Patient

Patients die when doctors don’t talk to one another

Poor communication in medicine can kill.

I wrote a piece a few years ago on the issue (What we have in health care today is a failure to communicate), and fellow primary care doctor Rob Lamberts revisits the topic in a recent post.

In fact, he goes one further, saying not only does it cost money, “It kills. Patients have died because of this.”

Hospitals and emergency rooms rarely have access …

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How patients can annoy their doctors

A study suggested that doctors rated up to 15 percent of patients they see as “difficult.”

What does that mean? This piece from MedPage Today and ABC News, gives six examples of what patients can do to frustrate their doctors.

I’ll leave the obvious ones for you to read, such as stopping medications without notice, or keeping silent about the herbs and supplements patients may be taking, and instead focus …

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Should patients lie to their doctors?

Apparently, there are some legitimate reasons why a patient may lie to their physicians.

A recent article in the Los Angeles Times discusses the phenomenon, which as Dr. Gregory House would aptly summarize as, “Everyone lies.”

In fact, a recent survey suggests that “38% of respondents said they lied about following doctors’ orders and 32% about diet or exercise.”

One interesting reason is that patients are wary disclosing potentially damaging information …

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Retail clinics are not for patients with chronic disease

A patient recounts a dubious recent experience at a retail clinic.

Blogging over at Ill and Uninsured in Illinois (via Duncan Cross’ new patient-focused blog carnival), the patient correctly surmises that, “they’re a stop-gap, not a replacement for a primary-care physician,” and, “if you rely on on such clinics for your medical care, it’s very possible that underlying problems will go on unrecognized.”

Worse, studies have shown that many of these …

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Do physician quality measures tell patients who’s a good doctor?

Not always.

Most quality measures are based on billable data, such as rate of breast or colon cancer screening, or in young women, the rates of chlamydia screening.

But do these numbers necessarily tell patients who are the best doctors?

Over at Better Health, Evan Falchuk has his doubts. He asserts that “the information is simply not valuable to consumers. Worse, I think it is deeply misleading. A medical group …

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What do patients want from their doctors?

With doctors pressed for time, and patients increasingly dissatisfied with their care, how can physicians do it all?

According to a 2006 study, patients want their doctors to be “confident, empathetic, humane, personal, forthright, respectful and thorough.” But in the age of conveyor-belt medicine, and the standard 15-minute office visit, it’s becoming apparent that today’s physician will have trouble fitting that mold.

There are some tips a busy doctor can …

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How difficult is it to measure medical errors?

It’s not as easy as you think.

In this piece from Slate, two physicians question the numbers circulating in the media that sensationalize medical mistakes. For instance, when citing the Institute of Medicine’s popular assertion that close to 100,000 patient deaths are preventable, they say that, “had [the researchers] used a different calculation method, the number of estimated deaths would have been less than 10 percent of the original.”

Determining …

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Does alternative medicine work? Or does it harm patients?

In a scathing review, the Associated Press reports that $2.5 billion in federal funding has been spent on researching alternative therapies.

None have been conclusively shown to work.

Despite this, more medical schools and hospitals are embracing alternative medicine, and in some cases, offering them to patients who are gravely ill. Also, health insurers are making deals to provide alternative services, as well as nutritional supplements, to their members.

The main reason …

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How should Oprah handle medical issues?

Oprah Winfrey has been taken to task, rightly, by both bloggers and mainstream media on her advice on health issues.

Most prominently is a recent front page story on Newsweek, titled, Live your best life ever!

Pediatrician Rahul Parikh was ahead of the curve on this topic, blogging a similar stance a few weeks before the Newsweek piece was published. But how should Oprah, who, as Dr. Parikh writes, is an …

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5 top medical comments, June 14th 2009

Here are some of the more interesting comments readers have left recently.

1. Carla Kakutani on how Massachusetts’ health reform won’t relieve ER overcrowding:
Insurance does not equal access (although it’s better than nothing). Nothing changes until every stakeholder recognizes they have to control costs and allow a rebuilding of primary care in the US. That includes doctors and patients, along with everybody’s favorite villians, the insurance companies and big pharma. …

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A soccer player collapses, but lives, thanks to his automatic defibrillator

Here’s a fascinating, and scary, video of an implanted automatic defibrillator in action.

