I've written previously that many doctors are finding the physical exam obsolete, and are favoring more technologically advanced, and expensive, tests. In fact, I alluded to traditional physical exam advocates as "arguing for staying with a horse and buggy when cars are rapidly becoming available." In a recent piece from the New York Times, internist Danielle Ofri says we need to look past the lack of evidence supporting ...

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"Avoiding those twin traps of overtreatment and therapeutic nihilism" Recognize this phrase? It's from our Hippocratic Oath, the one I took, standing beside my newly assigned cadaver, in my second year of medical school. "What Broke My Father's Heart", recently in the New York Times Magazine, is an exquisitely painful story of medicine and our Oath gone awry in the United States. I urge you to read it. End-of-life care is a ...

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An except from The Empowered Patient. by Elizabeth Cohen, MPH Did you ever see the Seinfeld episode where Elaine gets into trouble at the doctor’s office? While she’s waiting in the examining room, she sneaks a peek at her chart and notices that it says she’s “difficult.” When the doctor comes in, he whips the chart out of her hands. DOCTOR: You shouldn’t be reading that. ELAINE: ...

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An excerpt from Laugh, Sing, and Eat Like a Pig. Laugh, Sing, and Eat Like a Pig: Facing death, with hopeLast month Dave deBronkart, known on the internet as “e-Patient Dave,” released his first book, Laugh, Sing, and Eat Like a Pig: How an Empowered Patient Beat Stage IV Cancer (and what healthcare can learn from it) (www.LaughSingBook.com). It’s his personal cancer story – excerpts from the journal he ...

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Regina Holliday’s husband, Fred, age 39, died of cancer in June 2009 leaving his wife, and his two young, beautiful children behind.  During their journey through the healthcare system to try to get Fred the help he needed, too many hurdles were put in their way.  Their story makes you want to scream. Among the horrors of their journey was the fact that Fred was transferred ...

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People often seem to think that members of the medical world are excessively preoccupied with, defined according to, and ruled by a status-oriented system. That may have been an accurate perception a generation ago, but I've seen enough surgeons sweeping O.R. floors, attending physicians socializing with interns, and doctors having deep conversations with custodians to believe that "medical people" have matured a little past the old caste systems that governed the ...

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by Charles Bankhead My oldest sister died recently. She spent the last three years of her life in a nursing home, trying to hold on to reality and her dignity as her mind and body betrayed her. Barely five feet tall, my sister Peggy had a big heart and a vibrant personality that made her seem much taller. I have a lot of fond memories of her, many of which involve her ...

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They made a regal couple, the elderly man and woman sitting in Room 19. She was the patient, he the supportive husband. She sat in the treatment cot while he sat in a chair pulled near her bedside. Together, they greeted me with their warm smiles as I walked into their room. They both had full heads of healthy, silvery hair that shimmered from the overhead fluorescent bulbs. Their eyes were ...

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OncRN is a wonderful blog written by an anonymous author sharing stories and insights in her line of work that many times speak to palliative themes.  S/he says it best in her blog description,

my life gets intermittantly (sic) rocked by the wonders/horrors of being an oncology nurse. i just need to talk it all through sometimes.
A recent post is about how to say good-bye to our patients, particularly ...

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A while back I did in a post where I asked the question, What can patients really expect from their physicians today? In that post, I wondered at the fact that many patients still have a high degree of trust in their physician in spite of the quality and safety problems attributed to physicians in the press. For example:

  • On average, US adults receive only 50% of recommended ...

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