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Changing Patient Behavior: Two Power Words

“I recommend.” These are two word which, when spoken by a physician to a patient have tremendous power to change behavior. That assumes of course a trusting relationship between patient and physician (but that’s a topic for another day.)
 
Take the colonoscopy. The U.S. Preventive Services Task Force (USPSTF) recommends that adults aged ≥50 years get a colonoscopy every 10 years. In 2005, 50 percent of adults aged ≥50 years in the U.S. had been screened according to these recommendations. Not surprisingly, the rate of colonoscopy screening is much lower than that of other recommended adult preventive services. I was curious: Why?
 
Here are two interesting facts:

1. Studies show that patients cite “physician recommendation” as the most important motivator of colorectal screening. In one study, 75 to 90 percent of patients who had not had a colonoscopy, said that their doctor’s recommendation would motivate them to undergo screening.

2. In that same study, in 50 percent of patients where a colonoscopy was appropriate but not done, the reason given was that the physician simply did not “bring up” the subject during the visit. Reasons included lack of time, visit was for acute problem, patient had previously declined or forget. Read more »

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

Healthcare Transparency: Patient Experts At Medical Conventions

Interviewing Dr. Emile Mohler from the University of Pennsylvania at AHA Scientific Session 2010We are invading their home turf. Increasingly, in among the thousands of doctors, scientists, and medical industry marketers at the largest medical conventions you are finding real patients who have the conditions discussed in the scientific sessions and exhibit halls. Patients like me want to be where the news breaks. We want to ask questions and — thanks to the Internet — we have a direct line to thousands of other patients waiting to know what new developments mean for them.

I vividly remember attending an FDA drug hearing a few years ago and how there were stock analysts sitting in the audience, BlackBerries poised for the “thumbs up” or “thumbs down” on whether a proposed new drug would be recommended for approval. (At that session it was thumbs down.) When the analysts got their thumbs moving, a biotech stock tanked in minutes and before long the company was announcing layoffs. Those analysts were powerful reporters.

Now patients are reporters, too, and their thumbs are just as powerful. So are their video cameras and microphones. These folks are a different breed than the folks from CNN or the scientist/journalists from MedPageToday. Their questions are all-encompassing: “What do the discussions about my disease or condition here mean for me? What should change in my treatment plan? What gives me hope? What’s important for my family to know?” Read more »

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

Feeling Pretty Thankful

It’s Thanksgiving here in the States, and I’m feeling pretty thankful. While the day is reserved for turning hand tracings into turkeys, it’s also a good day to highlight what I’m thankful for this year:

I’m thankful that we have a backyard that the cats can go [potty] in, because I was tired of cleaning that litterbox. (And I’m also secretly glad that our neighbors have a ridiculous cat that comes over and starts trouble with ours, because when they pile into the bushes out back and cause the shrubbery to vibrate with their Andy Capp-style battles, it cracks me right up.)

I’m thankful for our family and friends, who have helped Chris and I adjust to our new lives as “parents” and who make “home” a place that matters. We’re so glad to be sharing this chapter of our lives with the people and in the places we love the most.

I’m thankful for having good enough health to take it for granted, and to actually have the luxury of feeling frustrated when I’m “sick” because it’s such a foreign concept.

I’m thankful for the wonderful work opportunities that have come up in the last few years, specifically for the companies and organizations that have embraced the voices of patient advocacy and who have decided to become part of the conversation.

I’m thankful I have an insulin pump and a continuous glucose monitor that can help me make sense of the holiday meals. Also known as: “Pie? Yes, please.” Read more »

*This blog post was originally published at Six Until Me.*

5 Tips On How To Be A Healthcare Survivalist

There are plenty of “survivalists” out there who stock their basements with canned goods, getting ready for some unexpected (and unlikely) apocalypse. Meanwhile there are things that are much more likely to happen to you — like getting sick — which many of us don’t prepare for at all. So to help you get started, here are five important tips on how you can become a healthcare survivalist:

1.  Take care of your chronic conditions. Whether it’s high blood pressure, diabetes, high cholesterol, depression, asthma or any other kind of ailment, do what it takes to manage your own care. Take your medications and follow your doctors’ instructions. Why? Because if you don’t, your condition can get worse and lead to even more serious problems. As much of a pain as it may (literally) be, there’s a reason the old saying “an ounce of prevention” still resonates today — because it’s true.

2.  Live a healthy lifestyle. Everyone gives you this advice, but with studies showing that 42% of Americans will be obese by 2050, it doesn’t seem to be getting through. Denial can wonderfully appealing;  but when it comes to your health, it can also kill you. Stop smoking, exercise, and eat right. You may find that your employer has programs in place that will help you do all of those things, and many of them work. Why not give one of them a try? You can’t improve your life all at once, but you can start. Your life will be happier if you keep yourself healthy. So rather than whistling past the graveyard, jog past it. Read more »

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

Sharing Your Health Issues: The Responsibility Of Survivorship

Jill ClayburghThis past weekend Oscar-nominated Hollywood and Broadway actress Jill Clayburgh died at age 66. The cause was chronic lymphocytic leukemia (CLL), which she had been fighting, privately, for 21 years.

As you may recall, I, too, have CLL and I was diagnosed at the same age, 45. For me, I am 16 and a half years into that “battle” although, fortunately, I have been feeling very good in the ten years since I received treatment as part of a breakthrough clinical trial. While I have no symptoms and take no medicine I do not consider myself cured.

So when someone like Ms. Clayburgh dies of CLL after 21 years, I can’t help but wonder if the disease will shorten my life too, even if I feel good now. That brings up the question of what do we do with the time we have when we know we have had a serious diagnosis and the clock may be ticking for us — or not? Read more »

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

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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