“The Dallas Buyers Club” Takes on AIDS, Peer Patients, and Not Taking “No” for An Answer

Published trials can be flawed. Even if they’re well-analyzed, the findings can be hard to interpret when it comes to a single patient’s course and well-being. What’s a dying man to do?

Posted in Empowered Patient, Essential Lessons, Infectious Disease, Life, Movies, Patient Autonomy, ReviewsTagged , , , , , , , 2 Comments on “The Dallas Buyers Club” Takes on AIDS, Peer Patients, and Not Taking “No” for An Answer

A Case for Slower Medicine

Anger is an understandable reaction to a system that dehumanizes patients, that treats bodies as containers of billable ailments and broken parts. But most doctors go about their daily work with good intention – to heal.

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How Much Do You Want Your Doctors To Say About Risks of Treatment?

This kind of paternalism, when a doctor assesses the risks and benefits, and spares the patient’s “knowing” seems anachronistic. But it may, still, be what many people are looking for when and if they get a serious illness. Not everyone wants a “tell me everything” kind of physician.

Posted in Breast Cancer, cancer treatment, Empowered Patient, Informed Consent, Life as a Patient, Oncology (cancer), Patient Autonomy, Patient-Doctor RelationshipTagged , , , , , , , , , 19 Comments on How Much Do You Want Your Doctors To Say About Risks of Treatment?

Illness is Not Discrete. On Feeling Sick, and Not Knowing What’s Next

A broken arm, a low-stage breast cancer that’s treated and done with, a bout of pneumonia – these are things that a career can afford, an editor can handle, friends can be supportive. But when you have one thing, and then another, and then another, it gets scary, it weighs you down.

Posted in Essential Lessons, Life, Life as a Patient, Life as a writer, Patient AutonomyTagged , , , , 2 Comments on Illness is Not Discrete. On Feeling Sick, and Not Knowing What’s Next

The Trouble With Placebos

The latest NEJM features a big story about a small trial, with only 39 patients in the end, on the potential for placebos to relieve patients’ experience of symptoms. This follows other recent reports on the subjective effectiveness of pseudo-pharmacology. My point for today is that placebos are problematic in health care with few exceptions. First, […]

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Lowering Cancer Care Costs by Reducing Tests After Treatment

This is the second in a series of posts on Bending the Cost Curve in Cancer Care. We should consider the proposal, published in the NEJM, gradually over the course of this summer, starting with “suggested changes in oncologists’ behavior,” #1: 1. Target surveillance testing or imaging to situations in which a benefit has been […]

Posted in cancer survival, Empowered Patient, health care costs, Informed Consent, Oncology (cancer), Patient AutonomyTagged , , , , , , , 2 Comments on Lowering Cancer Care Costs by Reducing Tests After Treatment

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 […]

Posted in Communication, health care delivery, language, Medical Ethics, Patient Autonomy, Patient-Doctor RelationshipTagged , , , , , , 3 Comments on Don Berwick, Head of CMS, on the Value of Patient-Centered Care

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 […]

Posted in Communication, Empowered Patient, Health IT, Patient Autonomy, Patient-Doctor Relationship, Social Media, Video, Wednesday Web SightingTagged , , , , , , Leave a Comment on E-Patient Dave Explains What It Means to Be An E-Patient

The Flip Side of Unrealistic Optimism

Last week, Pauline Chen wrote on medical ethics and clinical trials. She reflects on her training at a cancer research hospital, where some cancer patients go with unrealistic optimism.

Like Dr. Chen, I spent part of my training at a famous cancer center where I worked as a resident and fellow on rotations. And yes, some patients were unreasonably optimistic and some – perhaps even most, it seemed – didn’t fully “get” the purpose of their trial, which in Phase I studies were not designed to help them. This is a real dilemma for treating oncologists.

Posted in clinical trials, Ideas, Informed Consent, Medical Ethics, Oncology (cancer), Patient AutonomyTagged , , , , , 2 Comments on The Flip Side of Unrealistic Optimism

Stunning Comments on the Risk of Breast Implants, and Cancer

The FDA recently identified a link between breast implants and a rare form of lymphoma. From today’s report in the New York Times: When talking to patients about a rare type of cancer linked to breast implants, plastic surgeons should call it “a condition” and avoid using the words cancer, tumor, disease or malignancy, the […]

Posted in Breast Cancer, Communication, Informed Consent, language, Oncology (cancer), Patient Autonomy, Plastic and Reconstructive SurgeryTagged , , , , , , , , Leave a Comment on Stunning Comments on the Risk of Breast Implants, and Cancer
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