In 2005, my husband and I bought a small farmhouse in northern New England next door to Tom and Sally. They were in their early seventies, married nearly fifty years, with a large family. Tom's grandfather had built a farmhouse in 1900 on the family's small pig farm. In the 1970s, Tom and Sally had parceled off the land and built a modern house for themselves, a stone's throw from the ...

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Over the years, many people have shared with me their disappointment at the lack of acknowledgment from their physician when their loved one died. Especially, when their loved one had been a long time patient of the physician. In fact, many people have shared that they switched physicians because of what they perceived as a slight. When people go to a physician for many years, especially the family physician, it is ...

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In most states, doctors are mandated to ask their patients if they feel physically “safe at home.” With an aging population, perhaps another question should be added: are you financially safe? Two examples suggest the problem. “Trudy” had always managed her financial matters, even complex transactions. Aging, however, had made her short-term memory a bit more problematic and her focus diminished by TIAs. Even though her daughter shared responsibility on some of ...

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A frequent response to those contemplating suicide is to remember friends and loved ones, how much one is needed and how much one would be missed. Some people have a sense this statement is true and that the depressive emotions are inaccurate, so seeking therapy, medication, or riding out the episode will result in returning to whatever emotional mode is typical. Others don't believe this sentiment, and they potentially live ...

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As we reflect on the year that’s passing, it’s not unusual to formulate wishes and resolutions for the new year. I’m not much for resolutions anymore, but I do have hopes and wishes for me and for my readers. Of course, my first wish is that those of you who suffer from chronic illness -- including chronic pain -- have your health restored. I know that, for some, this is a ...

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Overheard in the gym: "Yeah, but I heard that ____ can be dangerous." "Oh, they wouldn't let us buy it if it was." Lately, the public's faith in the safety of prescription and over-the-counter drugs has been making me uneasy. Advances in drug development mean that many of us truly can live better lives through their wise use. But are we adequately guided and protected by a) regulators, b) our clinicians, c) a ...

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It is no secret that one of the best ways towards better health management is a good physician-patient relationship. There needs to be buy in from both participants to shared decision-making. One might object to the title of this post, stating that it puts the biggest burden on the patient, however when examining how this is achieved, you will, I hope, feel differently. 1. Establish a relationship. This might sound trite, but the first few ...

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Here are a few words some physicians and medical professionals have used to describe patients who have turned to Dr. Google for information and advice on their medical conditions: irritating, suspicious, distrustful and challenging. Perhaps frustrated with physicians’ continued resistance to Internet-empowered patients, Dr. Kevin Pho urged them to “deal with” the fact that patients “Google their symptoms.” But, we all know the Internet-informed patient is old news.  I’m here with ...

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Many years ago, Alfred Korzybski wrote that "the map is not the territory." Gregory Bateson went on to argue that the map, which represents reality, is not the reality. This distinction has implications for the role of patient voice in health care planning and policy. Today, many organizations are making serious attempts to include the patient voice in policy and decision-making. Unfortunately, more than a few of them are ...

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What can we learn from an experiment conducted on a single person? That is, when the subject population (N) is a single person, aka N=1? How and how much do such findings contribute to knowledge about the experimental intervention? How relevant are results to other patients or populations or diseases? In assessing what is known about a phenomenon, how are these findings treated in comparison to studies with 30 or ...

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