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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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
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 […]
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
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 […]
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.
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 […]
…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.