Incorporating patient preferences into evidence based medicine Remember the figure-ground drawing from psychology 101 that demonstrates (ahem) "how edge assignment designates perceptual groupings?" I always just thought it was cool how you could look at the picture of a vase and blink and -- whoa, Nellie -- now you saw two people face-to-face. I'm concerned that the frantic drive toward evidence-based medicine as a strategy for quality improvement and ...

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There’s an elephant in the room, one that’s preventing patients from getting the most out of their visits to the doctor -- and the name of that elephant is embarrassment. It’s not unusual to feel uncomfortable about some of the more intimate aspects of your health, but too often this discomfort turns into outright embarrassment.  This embarrassment can lead to omissions, which in turn make it impossible for your doctor to ...

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Can doctors help patients live fully after a medical diagnosis?Can doctors help patients live fully after a medical diagnosis? An excerpt from Second Firsts: Live, Laugh, and Love Again. I spent nearly 4 years in the waiting areas and patient rooms of cancer hospitals. I was not the one with cancer but my husband was. He was diagnosed with stage IV colon cancer. He was only 31-years-old. I remember the day ...

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While recently confronted with a cancer scare and several months of inconclusive diagnostics, I found myself thinking about how I want to die. Following some reading, my first answer was to die at home, with control over my care, and without substantial pain, views that are widely shared by others. But the more I thought about this, the less satisfactory the answer seemed. For instance, being at home was never of high ...

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Imagine your spouse, parent, or best friend gets a left ventricular assist device (LVAD). This is a mechanical device put into their chest. A wire sticks out of their body and connects to a bunch of different electronic pieces you’ve never seen before. You’re in charge of making sure this wire stays clean. If it doesn’t, it could mean infection and possible death. So, you know. It’s kind of a big responsibility. Of ...

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Outsourcing work to cheaper workers is a common strategy of corporations. It has largely escaped the public's notice, however, that much of this new labor force isn't located in Southeast Asia, but is rather found here in the U.S. and is virtually free. It is we, using our laptops and smartphones to perform tasks once carried out by knowledgeable salespeople and service representatives. This was particularly salient to me this week: ...

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My daughter loves her career as a probation officer. She is very good at what she does, and finds the work both challenging and rewarding. Yet her client case load includes some of the most unsavory of individuals, found guilty by the courts of child abuse, domestic violence, sexual assault or worse, many of them  living with added complexities like addictions or mental health issues. She’s been insulted and screamed at by ...

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As a healthcare writer, I often spend large chunks of the day reading about medical conditions. I often joke when starting work that it’s only a matter of time before I notice signs of the condition in myself. I remember being convinced I had gallstones for a while until I finished working on a gallbladder surgery multimedia program. Suddenly, the symptoms that had been preoccupying me for several weeks vanished. I ...

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In the world of health care, as in most enterprises where we must interact with one another for mutual benefit, we need words to describe one another. And the words we have for us people who use/need/want health care frankly don't cut the mustard. We need a new one. The French gave us tasty food, the Statue of Liberty, and the wonderful phrase, "le mot juste." Translated literally, it means "the exact ...

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Recently, both my husband and I came away from a conversation with my doctor positive that we understood my new weight gain plan. Funny thing: Each of us recalled a different plan. I am always struck by how our memories of the words spoken by my doctor can be so dissimilar. No, not all of them, but enough of them to be wary of going to any appointment without a ...

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