Engage with Grace: Talking About the Hard Stuff

When I practiced oncology, I relished time talking with patients and their loved ones about tough decisions – when an indolent condition accelerated and it seemed time to bite the bullet and start treatment, or when a cancer stopped responding to treatment and it seemed right to shift gears and, perhaps, emphasize palliation instead of more chemo, and at every value-loaded decision checkpoint in between.

These conversations weren’t easy; speaking of levels of care, palliation and end-of-life wishes are discussions that many doctors, even oncologists, still avoid.

Links Add Value to On-Line Reading and Medical Blog Content

This post is intended mainly for medical bloggers, but it has applications elsewhere. It’s about links and uniform resource locators (URLs), terms that I didn’t fully appreciate until the last year or so. That’s because like most of my colleagues and readers, I grew up reading printed books, newspapers and magazines. Now, perhaps as much as 90 percent of the non-fiction I read is on-line.

The Web has a lot of advantages for readers – you can see multimedia presentations, or double-click to enlarge a graph of interest. What I think is best, though, is the third

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.

Are Doctors Necessary?

Ten years ago, my colleagues and I squirmed in our swivel chairs when a few tech-savvy patients filed in bearing reams of articles they’d discovered, downloaded and printed for our perusal.

Some of us accepted these informational “gifts” warily, half-curious about what was out there and half-loathing the prospect of more reading. Quite a few complained about the changing informational dynamic between patients and their physicians, threatened by a perceived and perhaps real loss of control.

How a decade can make a difference. In 2008 over 140 million Americans…

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