Patient

Costs are forcing more patients to leave against medical advice

But can that be a good thing?

More patients have higher deductible health insurances, making them question the costs of emergency room tests and treatments. The fear of sticker shock is causing some to leave the hospital against medical advice.

In fact, discharges against a doctor’s advice jumped by almost 50 percent over the last decade.

Such cases can range from patients not willing …

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Worrying about a miscarriage while performing a liver transplant

Transplant surgeon Pauline Chen uses that harrowing personal account to discuss the intersection between motherhood and medicine.

Women currently make up the majority of students at most medical schools, which means that female physicians will comprise a major part of the future medical workforce. But, despite the stress that you’d intuitively associate between juggling medicine and raising children, “work-family conflicts were not a major source of stress …

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How the physical exam can affect the doctor-patient relationship

The physical exam is increasingly being overlooked, and replaced by diagnostic tests, which are easier, and take less time, to order.

At this new blog over at The Atlantic, Abraham Verghese talks about how the physical exam, when done well, “earns the trust of the patient, and it also lays the foundation for the patient-physician relationship.”

However, when done poorly, “it does the opposite–it creates …

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How you can catch the flu after touching money

Yes, cash can transmit the flu.

In an interesting report (via Well), it’s noted that the flu, including the H1N1 virus, can last for as long as an hour on money and other forms of paper currency. Worse, “mix in some human nasal mucus, and the potential for the virus to hang on long enough to find a victim increases, according to one of the few …

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Is IV sedation being overused?

Prior to a breast or bone marrow biopsy, intravenous sedation is typically offered to, and accepted by, patients.

But, what if some don’t really need such heavy sedation?

Over at Better Health, Harriet Hall wonders if some patients would do just fine with a simple local anesthetic: “Has it become a knee-jerk reflex to sedate everyone as a general principle? Why? To avoid complaints and keep patients …

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How is swine, or H1N1, flu affecting your doctor’s office?

Coverage on the H1N1 influenza has been nothing short of constant.

But, how is it affecting your physician’s office? For me, there’s been many questions, some patient anxiety, and lots of diagnostic nasal swabs. But, being in New Hampshire, the prevalence of the H1N1 virus has been relatively low, compared to other parts of the country.

For a more detailed look behind the scenes, Rob Lamberts …

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Abraham Verghese on the KevinMD Live Q&A: Monday, May 4th at 10:30pm Eastern

Abraham Verghese will be answering your questions at my next live Q&A.

Dr. Verghese, a Professor for the Theory and Practice of Medicine at the Stanford University School of Medicine, is one of the most accomplished and admired physician educators today. His pieces have appeared in The New York Times and The Wall Street Journal, and one of his recent articles, entitled Culture Shock, …

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When is it alright to advise a patient to smoke?

Believe it or not, there are such instances.

Peter Ubel tells us of one, in a sad case of end-stage metastatic lung cancer. While observing a patient and his wife arguing about his cigarette use, Dr. Ubel realizes that in this instance, it’s quality of life that matters.

So, instead of watching them fight, he encourages them to see the bigger picture: “My duty as a …

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Why doctors skip medical interpreters, and how that damages physician-patient communication

Physicians are often pressed for time, both in the hospital and the clinic.

And for those who don’t speak English, that represents a huge problem. Not only are many cash-strapped hospitals cutting back on interpreter services, those that have them aren’t always being utilized.

As surgeon Pauline Chen notes, “Patients who speak English poorly or not at all face longer hospital stays, an increased risk of …

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Poll: Should salt intake be regulated by the government?

New York City mayor Michael Bloomberg recently introduced an initiative to pressure the food industry to cut salt intake by half over the next decade.

Combined with the city’s ban on trans-fats and move to post calorie counts in restaurants, this is part of an emerging trend where the government is taking decisive steps to control what we eat. But, in the case of salt – to what end?
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Stanford’s Abraham Verghese has open office hours on Facebook

Abraham Verghese is an internal medicine physician at Stanford, and a prominent physician-writer.

Stanford University is utilizing Facebook as a way to ask Dr. Verghese questions. He’s one of the most eloquent and introspective doctors working today, so it’s a treat to hear him talk about the various issues readers bring up.

Here are the first few videos in the series.

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A pediatrician takes the anti-vaccine movement head on

Would you rather have your kids get measles or autism?

That’s the choice that anti-vaccine proponent Jenny McCarthy lays out on the talk show circuit. But in a LA Times column, pediatrician Rahul Parikh comments, “At best, that’s a false choice; at worst, it’s a sick, horrible wish for her or anybody else’s child.”

He further observes, rightly, that the anti-vaccine movement has done a much better …

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Professional athletes going half-speed, and the dangers of overtraining

With the NBA playoffs now upon us, do basketball players go all out, all the time?

Not necessarily.

Over at Better Health, Nick DeNubile, orthopedic consultant to the Philadelphia 76ers, says that there’s “an important distinction between going half-speed and being tentative. If you’re tentative ““ in any sport at any time ““ that’s when you risk injury.”

The key is staying relaxed, and Dr. DeNubile notes …

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Does consensual doctor-patient sex actually harm the public?

When it comes to disciplinary action, Texas punishes doctors who engage in consensual sex with patients seriously.

Hospitalist Chris Rangel says they’re going overboard.

Consider the cited case, where a doctor who had consensual sex was given a harsher penalty than physicians who were negligent and actually harmed patients.

“A sexual relationship, even a consensual one, between a doctor and their patient is certainly improper,” writes Dr. …

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All doctors say they want to help people in pain, but how do you know for sure?

How do you know which doctors are the ones who can appropriately comfort patients during times of suffering?

You don’t.

Anesthesiologist Dr. T talks about how medical schools don’t really screen which prospective physicians are “cavalry-ready,” or not.

“People are either ready, willing, and able to be close to human suffering – to look at a weeping man, woman, or child in the eye, talk …

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Should patients own their medical records?

Personal health records have been in the news lately, with the focus on how inaccurate they can be.

Should patients have complete access to medical records at their physician’s office or hospital?

Primary care doctor Rob Lamberts offers some thoughts on the subject. There are some parts of the record that patients shouldn’t read. “What if someone comes into the office with a child and I have …

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Why giving free care to the uninsured is good business

Walgreens made some headlines with their program to give free acute care services to those who are unemployed.

Before you think that they’re doing this out of the goodness of their hearts,

Doctors rarely would drop patients who have recently gone on Medicaid, or worse, lost their health insurance altogether. Why? As Dr. Sidorov …

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The cost of limited health literacy, and how can it be fixed?

Patients who have trouble understanding, or acting upon, the information as it relates to their health are more than twice as likely to die.

So writes Pauline Chen in recent column, where she writes about how patients need to take a more active role understanding their health. It’s indeed a big problem, especially given the trend towards a more patient-centered orientation for medical care.

But, that …

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Can patients and doctors handle the truth?

An inspiring post supporting the use of evidence-based medicine.

Often times, what’s deemed common-sense and based on ideology is proved wrong by the evidence. And it’s up to both patients and doctors to accept the findings of studies that disproves previously accepted dogma.

Physician David Newman gives us his best Jack Nicholson impression in driving that point home: “The critical question that looms …

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Susan H.: Cura te ipsum

The following is a reader take by Susan H.

To solve the current healthcare crisis
And obviate unconscionable insurance prices
We should all get requisite medical degrees,
And minister alone,
To our own maladies.

This may present a quandary
To the Juris Doc., M.D.;
What will the legal remedy be
For a literal personal injury?

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