September 9th, 2011 by GarySchwitzer in Health Policy, Opinion
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In a comment left on my blog, Jamie Bearse, the chief operating officer of Project Zero – The Project to End Prostate Cancer, showed how quickly and deeply discussions about screening tests can devolve into ugly rhetoric. Bearse wrote:
“Your comments along with Otis Brawley’s vendetta against the PSA sentence men to die from prostate cancer testing. Shame on you. It’s important to know your score to make a proper diagnosis and decision of if and how to treat prostate cancer. Groups that create screening guidelines for cancer such as American Urological Association and National Comprehensive Cancer Network say get tested. In fact, Brawley is at odds with his own organization. ACS supports testing as well. Otis Brawley has killed more men by giving them an excuse to not be tested. Don’t follow that path just because of your own bad experience.”
I responded:
“Jamie,
My comments policy states that I will delete comments that make personal attacks. You certainly did that with your statement that the chief medical officer of the American Cancer Society “has killed” and that he has “sentenced men to die.”
Nonetheless I have posted your comment because I think it’s important for other readers to see how some pro-screening rhetoric so quickly and completely devolves into ugliness.
…
YOU ARE WRONG Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
July 17th, 2011 by Jessie Gruman, Ph.D. in Opinion
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Twenty percent of people who leave their doctors’ offices with a new prescription don’t fill it. Up to one-half of those who do fill their prescriptions don’t take the drugs as recommended. These individuals are considered non-compliant. But does that mean they are not engaged in their health care? Engagement and compliance are not synonyms.
I am compliant if I do what my doctor tells me to do.
I am engaged, on the other hand, when I actively participate in the process of solving my health problems. This new prescription is an element in that process. If I am engaged in my care, I might want to learn about this medication. Such as: what it can and cannot do to ease my pain or slow the progress of my disease; what side effects it might produce and what I should do about them; how long it will take to work; when I should take it and how; how much it may cost; and what will happen if I don’t take it. I might want to consider the barriers to taking it and weigh the risks and benefits of alternatives. Could I instead make changes in my physical activity level or diet, try a dietary supplement or watchfully wait to see if the symptoms subside?
If my clinician has done more than just hand me the prescription – if she has, for example, raised these questions and discussed these concerns with me, I probably won’t have a prescription in my hand if I don’t intend to fill it.
But I can be engaged in my health care even if I don’t have that conversation with my provider. I can Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
June 18th, 2011 by Jessie Gruman, Ph.D. in Health Policy, Opinion
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I sat in a dingy pharmacy near the Seattle airport over the holidays, waiting for an emergency prescription. For over two hours I watched a slow-moving line of people sign a book, pay and receive their prescription(s). The cashier told each customer picking up more than one prescription or a child’s prescription to wait on the side. In minutes, the harried white-haired pharmacist came over to ask the person if they were familiar with these medications, described how to take them, identified the side effects to look out for and demonstrated the size of a teaspoon for pediatric medications. Then he asked the person to repeat back – often in broken, heavily accented English – what he or she had heard and patiently went over the parts they didn’t understand.
I was impressed. This is what every pharmacy should be like – except, of course, for the dinginess, the creeping line and the fact that it was so crowded I could overhear these conversations. Maybe if we got federal legislation enacted requiring pharmacists to offer counseling with each prescription filled, this kind of attention would be the norm, adherence to medication regimens would improve and drug-related injuries would be reduced.
Wait a minute. Someone already had that good idea. It was Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
May 25th, 2011 by StevenWilkinsMPH in Health Policy, Opinion
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The short answer: No.
At least not in the context of a strong physician-patient relationship.
Many physicians have legitimate concerns about the prospects of having their salary or level reimbursement linked to patient satisfaction. I would too given the way most health care providers go about measuring and interpreting patient satisfaction data.
A major concern of physicians is the issue of patient requests – particularly the impact of unfulfilled (and unreasonable) requests upon patient satisfaction. According to researchers, explicit patient requests for medications, diagnostic tests and specialty referrals occur in between 25% to 40% of primary care visits. This figure is much higher when requests for information are factored in. Read more »
*This blog post was originally published at Mind The Gap*
April 2nd, 2011 by Jessie Gruman, Ph.D. in Opinion
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Members of the American public are frequently surveyed about their trust in various professionals. Doctors and nurses usually wind up near the top of the list, especially when compared to lawyers, hairdressers and politicians. Trust in professionals is important to us: they possess expertise we lack but need, to solve problems ranging from the serious (illness) to the relatively trivial (appearance).
How much professionals trust us seems irrelevant: our reciprocity is expressed in the form of payment for services rendered or promised, our recommendations to friends and families and repeat appearances.
So I was surprised to read an article in the Annals of Family Medicine describing a new scale to measure doctors’ trust in their patients. This scale, based on input from focus groups and validation surveys of physicians, was developed for research purposes on the grounds that trust is a “feature of the clinician-patient relationship that resonates with both patients and clinicians.” Read more »
*This blog post was originally published at CFAH PPF Blog*
