The biggest mistake patients make isn’t what you think. It isn’t turning down tests or treatments their doctors recommend. Nor is it deciding not to take the medicines their doctors prescribe. It isn’t insisting on getting a test or beginning a treatment their doctors recommend against, either, and it isn’t failing to exercise, stay out of the sun (or use sunscreen), quit smoking, or lose weight. No, the biggest mistake ...

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I treat uninsured patients and insured folks who face high deductibles who are under financial strain because of the sagging economy and other personal pressures. These folks need care that may be unaffordable. Medical diagnostic testing is expensive. Even routine laboratory testing can be very costly as those without insurance may be forced to pay the ‘retail cost’, which is quite different from insurance company discounted pricing. This absurdity is often ...

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As a healthcare consultant, it is not unusual to be asked about HIPAA regulations on a weekly basis. Three questions come up regularly and seem to cause the most confusion when discussing HIPAA. I call them the Three Big HIPAA Myths – you can't place medical charts on exam room doors, you can't use sign-in sheets, and you can't leave messages on patients’ voice mail or answering machines. Here, then are ...

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Hospice is beset by many societal obstacles in its care of the transgendered patient.  I saw a most recent example of this in our local community hospice.  An elderly female (MTF) transgendered patient had developed metastatic cancer.  Chemotherapy had failed and had left her profoundly weak and infirmed.  Estranged from her family, she had only a few friends to rely on but then only intermittently so. Hospice admitted her and, with ...

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Decisions in medicine are supposed to rest on concrete observations and hard evidence. Often, hard evidence does not exist or when it does, it isn't used.  Why is this? Concrete observations, too, are increasingly missed as we stare at computer screens longer and patients less.  Yet we persist. Why? This is our reality now, our evolving medical world. But if we stop and think about it, medicine, by definition, is a world of technological ...

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An excerpt from Talking to Your Doctor: A Patient's Guide to Communication in the Exam Room and Beyond (Rowman & Littlefield, 2013. All rights reserved.) There are plenty of books out there to teach us how to boldly and proudly advocate for ourselves in the doctor’s office. ...

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Hal Movie buffs and science fiction fans certainly remember HAL, the computer in 1968’s hit movie “2001:  A Space Odyssey”.  Considered one of the greatest villains in film history, HAL was capable of reasoning and language processing to assist the astronauts on their space mission.  Ultimately, however, HAL decided that its best course of action was to kill all the astronauts. “I am ...

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A study published in the British Medical Journal highlights the importance of carefully choosing which children should receive diagnostic CT scans.  As a diagnostic test, CT scans utilize ionizing radiation that can cause cellular DNA damage, increasing the risk of cancer.  Children who received a CT scan were 25% more likely to develop a cancer in 10 years after radiation exposure, according to a study of 11 million ...

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A JAMA Pediatrics article found that the use of pediatric CT scans rose in the late 1990′s and early 2000′s. Further, research shows that these CT scans can increase risk for future cancer diagnoses. Authors calculated the risk: they estimate that for every 4 million pediatric CT scans preformed annually, some 4800 children will go on to develop cancer as a result. Like many studies published this decade, the ...

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Who is responsible for mistakes in health care?  Who should take credit for success or blame for failure?   Most families, patients and obviously the courts, hold the doctor responsible.  It seems to me this is reasonable; it is the obligation physicians assume and which society returns with empowerment and respect.  However, is this changing because of the Internet and big data? In 2013, most patients have spent hours on the Internet ...

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