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How An Empowered Patient Finds A New Doctor

What if the average patient (person) knew what healthcare insiders, providers and expert patients know?

Take the process of looking for a new personal physician. Conventional wisdom tells people that when looking for a new physician they need to consider things like specialty, board certification, years in practice, and geographic proximity. Online services like Health Grades allow you to see and compare the satisfaction scores for prospective physician candidates.

But industry insiders know different. Consider those patient satisfaction scores for physicians. In reality, “one can assume that the quality of care is actually worse than surveys of patient satisfaction would seem to show,” according to a 1991 lecture by Avedis Donabedian, M.D.:

“Often patients are, in fact, overly patient; they put up with unnecessary discomforts and grant their doctors the benefit of every doubt, until deficiencies in care are too manifest to be overlooked.”

Given the constant drumbeat about the lack of care coordination and medical errors, it would seem that some people (patients) are beginning to reach the breaking point alluded to by Dr. Donabedian. The empowered among us are starting to compare physicians (and the hospitals that employ them) to a higher standard — a higher standard that reflects the nature and quality of the medical services physicians actually provide. Empowered patients today are “being taught to be less patient, more critical, and more assertive.” Read more »

*This blog post was originally published at Mind The Gap*

Is “Minimally Disruptive Medicine” An Emerging Field?

I recently stumbled onto the “Minimally Disruptive Medicine” blog maintained by Dr. Victor Montori from the Mayo Clinic. I have to admit that the name caught my attention so I scoped it out.

According to Dr. Montori, “minimally disruptive medicine refers to the practice of medicine that seeks to design effective treatment programs for patients while minimizing the burden of treatment.”  He describes this as an emerging field.

I have to admit that I was simultaneously puzzled and intrigued. After all, how is this different from the way good medicine is practiced? I, for one, like to think that I create individually-tailored programs that meet my patients’ needs while minimizing their treatment burden. Read more »

*This blog post was originally published at 33 Charts*

I’m Your Doctor, And I’m Worth It

Rx Vending MachineI saw the note on the patient’s chart before I opened the door: “Patient is upset that he had to come in.”

I opened the door and was greeted by a gentleman with his arms crossed tightly across his chest and a stern expression. I barely recognized him, having only seen him a handful of times over the past few years. Scrawled on the patient history sheet in the space for the reason for his visit were the words, “Because I was forced to come in.”

My stomach churned. I opened his chart and looked at his problem list, which included high blood pressure and high cholesterol –- both treated with medications. He was last in my office in November — of 2008. I blinked, looked up at his scowling face, and frowned back. ”You haven’t been in the office for over 18 months. It was really time for you to come in,” I said, trying to remain calm as I spoke.

He sat for a moment, then responded with very little emotion. “I’m doing fine. You could’ve just ordered my labs and called in my prescriptions. I don’t know why I had to be seen.” Read more »

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

The Value Of Social Media For Patients, Doctors And Nurses

A patient apologized to me for asking so many questions. “There’s no need to apologize,” I said to the patient, “It’s wonderful that you have so many questions concerning your healthcare.” I mentioned to her that she is an “empowered and engaged patient,” and that’s a good thing.

It’s no secret that health consumers are turning to the Internet for health information.

In a recent article from MediaPost News, Gavin O’Malley writes that, according to new a study by Epsilon Strategic & Analytic Consulting Group, “40% of online consumers use social media for health information — reading or posting content — while the frequency of engagement varies widely. According to the study, individuals who use healthcare social media fall into two broad groups: the 80% who are highly engaged patients, and take active roles in health management; and the 20% who lack confidence to play an active role in their own health.” Read more »

*This blog post was originally published at Health in 30*

Health And Medicine: Scientific Or Miraculous?

I was recently listening to an audiobook about diet, written and read by a “famous” doctor who gets people healthy through dietary changes.

Since my podcast pushes me a little into the mainstream (more than this blog does), I thought it would be good to hear what the “average” person is reading about health. Plus, I am not exactly the most compliant patient when it comes to diet, so I thought I could possibly get something out of it personally.

I did my best to listen with an open mind, ignoring what I thought were gimmicks and trying to glean the valuable information from what this doctor was saying.

I had to stop, however, before finishing the book. It wasn’t the content so much that gave me cause to feel the desire to smash my iPod, it was the hype. The author was constantly using words like “amazing,” “magical,” and “miraculous.” Read more »

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

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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