Dr. Elaine Schattner's notes on becoming educated as a patient
Dr. Elaine Schattner's notes on becoming educated as a patient
© Elaine Schattner, 2009, 2022 By : Template Sell.
A few years ago my family took a trip to China. Even before we arrived, I learned something about an unfamiliar health care culture. What I observed en route was that many of the older passengers on that long flight to Beijing were getting up from their seats and stretching. Not just once, but regularly […]
…This goes well beyond a new approach to finding a cure for Parkinson’s disease.
This story, largely based in genomics and computational advances, reflects the power of the human mind, how the gifted son of two mathematicians who fell into a particular medical situation, can use his brains, intellectual and financial resources, and creativity, to at least try to make a difference.
Earlier this month employees at most of 7500 Walgreens pharmacies geared up to stock a new item on their shelves: a saliva sampler for personal genetic testing. On May 11, officials at Pathway Genomics, a San Diego-based biotech firm, announced they’d sell over-the-counter spit kits for around $25 through an arrangement with the retailer. A curious consumer could follow the simple package instructions and send their stuff in a plastic tube, provided in a handy box with pre-paid postage, for DNA analysis.
I can’t even begin to think of how much money this might save, besides sparing so many women from the messy business of infusions, temporary or semi-permanent IV catheters, prophylactic or sometimes urgent antibiotics, Neulasta injections, anti-nausea drugs, cardiac tests and then some occasional deaths in treatment from infection, bleeding or, later on, from late effects on the heart or not-so-rare secondary malignancies like leukemia. And hairpieces; we could see a dramatic decline in women with scarves and wigs.
(in the Style of a Magazine Cover)
If patients knew more:
1. they’d understand more of what doctors say;
2. they’d ask better questions;
3. they’d be more autonomous;
4. they’d make better decisions (ones they’re comfortable with, long-term);
5. they’d spend less money on care they don’t want or need.
If doctors knew more…
Last week the journal Cancer published a small but noteworthy report on women’s experiences with a relatively new breast cancer decision tool called Oncotype DX. This lab-based technology, which has not received FDA approval, takes a piece of a woman’s tumor and, by measuring expression of 21 genes within, estimates the likelihood, or risk, that her tumor will recur.
As things stand, women who receive a breast cancer diagnosis face difficult decisions…
MedlinePlus, a virtual superstore of medical information, is one of the most frequented health-related websites worldwide. The site, co-sponsored by the National Library of Medicine and the National Institutes of Health, is comprehensive and, with some exceptions (see below) relatively free of commercial bias. I find it a useful starting point for almost any health-related search…
For those of you who’ve been asleep for the past year: the health care costs conundrum remains unsolved. Our annual medical bills run in the neighborhood of $2.4 trillion and that number’s heading up. Reform, even in its watered-down, reddened form, has stalled.
Despite so much unending review of medical expenses – attributed variously to an unfit, aging population, expensive new cancer drugs, innovative procedures, insurance companies and big Pharma – there’s been surprisingly little consideration for patients’ preferences. What’s missing is a solid discussion of the type and extent of treatments people would want if they were sufficiently informed of their medical options and circumstances.
Maybe, if doctors would ask their adult patients how much care they really want, the price of health care would go down. That’s because many patients would choose less, at least in the way of technology, than their doctors prescribe. And more care.
What I’m talking about is the opposite of rationing. It’s about choosing.
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…
It was sometime in April, 1988. I was putting a line in an old man with end-stage kidney disease, cancer (maybe), heart failure, bacteria in his blood and no consciousness. Prince was on the radio, loud, by his bedside. If you could call it that – the uncomfortable, curtained compartment didn’t seem like a good place for resting.
Last week I received an email from a former patient. He has hemochromatosis, an inherited disposition to iron overload. His body is programmed to take in excessive amounts of iron, which then might deposit in the liver, glands, heart and skin. He mentioned “some amazing videos on hematology and hemochromatosis and genetics” he’d discovered on YouTube.
This is the future of medicine, I realized. … Whether physicians want their patients to search the Internet for medical advice is beside the point. We’re there already, whether or not it’s good for us and whether what we find there is true.
Family gatherings centered on two things – food, and talk about medicine. We spoke of interesting cases (always nameless), challenging conditions and, even back then, the constraints of health care costs. My fiancé, now husband of over 20 years, couldn’t get over how debate over health care dominated our Rosh Hashanah and Thanksgiving feasts…
…when I learned I had breast cancer, I knew exactly what to do. The decisions, though difficult, were almost straightforward, buttressed by my knowledge and familiarity with the language of medicine…
