Medical decision making is influenced by patients, lawsuits, and money

Ideally, the medical decisions doctors make for their patients should be free of any outside influence.

But for regular readers of this blog, we know that’s not always the case.

A 2010 HealthLeaders Media Industry Survey identifies some factors that may influence a physician’s medical decision. Here are some of the results.

Pressure from patients was a significant influence, with only 17.9% of doctors saying it wasn’t a factor. Doctors often …

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A nurse practitioner is valuable in hospice and palliative care

by Patrice Villars

Recently, a physician colleague expressed her concern about signing routine hospice admission orders for her elderly patient with end stage heart failure. The routine ‘as needed’ (PRN) orders included phenobarbital, pentobarbital, haloperidol, lorazepam, and morphine. “The hospice nurses know more about this than I do, don’t they?” she said.

Yesterday, a longtime palliative care nurse told me she didn’t want to put her mother with end stage heart …

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Condoms don’t work all the time, and here’s why

Originally published in MedPage Today

by Chris Emery, MedPage Today Contributing Writer

Condoms that don’t fit properly are more likely to break, slip off, and decrease the pleasure of both partners during sex, which may discourage their use and undermine their public health benefits, a survey found.

Ill-fitting condoms were reported by 44.7% of the men polled. They were more likely than …

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How doctors can improve patient interactions

by Lockup Doc

Physicians learn a lot about many different topics, both in medical training and in practice. However, there are some life lessons that we never learn as well as when we become patients ourselves.

When I was 13 or 14 years old, I regularly interacted with 2 different physicians with disparate interpersonal styles. Little did I know then that these seemingly meaningless encounters would indelibly shape my own beliefs about …

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Why being President of the United States is a health hazard

Originally published in MedPage Today

by Liz O’Brien

Exactly whom are we honoring on Presidents (or is it President’s) Day?

A. George Washington
B. George Washington and Abraham Lincoln
C. All presidents

The answer is more complicated than you’d ever expect. Probably A is most correct, but if it were up to me, I’d pick C.

Certainly every one of these 43 men has earned the …

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How speed dating can help the doctor patient relationship

Not literally, of course.

In an interesting marketing concept, some would call it a gimmick, a Texas hospital is utilizing speed dating concepts to match patients with obstetricians.

I like it.

As chronicled by the American Medical News, here’s what happens:

It involves setting aside a room for two 30-minute sessions over the lunch hour. About five or six physicians sit at tables while a dozen or so potential patients rotate through. Every five …

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End-of-life decisions and making advance directive choices

Originally published in MedPage Today

by Crystal Phend

“I do not want my life to be prolonged if, to a reasonable degree of medical certainty, my situation is hopeless.”

“I want my life to be prolonged as long as possible within the limits of generally accepted medical standards, even if this means that I might be kept alive on machines for years.”

Check …

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How physician burnout worsens patient care

It’s no secret that primary care doctors are getting burnt out.

Last July, I pointed to a study observing that “large numbers of physicians claimed a lack of control of their work, a chaotic work pace and time constraints during patient visits,” and, “more than a quarter complained of burnout. More than 30 percent indicated they would leave the field within five years.”

Now there’s data showing that unhappy physicians provide …

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Why are doctors so reluctant to discuss end of life care?

A recent study suggests that doctors may put off holding end of life care discussions that involve subjects like advance directives, hospice or site of death.

Recommendations suggest that physicians hold these conversations when patients have about a year to live, but the data shows  those guidelines aren’t being followed.


According to the study’s authors, they suggest that doctors “may not be comfortable discussing it,” and, “these conversations are time-consuming and …

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