations with patients who have the capacity to make poor medical decisions but refuse life saving medications?  How do I convince my hospitalized patients to take their medications I’ve prescribed? Read more »

*This blog post was originally published at Happy 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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