Dear Congress: Listen to doctors on the front lines of medicine A follow-up to Dear lawmakers: This is what it’s like to be a doctor today. Thank you to everyone for the positive feedback.  Over 60,000 Facebook “likes”, tweets, and newspaper requests was quite a surprise. I was especially moved by the multiple tweets from hospices, physician groups, and individuals recommending my article. This article really has hit a nerve and shed light ...

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Let's explore one of the most well-studied health behavior theories - the health belief model (HBM). The HBM states that our health choices are a direct consequence of our perceived susceptibility to a disease, our perceived severity of a disease, and the perceived barriers that keep us from adopting better habits. Perceived susceptibility, perceived severity, and perceived barriers are three of the main constructs from the HBM.  The word "perceived" is very ...

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A psychiatric colleague once told me that the incidence of anxiety disorders went down drastically during the blitz, when London was under constant siege by German bombs in 1940-1941. I don't know whether this is true, or even how you could measure such a thing under those conditions--but it makes sense to me. The patients I saw at Massachusetts General Hospital the day after the terrorist attacks just two miles ...

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There was an article in the New York Times recently about the importance of cultivating a family narrative to instill a sense of identity, control, and resilience in children. The more children know about their family story, the better equipped they are to handle stresses that would shake their foundation. Is it possible that, in the realm of personal health and well being, the cultivation of an affirmative ...

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It all started with my sending a tweet. Actually, that's not quite true. The way it really started was with my frail elderly patient calling me in mid-January, to tell me he thought he had a UTI. But that part of the story is not new and novel; I've often had patients contact me with similar concerns. I did what I usually do: ordered a urinalysis (UA)  and urine culture (UCx). (I ...

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On the morning that I began this post, I read in our local newspaper that Tennessee is soon expected to have a law that would permit public school teachers to offer views on climate change and evolution that are counter to orthodox doctrine on these subjects. No, I don’t think that creationism is science and it should not be disguised as such. Global warming, or climate change, however, is more nuanced. ...

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8 surprising thoughts about patient wait times Every one of us feels a high level of anxiety when we are made to wait.  In grocery stores, we jockey back and forth to the line we perceive is moving the fastest and easily get frustrated when we choose the “wrong” line.  When driving, we will swerve across multiple lanes of traffic to avoid a line at a toll booth or ...

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The dictionary defines humanism as “a system of thought that centers on humans and their values, capacities, and worth.” No sector of the economy comprehends this definition better than a small business. In a sea of competition, the small business whose primary focus strays from its customer’s best interests will surely sink. Those with business experience will undoubtedly attest that, whether in a hair salon or restaurant, a happy customer ...

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For a large and growing number of us with meager or no coverage, health care is the ultimate “gotcha.” Events conspire, we receive care and then are on the hook for a car- or house-sized bill. There are few alternatives except going without or going broke. Steven Brill’s recent cover story clearly detailed the predatory health care pricing that has been ruinous for many rank-and-file Americans. In Brill’s report, a ...

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I hate saying I told you so.  But "patient engagement is a physician-patient communications challenge and not an HIT (health information technology) challenge.” Just take a look at the Mayo Clinic’s patient portal experience which was discussed at a HIMSS 2013. The headline: "Mayo Clinic struggles to meet stage 2 meaningful use thresholds for engaging patients." Always innovating, the Mayo Clinic some three years ago introduced a web-based portal to share ...

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