February 8th, 2011 by RyanDuBosar in Better Health Network, Research
No Comments »
Physicians see nearly one in five patients as “difficult,” report researchers. Not surprisingly, these patients don’t fare as well as others after visiting their doctor.
Researchers took into account both patient and clinician factors associated with being considered “difficult,” as well as assessing the impact on patient health outcomes. They reported results in the Journal of General Internal Medicine.
Researchers assessed 750 adults prior to their visit to a primary care walk-in clinic for symptoms, expectations, and general health; for how they functioned physically, socially and emotionally; and whether they had mental disorders. Immediately after their visit, participants were asked about their satisfaction with the encounter, any unmet expectations, and their levels of trust in their doctor. Two weeks later, researchers checked symptoms again.
Also, clinicians were asked to rate how difficult the encounter was after each visit. Nearly 18 percent were “difficult.” They had more symptoms, worse functional status, used the clinic more frequently and were more likely to have an underlying psychiatric disorder than non-difficult patients. These patients were less satisfied, trusted their physicians less, and had a greater number of unmet expectations. Two weeks later, they were also more likely to experience worsening of their symptoms.
But the label works both ways, as physicians with a more open communication style and those with more experience reported fewer difficult encounters, researchers said.
On a lighter note, TV’s comedy “Seinfeld” dedicated an entire plotline from one of its many episodes to Elaine, her doctor, and the label of being a difficult patient. It’s worth watching here.
*This blog post was originally published at ACP Internist*
December 2nd, 2010 by RamonaBatesMD in Better Health Network, News, Opinion, Research, True Stories
No Comments »
Dr. Richard Edwards, a chiropractor from Oklahoma and the nation’s third double-hand transplant, was recently in the news again. This time it a report that he “may lose the fingertips on his right thumb and pinkie because his body started to reject the new limbs.”
Dr. Edwards’ surgery was live tweeted when it was done in August by Louisville surgeons at The Jewish Hospital Hand Care Center.
Jeff Kepner, the first patient in the United States to receive two hands simultaneously, experienced an episode of rejection which was dealt with successfully.
Rejection is never a good thing in a transplant patient no matter which organ or body part is transplanted. Even though I applaud the advances being made, we must always consider the cost of the proposed treatment and ask: Is there a better option for this individual? Read more »
*This blog post was originally published at Suture for a Living*
October 6th, 2010 by StevenWilkinsMPH in Better Health Network, Health Tips, Research, True Stories
No Comments »
A 69-year-old woman who swims in my master program came back to the pool after a total knee replacement. I asked her how she was doing. She said she is still in a lot of pain because of her physical therapy. She said that her physical therapist was disappointed that she still was still unable to achieve full flexion of 120 degrees. Why 120 degrees? Did you set that goal I asked her? “No,” she said, “the therapist did.”
She went on to tell how she already had more range of motion in her knee than she did before the surgery. My friend was quite satisfied with her progress and wanted to stop physical therapy. The pain from the PT was worse than anything she had experienced before the knee replacement. I knew she and her 80-year-old boy friend were going on a cruise and she didn’t want to still be hobbling around.
It turns out that patients and physicians disagree on quite a few things. We hear a lot about patient-centered care. You know, that’s where the provider is supposed to consider the patient’s needs, preferences, and perspective when diagnosing and treating health problems. But medicine is still very provider-centered. Read more »
*This blog post was originally published at Mind The Gap*
August 4th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
No Comments »
Say the words, “Patient-centered medical home,” and you’re bound to get a variety of opinions.
On this blog alone, there are a variety of guest pieces critical of the effort, saying it does not increase patient satisfaction, nor does it save money. And that’s not good news for its advocates, who are pinning primary care’s last hopes on the model.
Medical homes hit the mainstream media recently, with Pauline Chen focusing one of her recent, weekly New York Times columns to the issue. She discussed the results of a demonstration project, showing some positive results. Read more »
*This blog post was originally published at KevinMD.com*
July 25th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News, Research
No Comments »
Patients don’t mind waiting in the ER as long as they’re kept apprised of the time, an industry survey revealed. This is a good thing, since ER waits have risen nationally to an average of four hours and seven minutes this year.
Press Ganey Associates, Inc., has conducted the survey annually and says that ER wait times are four more minutes than last year, or a half hour more than the first survey in 2002. The company collected data on 1.5 million patients treated at 1,893 hospitals in 2009.
Despite longer wait times, patient satisfaction with U.S. hospital emergency departments stayed about the same in 2009. Communication was the key, as patients who waited more than four hours, but received “good” or “very good” information about delays were just as satisfied as patients who spent less than one hour in the emergency department.
*This blog post was originally published at ACP Hospitalist*
