It is said that "turn around is fair play."So if providers (physicians, hospitals and other health care professionals) expect patients to become more engaged in their own care, isn’t it fair for patients to expect their physicians to also get more involved in their care?If you look closely at "proxy measures" for physician engagement, you will see that this is a legitimate if not equally important line of inquiry.Hello? Hello? ...
Patient
Question the price of drugs and medical procedures
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure it would be prudent to prescribe a blood pressure medication and order a nuclear stress test. With only a catastrophic insurance policy and a $5000 deductible it was imperative for my financial health to know the cost of both the drugs and the procedure up front.The prescription was ...
In love there is a life giving force
Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm sandy beach vacation, new bigger home and grand Thanksgiving dinner love. Not even baby’s first words love. I mean power passion that gets us through the hard times, type of love.Edna and Ken are 90, married and both have active cancer. They have been partners for 62 years. ...
How to get ready for death
No one wants to die. Even people who want to go to heaven don't want to die to get there. And yet death is the destination we all share. No one has ever escaped it. And that is as it should be, because death is very likely the single best invention of life. It is life's change agent. It clears out the old to make way for the new. -Steve Jobs, ...
The long term cost of a pain in the neck
One morning this May, I woke up with a stiff neck. I applied hot and cold therapy all day and took an Advil before bed. By the end of that week, I was unable to comfortably move my head and I was feeling numbness down my left arm to my fingertips. I saw my doctor within 24 hours of calling his office. After a brief exam, he was sure of ...
Preparing for your visit with someone in hospice care
Visiting someone who is dying or critically ill is an experience many of us will have in the course of our lives. Whether your visit is to be in the person’s home, a hospice or a hospital, there are a few rules of thumb to guide your time together so that it can be mutually satisfying.This post introduces some of the basics.1. Call ahead. Find out what prime visiting times ...
Why we need to go from e-patient to i-patient
I found a recent Associated Press article on an aspect of the new health care law that many of us may have overlooked. It requires consumer-friendly summaries of what insurance plans cover, a provision that now seems to be at risk. The insurance industry is up in arms about implementation costs and added regulatory burdens. (There’s a good story at NPR, which includes a link to an example of ...
Good communication in health care is about listening
A great deal of effort in the current health care environment is being put into improving communication - between patients and families and members of the health care team, among family members, and among members of the team. The case can be made that good communication is at the heart of patient safety, cultural sensitivity, and the pillar of palliative care -- aligning patient’s wishes and goals with treatment plans.So ...
How will the Baby Boomers age and die?
I love listening to life stories. As a hospice chaplain, I loved sitting with our patients and their loved ones engaging in what many hospice teams call “life review.” When did you meet your spouse? When was Reggie born? What is your favorite holiday? When did you learn you were ill? A few simple questions and the stories come pouring forth.Of late, I’ve been listening to the life stories of ...
Patient engagement is the holy grail of health care
For health care professionals, patient engagement is the holy grail of health care. It is the key to patient adherence – a prerequisite to achieving better outcomes, fewer ER visits and hospitalizations and more satisfied patients. It is easy to recognize an engaged patient – they do what their health care providers recommends …what their health care team knows what is right for them.But doesn’t engagement depend upon your perspective?In ...
Why do doctors delay hospice referrals?
This is a response to Deb Discenza's article requesting a one page informational sheet informing a patient about hospice or palliative care.This would allow the patient and their family to make decisions regarding end of life care before it becomes a necessity. I am a crisis care hospice nurse. I am the one who comes to your home, whether it is a million dollar beachfront mansion, or a single wide mobile ...
How touch can calm patients
So, Megen at Not Nurse Ratched wrote post recently about therapeutic presence. The following passage really caught my attention: "Question is: are there more things in nursing, Horatio, than science can explain? Can we touch patients and zap them with calmness or take away their pain? Can we, by our mindset during our provision of care, substantially affect our patients’ outcomes? Can any of this be taught? Can we ...
How I became a hospice volunteer
People often ask me how I became a hospice volunteer. For the record, nobody is more surprised than I am. You know how some people can walk into a patient’s room, plump pillows, and make all the right comments? Years ago, I was not that person. I never really felt comfortable visiting sick people. Working in the healthcare arena seemed depressing. Besides, I had made a conscious decision to become ...
How well does your child play?
All play is not equal. With the power of marketing, play has become increasingly associated with toys, electronic gadgets, television, and video games. Just think about the amount of ads for children’s toys over the holidays. Just think about the things your child might have asked for and the latest trends that become the new must-have of the season.Without realizing it, we may be intervening in a child’s most natural form of ...
Granting rights to a fetus at the cost of the mother
While I, as a physician, would not perform an abortion unless there was an extreme, medical rational, abortion is a choice. It is a woman’s determination of how best to live and manage her life. Also, while the issue of viability is an important medical topic, and while I believe that any life, from the moment of conception, is of supreme value, some women do not. If they are the ...
How patients can avoid medical errors
Most of you are quite familiar with the rather astounding facts regarding medical errors. There are many reasons why medical errors occur in healthcare. There are errors in omission, there are errors because of poor communication, there is the ever present risk of human error and perhaps the ever increasing stress on physicians to see more and more patients in less and less time. ...
Overcoming tragedy requires a team
When tragedy strikes, one looks for comfort in many places. When traditional resources--relatives, physicians, clergy members--do not completely satisfy, one may reach out for comfort from unexpected places. Increasingly, people turn to online health and wellness support communities.My family’s tragedy occurred when my father suffered a Sudden Cardiac Arrest, or SCA, in 2010. As I watched him lay lifelessly on life-support in that hospital bed, the man who was undoubtedly ...
Making tailored health education standard of care
The recently instituted 30-hour-shift work restrictions placed on medical residents have created a need for "dayfloat" services to safeguard potentially unsafe handoffs in patient care and help residents adhere to duty hour limits. The past two weeks I’ve been the dayfloat resident for the cardiology inpatient service. My job is to round with the post-call team, help them get out of the hospital on time, and then take care of their ...
How many parents are failing their children
Our children (and grandchildren) are the future and we are responsible for their growth and development. As responsible parties, we are clearly failing.That is my interpretation of the report issued a few days ago by the Centers for Disease Control (CDC) on seven criteria known to the associate with ideal cardiovascular health as part of the National Health and Nutrition Examinination Survey. They are defined, briefly, as 1) a diet ...
The powerful connection of emotions in healthcare
I remember like it was yesterday. My patient was a young blond female with two beautiful Samoan dogs. Her name was Margaret. I was only two years younger than she was. The diagnosis was poor. She was friendly when I introduced myself. And she proceeded to tell me about her health issues, how she was diagnosed and what treatment she was receiving. Marge as she wanted to be called was ...
