I covered one of the chief residents in our hospital for two days recently, seeing more than 40 patients in total. My off-the-cuff remarks on Facebook still apply: “Twenty-two inpatients later, it is time once again to declare my awe and admiration for all who do this work daily: hospitalists, housestaff, nurses, techs, custodial staff (et al., et al.). And, of course, the patients who are -- on the other side ...

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A recent research article in the Journal of General Internal Medicine, and the gap between its findings and the real world, helps point up the usefulness and limitations of research. The article, by Susan H. McDaniel, PhD, and coauthors, set out to determine how often doctors speak about their colleagues in supportive or critical ways. Their method is one widely used in the field: simulated patients, actors, were prepared with lifelike stories ...

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I’m not going to discuss the entire subject of cholesterol in this post, but one part of it: specifically, how to discuss with your doctor how much cholesterol should matter to you. If you have read any health news recently, you know that the American College of Cardiology and the American Health Association issued new guidelines to help doctors advise patients about cholesterol medications. The new recommendations are accompanied by a ...

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As an advocate of patient-centered care, I have to recognize that some varieties of patient-centrism make me more comfortable than others. If I really want the patient to do X, and the patient doesn’t want to, I generally feel okay about that. Frustrated, sure, and often times convinced that my way is the right way and the patient’s way is some sort of detour. Most often, though, I am able to ...

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There’s one question I get asked a lot: “I research my health problems on the Internet. Am I a hypochondriac?” First, we should ban that word when talking about ourselves. No one wants to be called that, and doctors who use that word are committing malpractice. Everyone has some range of complaints and worries in life, often physical and mental together, and this is our job as doctors: to hear them ...

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At the International Conference on Communication in Healthcare, which I just returned from, there was a discussion continuously coursing beneath the surface and bubbling up every once in a while. If we, acolytes of shared decision making, whether patients or providers, want to encourage decision making that has the person involved at the center, recognizing their preferences and values, does the kind of decision in question have anything to do ...

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My institution recently switched from its home-grown electronic medical record (EMR) to EPIC, a system for which many great things have been promised. Indeed, it is a considerable improvement over the past one. A number of hopes have been pinned on the latest-generation EMRs, not the least of which is the idea that finally, with this newest generation of tools, a nexus can be created and sustained among comparative effectiveness ...

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Doctors should give patients their damn dataDoctors should give patients their damn data

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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The more I try to help people in this field of mine, the more I realize that it doesn't take a village. It takes a huge industrialized city, all its wires and arteries humming with constant activity, just to try and make one woman better. In this case, one smiling woman in her 50s, ethnicity I couldn't figure and of dubious relevance, who came to our clinic seeking advice about ...

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Would Nate Silver make a good doctor? The blogosphere is alive with the sound of Silver -- Nate Silver, that is, the head of what should be called the FiveThirtyEight Modeling Agency. Silver constructs statistical models to calculate the probability of electoral outcomes. Though he hasn't shared his model yet, the results fit his model very well. Is that the point? Statistical models can be constructed to serve various ...

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