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A Story Of Online Care Without OpenNotes

Next in our series on my experience with OpenNotes, a project sponsored by the Robert Wood Johnson Foundation’s Pioneer Portfolio.

This item has nothing to do with OpenNotes itself –- it’s what I’m seeing now that I’ve started accessing my doctor’s notes. In short, I see the clinical impact of not viewing my record as a shared working document.

Here’s the story. 
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In OpenNotes, patient participants can see the visit notes their primary physicians entered. Note “primary,” not specialists. I imagine they needed to keep the study design simple.

So here I am in the study, going through life. Five weeks ago I wrote my first realization: After the visit I’d forgotten something, so I logged in. Read more »

*This blog post was originally published at e-Patients.net*

My Brother, The Red Sox, And A Wrong Diagnosis Gone Right

How often do people get the wrong diagnosis? Too often.

There are things you can do help protect yourself. Things like, asking questions, being sure everything makes sense to you, not doing anything you’re not sure about.

At Best Doctors, helping people do this is what we do every day, and so I want to tell you a story. It’s about my brother. I want to tell it to you it because it will help you understand the important work we do here, and because of something very special that happened for him this weekend. Read more »

*This blog post was originally published at See First Blog*

Life Insurance Companies And Cancer Survivors

I have always heard that Northwestern Mutual Life (“The Quiet Company”) was a grade-A company. And for years I have been happy to have a disability insurance policy and a term life one with them. I got those policies back in the early 1990s, and it was a good thing I did.

In 1996 my health changed. I was diagnosed with leukemia. I knew I was very lucky to have insurance in place because, as many told me: “You’ll never get insurance now.”

Now fast-forward 14 years, and 10 years after receiving treatment in a phase II clinical trial. I have no evidence of disease and have not had any evidence for nine years. The drug therapy I received in a trial has now been approved by the FDA and in Europe as the standard of care. People are living well with this leukemia and it is extending life — some people may even be cured.

So I asked the insurance company to consider giving me the ability to change my policy, to take advantage of lower rates and optimize my coverage for a longer life. Read more »

*This blog post was originally published at Andrew's Blog*

Dr. Don Berwick’s “Patient-Centered” Medicine

There’s been a bit of buzz in the health blogs over President Obama’s decision last week to use the mechanism of a recess appointment to be the director of the Centers for Medicare and Medicaid Services (CMS).

Recess appointments, for those who may not be aware, allow a President to put a nominee in place when Congress is in recess in order to have him in place without the messy process of having him approved by the Senate. True, the Senate still has to approve a recess appointment by the end of its term, or the seat goes vacant again, but it’s an excellent way to avoid having nasty confirmation fights during election years. Of course, both parties do it, and the reaction of pundits, bloggers, and politicians tend to fall strictly along partisan lines.

If you support the President, then a recess appointment is a way to get around the obstructionism of the other party. If you don’t support the President, it’s a horrific abuse of Presidential power. And so it goes. Either way, I don’t really care much about the politics of how such officials are appointed so much as who is being appointed.

The man who was appointed last week to head CMS is Donald Berwick, M.D., CEO of the Institute for Healthcare Improvement. His being placed in charge of CMS will likely have profound consequences not just for how the recent health care/insurance reform law is implemented, but for how the government applies science-based medicine to the administration of the this massive bill. Read more »

*This blog post was originally published at Science-Based Medicine*

How ePatients Can Help Heal Healthcare

ePatient Dave, who shared his story (video below) with my students in the “Internet in Medicine” course this semester, is about to publish his own book: “Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer.”

Now three of his friends have written essays about this important issue:

We who’ve worked on it hope it will provoke thought about how healthcare is changing because of what e-patients can contribute, empowered as individuals and enabled by the Internet. To start that process, we’re publishing the introduction.

Three friends and mentors generously offered introductory essays. These essays they have little to do with my story, and everything to do with how e-patients can help heal healthcare:

 

My message to @Berci’s Medicine 2.0 course, March 25 2010 from e-Patient Dave deBronkart on Vimeo.

*This blog post was originally published at ScienceRoll*

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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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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