As a geriatrician in a locale with many elderly retirees, I am frequently asked how long mom or dad (or both) can stay in their home and live safely and successfully. It is clearly a complicated issue even if the individuals involved are cognitively and mentally intact, physically capable and financially able to pay for support and help.There is much to consider. Are the patients physically able to maneuver within ...
Patient
Using the emergency room for routine physicals
One of my patients thanked me for saving his life. Apparently, many years ago I had told him that most men’s first complete physical is in the emergency room in the midst of their heart attack or stroke. I have been in practice long enough to have forgotten many of the things I have told patients. I try to capture the pearls I have learned over the last 30 ...
Unexpected medical bills on a graduate student’s budget
Last July, I found myself needing to visit a doctor for an urgent medical issue. My period had started in April and never stopped. It was light, so it wasn’t too much of an annoyance, but after three months I figured I needed professional help.I had started graduate school in Michigan the year before and was back home in California for the summer. I wasn’t sure if the new insurance ...
How to talk to teens about tanning beds
You’ve had the sex talk, the smoking talk, and the drugs and drinking talk. But have you talked to your kids about tanning beds?You should. Tanning bed use can cause skin cancer, including the deadliest form, melanoma. And, using tanning beds before age 30 increases a person’s risk of melanoma by 75%.Equally worrisome: tanning beds can become addictive. A recent study showed that 80% of college-age tanning beds users couldn’t kick the ...
Care costs a lot and it’s not straightforward what the cost is
Up until last May, my experience of medical costs was limited to the $100 per month premium I contributed towards my employer-sponsored insurance and the nominal co-pays associated with well-child checkups and generic prescriptions. There was never any hesitation in seeing a doctor or filling a prescription. That all changed when went I back to school.I blindly signed up for the school-recommended family insurance and naïvely assumed myself, my ...
To connect with patients is key
con·nect (from dictionary.com)verb (used with object)1.to join, link, or fasten together; unite or bind: to connect the two cities by a bridge; Communication satellites connect the local stations into a network.2.to establish communication between; put in communication:Operator, will you please connect me with Mr. Jones?To connect with your patients is truly the key solution.Connect takes on two meanings:
- Establish a relationship; develop, dig, pursue
- Maintain via all the tools now available: email, texting, Facebook, blog, etc.
All of us are role models, whether we see ourselves that way or not
All of us are role models, whether we see ourselves that way or not. Of course I love to imagine myself as a positive role model, but my eleven-year-old daughter has already informed me that things will be way different at her house when she’s a mama. However, we’re not going to focus on how uncool I am, instead, I’m going to share the stories of a couple of people ...
Children who curse, and the power of words
Today was a rough day at work. My schedule of 10 patients for the afternoon rapidly ballooned into 17. People were sick and miserable. Those who were healthy were frustrated by the long wait. I heard myself apologizing over and over to each family.The day was mostly a chaotic blur. Babies crying, phones ringing, parents reprimanding children on the brink of a meltdown. I don't remember much of it, except ...
Explaining human motivation towards unhealthy behavior
We have all seen people exhibit flagrantly unhealthy behavior. Some of us–though we’d never admit it–derive a certain, smug satisfaction by observing them. At least I don’t do that!Somewhere in the course of our daily lives though, most of us do exhibit behavior that suggests at least some disregard for our health. We don’t change our diet, though we know we should. We don’t floss, take medications as prescribed, or ...
Who benefits most from psychological therapy?
There is a saying in psychiatry, "even bad therapy is good therapy."I always thought this was a terrible thing to say, but really, there’s some truth to it. The basic tenet of therapy is that a person is able to vent their feelings with an objective third party. Depending on how good the therapist is, he or she will be able to help that person process their feelings in ...
Born premature, my sons have already endured a lifetime of hardship
Thump.There is a strange sound emanating from the hallway. It’s more of a series of sounds, of thuds, punctuated by an odd, louder noise. The hallway is narrow, not much room for a five-year-old to create too much havoc. I close my eyes, and as I try to visualize the corresponding sequence of events the rhythm is interrupted by a much louder sound and the house shakes. A child has fallen ...
A contract for patient responsibility
I often refer to myself as a fireman pouring water on the flames that are burning my patients. Often, I view my patients as arsonists, pouring gas on the fire I am working to put out. Taking personal responsibility is a critical component of success in any of life’s ventures. While my patients are very responsible business and family men and women, they often take no responsibility for their ...
How elderly patients can be stubborn to their own detriment
The elderly population can be fun to take care of (they have more stories than you have time to hear), or they can be a handful in regards to all of their chronic complaints and numerous medications. But then, there are those senior citizens that come into clinic and tell us, "I don’t need to take medications, I haven’t taken medications my whole life, and look at where it’s ...
What to ask a doctor when faced with a difficult diagnosis
We live in an era of medicine in America in which patients want to be involved in their healthcare. This is very satisfying to physicians like me, who prefer to educate and engage patients rather than just telling them what to do. Granted, there are some instances when a patient does need to be told what to do (ex: "You have appendicitis. You need surgery.")However, when faced with a ...
The dual tragedy of suffering catastrophic illness and being uninsured
An estimated 60% of American bankruptcies result from overwhelming medical costs. My uncle’s tale illuminates the dual tragedy of suffering catastrophic illness and being uninsured.The 2008 recession claimed my uncle’s job, health benefits, and assets, except for a small inheritance. By 2009 he found work (but not health coverage) as a consultant.One day he noticed that his eyes were yellow. He emailed a photograph, and I immediately recognized jaundice. I ...
Defining what health truly is
I read an interesting article by Jason Luban, a licensed acupuncturist, on why so many patients flock to alternative practitioners. Mr. Luban brought up an interesting question, "What is health?"Is health simply the absence of disease? If it is, there certainly aren’t very many healthy patients in my neck of the woods. Most of the patients I take care of have something that’s not quite right. I only know one perfect ...
Asking patients about their health care financial concerns
I remember joking with Dad about how he'd outlive us all. He had gone vegetarian 10 years before I was born, never smoked, took vitamins, and asked for a designated driver after his annual Heineken at the neighbor's Christmas shin-dig. He flossed, wore a seat belt, and looked forward to annual physicals. If I tried leaving our Michigan house in the winter with more than 3 inches of skin exposed, ...
An incorrectly coded $1,000 billing error
As a graduate student in the health field I often get phone calls from various family members and friends asking what I happen to know about different drugs, procedures, and devices. I was having one such conversation with my younger sister last spring. She had just completed her undergraduate education, started a new job, and was very proudly financially self-sufficient for the first time.We were talking about birth control. Her ...
Slipping through the cracks in our health care system
Between the cracks is a frightening place to be.During the course of trying to improve our family’s financial stability, my husband and I were blind-sided by one hidden detail: We’d face $10,000 in costs to continue my husband’s serious medical treatment because we found ourselves unexpectedly without coverage for 30 days.This was money we simply did not have. We had been prepared to foot the full bill for good health ...
A real doctor will first do no harm
I’m really miserable and need that 5 day antibiotic to get better faster.Ninety eight percent of the time it is a viral infection and will resolve without antibiotics.But I can’t breathe and I can’t sleep.You can use salt water rinses and decongestant nose spray.But my face feels like there is a blown up balloon inside.Try applying a warm towel to your face.And I’m feverish and having sweats at night.Your temp ...
