The Immeasurable Value of Continuity of Care

Today I visited my internist for a checkup and flu shot. We talked about how I’m doing, and she examined me, and we discussed what procedures I ought have done and not done. She’s been my doctor since the summer of 1987, when I was an intern at the hospital. We reviewed so much that […]

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‘The Big C’ is Failing

Watching the Big C feels like a chore lately. It reminds me of the feeling I used to get when I had to see and examine a patient in the hospital, under my care for some administrative non-reason, who didn’t need to be in the hospital IMO,  and whose hospital presence took time my time […]

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Cathy Wants a New Doctor and a Second Opinion

Last night the Big C returned, not surprisingly with an opening dream sequence. Laura Linney, portraying Cathy Jamison in the Showtime series, is running. The scene turns out to be a nightmare, and she awakens with a headache and her husband by her side. OK so far. Within a few minutes, Cathy’s young oncologist informs […]

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Don Berwick, Head of CMS, on the Value of Patient-Centered Care

A few weeks ago I had the opportunity to hear Dr. Don Berwick speak at the annual meeting of the Association of Health Care Journalists. Berwick now heads the Centers for Medicare & Medicaid Services. When he spoke in April, on transparency and how we might simultaneously cut costs and improve care, I thought his […]

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Shoutout: This Week’s Grand Rounds Hosted by the Prepared Patient Forum

Yesterday’s medical-blog Grand Rounds, on What it Takes, is hosted by the Prepared Patient Forum. There’s a nice array of diverse posts. Among my favorites this week are from patients’ perspectives: by Warm Socks, on complex and simple physical systems for remembering to take pills and by Heart Sisters, on ditching the bucket list. I […]

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E-Patient Dave Explains What It Means to Be An E-Patient

Med-blog grand rounds this week is hosted by e-patient Dave, who is Dave deBronkart, a real man who was diagnosed with a renal cell (kidney) cancer a few years back. He’s a terrific speaker and an Internet friend. By coincidence I was searching for the definition of an e-patient, and came upon it there, in […]

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On Pleasant Behavior And Being A Patient in the Hospital

Dr. Wes has a short post today, How to Optimize Your Care While Hospitalized that got me thinking. He writes: …A lone doctor listening to some highly experienced and capable nurses, reflecting on their work: “If the patient’s nice, it’s a lot easier to want to go back in that room with them. Their reputation […]

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Contemplating Empathy, Early This Morning After the Earthquake

Last night I began reading a long essay, Regarding the Pain of Others, by Susan Sontag. The work dates to 1993, and centers on the power of photographs of war. She considers Virginia Woolf’s earlier reflections on horrific images from the Spanish Civil War, in Three Guineas. Sontag writes: “Not to be pained by these […]

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A Video About a Robot and a Patient

Since Watson won on Jeopardy, there’s been lots of talk of robots assuming doctors’ roles. Ten years into our future, machines with programmed empathy and nuanced diagnostic skills will solve diagnostic dilemmas, deduce optimal treatment and make us well. Yesterday I found a new Xtranormal video, this one crafted by Dr. Charles of his excellent […]

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May I Call You ‘Doctor’?

Last week I considered the relationship between the Prince Albert and his speech therapist in The King’s Speech. One aspect I wanted to explore further is why the future king initially insisted on calling the practitioner “doctor.” In real life, now, patient-doctor relationships can be topsy-turvy. This change comes partly a function of a greater […]

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The King’s Speech is Not Just About Stuttering

Over the weekend I went to see the King’s Speech. So far the film, featuring Colin Firth as a soon-to-be-King-of-England with a speech impediment, and Geoffrey Rush as his ill-credentialed but trusted speech therapist, has earned top critics’ awards and 12 Oscar nominations. This is a movie that’s hard not to like for one reason […]

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Considering the Significance of a Doctor’s White Coat

A while back, a first-year med student asked me if I think physicians should wear white coats. There’s a debate about it, she mentioned. Indeed, in the spring of 2009 the AMA considered an unenforceable mandate that physicians in the U.S. not wear white coats. The news was getting around that doctors spread infection from […]

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Why It’s a Good Idea to Get a Second Opinion, and Maybe a Third, But Rarely a Fourth

A few years ago I started writing a book on what it was like to be a cancer patient and an oncologist. This morning I came upon this section on second opinions: Is it OK to get a second opinion? Definitely. And there’s no need to be secretive about it, or to worry about hurting […]

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Why the Term ‘Patient’ Is So Important in Health Care

roviding health care is or should be unlike other commercial transactions. The doctor, or other person who gives medical treatment, has a special professional and moral obligation to help the person who’s receiving his or her care. This responsibility – to heal, honestly and to the best of one’s ability – overrides any other commitments, or conflicts

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I Feel Your Pain (not)

A tweet hit me on Sunday evening, from a stranger: @Mibberz I’m saddened by how many ADULTS can’t get their #rheum 2 understand the level of severity of their pain.What hope is there for my daughter? I half-watched an on-line exchange about the issue, and then went about my family’s dinner preparations. The message came […]

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A Patient’s Internal Conflict of Interest: to Mention a Symptom, or Not?

Here’s a partial list of why some thoughtful, articulate patients might be reluctant to mention symptoms to their doctors:

1. Respect for the doctor – when the patient feels what he’s experiencing isn’t worth taking up a physician’s time, what I’d call the “time-worthy” problem;

2. Guilt – when the patient feels she shouldn’t complain about anything relatively minor, because she’s lucky to be alive;

3. Worry – when patient’s anxious or afraid the symptoms are a sign of the condition worsening, and so

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A Video About a Patient Who Might Have Too Much Information

A link to a video, the Too Informed Patient came my way several times lately. You can find the curious clip on NPR’s Marketplace site: The Too Informed Patient from Marketplace on Vimeo. — The skit depicts the interaction between a young man with a rash and his older physician. The patient is an informed […]

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Hospital Fashion News from AARP and the Cleveland Clinic

The November AARP Bulletin highlights a promising development in hospital couture: trendsetter Diane von Furstenberg has designed new, unisex gowns ready for wearing in hospitals. The new gowns provide style and full coverage, with options for opening in front or back according to the bulletin. A trial is underway at the Cleveland Clinic.

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A Story About A Doctor and His Neighbors

In recent years, some physician authors have wrestled with why doctors might want to think twice before “friending” their patients on Facebook. The usual reasons are to protect the physician’s professional image – that the public might see their weirder, or not-so-polished-as-while-working side and, also, to maintain a certain “distance” – lest doctors become so […]

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On Patient Empowerment and Autonomy

…I think the answer is inherent in the goal of being engaged, and that has to do with the concept of patient autonomy – what’s essentially the capacity of a person to live and make decisions according to one’s own set of knowledge, goals and values.

Autonomy in medicine, which borders on the empowerment idea, can be an aim in itself, and therefore valuable regardless of any measured outcome.

Posted in Communication, Empowered Patient, Neurology, Patient Autonomy, Patient-Doctor Relationship, Social MediaTagged , , , , , , , , , 3 Comments on On Patient Empowerment and Autonomy
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