20 year-old Belgian soccer player, Anthony Van Loo, collapsed during a match. Blogging over at MedPage Today, electrophysiologist Dr. Wes analyzes the subsequent video, giving a precise play-by-play, so to speak, of when the defibrillator kicked in, likely restoring the arrhythmia into a normal heart rhythm.

As for the cause, Dr. Wes has got you covered: “In …

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It’s difficult to treat the morbidly obese

There have been plenty of stories detailing how difficult it is to treat the morbidly obese.

Most of the time, the stories have centered on simply how difficult it is to transport these patients to the hospital.

Once there, however, emergency physician Shadowfax talks about other issues. For instance, obtaining IV access is near impossible, and 500+ pound patients present grave challenges to securing an airway, managing ventilation, or performing …

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Would you be willing to pay more to be seen more quickly in the ER?

This ER in Atlanta is betting that you will.

Taking advantage of worsening patient wait times in emergency departments, the Emory Adventist Hospital is offering a “Hold my place in line” service.

For a fee of $24.99, patients are guaranteed to be see in 15 minutes or less – or the entire visit is free.

It seems to me like shrewd business, and the blatant beginning of tiered emergency service. However, WhiteCoat …

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Executive physicals, and what the Mayo Clinic doesn’t want you to know

The Mayo Clinic has been touted by policy wonks as a low-cost, high-quality integrated health system that American physician practices should aspire to.

What’s somewhat less publicized is that they are also a leader in so-called “executive physicals.” (via Schwitzer)

These exams, which often exceed thousands of dollars, offer CEOs and other executives a battery of tests that are often not evidenced-based. These can include stress tests, cardiac CT scans, and …

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Can patient empowerment be taken too far?

Donald Berwick is a physician at the forefront of the patient empowerment movement.

In a recent interview, he believes that medical care needs to be more patient-centered, in effect, “transfer[ring] control from doctors to the patients themselves,” and, “patient preference occasionally putting evidence-based care “in the back seat.”

I wonder how, as a pediatrician, he’s handling the anti-vaccine movement.

In response to a question on patient choices that come in conflict with …

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Losing the anti-vaccine fight, and what we should do next

The fight versus anti-vaccine proponents is a losing one.

Orac, a general surgeon who blogs over at Respectful Insolence, is on the front lines of the debate. In this post, he writes about how vaccine supporters are facing an uphill battle:

One problem is that vaccines have been so successful that parents rarely see the full, ugly consequences of the diseases against which vaccines defend anymore. The other problem is that …

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Doctors and midwives need to cooperate more

There has always been an underlying tension between obstetricians and midwives.

From the doctor’s side, the only times they interact with midwives is when trouble arises. Or, as this article in Time puts it, “When hospital-based obstetricians see midwives and their clients it’s usually because something has gone wrong . . . OBs don’t see the uneventful births that proceed successfully at home [and] doctors in this position find themselves …

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Same-sex partners being denied visiting rights

A hospital that denied a woman from visiting her dying partner at a hospital is now at the center of a federal lawsuit.

Tara Parker-Pope details the case, which is sparking outrage. I won’t rehash the discussion, which has been quite vigorous over at her blog. Indeed, the results of the pending lawsuit can have far-ranging effects, including “the way hospitals treat all patients with non-marital relationships, including …

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Should Oprah be giving medical advice?

When it comes to influence, you need not go further than Oprah Winfrey.

Just ask Kentucky Fried Chicken.

With the recent news that she is giving anti-vaccine proponent Jenny McCarthy prominent airtime, as well as her previous endorsement of Suzanne Somers’ book on “bioidentical hormones,” is she doing more harm than good?

That’s what Rahul Parikh suggests in a piece on Salon. Despite her soaring ratings captive audience, Dr. Parikh thinks that, …

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Poll: Should doctors discuss the price of medical treatment?

A recent poll conducted by the Consumer’s Union, publisher of Consumer Reports, found that only 4 percent of patients said their doctors talk with them about the cost of prescriptions. And 60 percent find out what the price is for the first time when they pick up their drugs at the pharmacy.

Should doctors discuss the price of medication before prescribing it?

As physicians, we’re trained to make treatment decisions without the …

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