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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Silence -- it's deafening. I look around at this empty apartment and take in the sinking feeling that I'm alone. New Yorkers seem to crave "alone time." I see individuals sitting on park benches all over the city, stealing moments, staring into space, encased in an invisible aura of solitude. It's quite a feat actually to do this amidst the noise and tidal wave of humanity that ebbs and flows through ...

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You may have noticed an uptick in messages from your health plan or clinician notifying you that "You are the captain of your health care team." I have seen them here and here and here and here, for example. My response to this message? Bad metaphor: I am not the captain of my health care team. I may -- on some days -- consider myself a member of that team, should I actually be cared ...

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I’ve learned that people will forget what you said, People will forget what you did, But people will never forget how you made them feel. -Maya Angelou We are often asked, “How can you do that?”  How can you stand to do that work?  Such a dreary subject.  Grim but supposedly necessary.  Don’t you get depressed with all the talk of dying?  Facing death and its consequences every day must be the prime route ...

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When he was five, my son Daniel went through a rough patch with his asthma. Both he and his sister Allison had been diagnosed the year before, when we were living in Colorado. I never knew if it was the fault of the pollution that too often smeared our view of the mountains, or my then-husband's two-pack-daily cigarette habit. Or was it the unspoken shriek of anxiety? After I divorced my ...

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