I wish I had a dollar every time someone gets misty-eyed about the physician-patient relationship -- and two dollars every time they say protecting it is the key to health care. That might be true, if you thought health care was awesome circa 1960. Hereʼs what the physician-patient relationship meant back then: Physicians say, patients pay. We have seen little progress since then. The claim that the relationship is now symmetrical ...

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Not long ago, Tracy Hume, a freelance writer who lives in Greeley, Colorado, sent me an email posing this question: "Do ER-affiliated urgent care providers ever try to escalate patients to the ER when it is not medically necessary?" It seems that over the July 4th weekend, Tracy’s teenage son was complaining of a headache, nausea and abdominal pain, and was vomiting. He doesn't complain much, she said, so thinking that ...

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My grandmother recently went into hospice care. At 94, she has lived a longer, richer life than probably most of us will ever hope to. Given the nature of the work I do, end of life care is not a topic I’m unfamiliar with. Initially, I spent a lot of time asking my mother probing questions about the care my grandmother was receiving. I imagine I did this partly out ...

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An interview with Jessie Gruman Jessie Gruman, who sadly died July 14, 2014, was someone I greatly admired as a person and as a patient activist. I interviewed her in late April for research I was conducting on patient activism, and she graciously allowed me to publish the interview, wanting, not surprisingly for those who knew her, to do everything she could to use ...

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In medicine, the patient is not always right Beginning with the Institute of Medicine's (IOM) landmark Quality Chasm report in the late 1990s, the health policy establishment, the medical profession and the American public began to hear a new and disconcerting message: American health care was not patient-centered. The IOM prescribed a number of recommendations to redesign health care delivery, one calling for patients as the source of control over their care. "Patients should ...

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A popular television commercial shows a group of older women playing cards. One woman talks about her friend who is struggling financially since her husband died (the husband only had a small life insurance policy). Another lady said that she doesn’t have to worry about that happening since her husband has an XYZ insurance policy. The other ladies immediately ask about the policy. Then a TV pitchman describes the policy ...

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Before losing my health insurance in 2009, it never occurred to me to be concerned about a little thing like a blood test.  Since 1986 I’d been having three vials of blood drawn each year during my physical.  My doctor would authorize it, the nurse would draw the blood in the office and send it to the lab for processing. A few days later she would call me with the results ...

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I'm impressed by how much we struggle with seemingly simple health decisions when faced with sorting through too much information. Buying sunscreen: It's a simple task, right? Most of us do it every year about this time. And among actions we can take to reduce our risk of cancer in general and skin cancer specifically, this choice is fairly important. So my colleague was surprised to hear this snippet of conversation as she contemplated ...

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The interview had lasted fifteen minutes so far, and we'd made minimal progress. I was a medical student doing a rotation at a physical medicine and rehabilitation clinic back in my home state, Wisconsin. It was the end of the day; to save time, the senior resident, Paul, had joined me in the exam room so that we could hear Leora's medical history together. A year earlier, Leora, in her mid-fifties, ...

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It was an ordinary summer day.  People were milling on the main thoroughfare, bikes zig-zagging through traffic, cafés and pubs spilling onto the sidewalk, patrons sipping their way through a lazy Friday afternoon. We were ordinary that day too.  Just another family, managing the hectic jumble of kids’ lessons, bills, our careers, endless streams of birthday parties, too little sleep and the occasional date night out. But it was all shattered with ...

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