Patient

Do canes and walkers prevent falls in the elderly?

Patient
August 4, 2009

Not always.

Although when used correctly they can help maintain mobility, MedPage Today reports a study showing that they are associated with an increase in falls when used improperly.

According to the study, it’s “estimated that 47,312 fall injuries associated with walking aids are treated each year among older Americans.”

And worse, falls associated with canes and walkers resulted in more severe injuries, with a third of these cases requiring hospitalization. …

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When fat doctors talk to obese patients

Patient
August 3, 2009

How can doctors counsel obese patients why they themselves struggle with their own weight?

That’s the question pediatrician Perri Klass discusses in a recent New York Times column. On one hand, doctors who are obese may better connect with patients when they “understand their frailties.”

But on the other, patients also ignore advice from physicians who can’t follow it themselves. Indeed, that’s what pediatrician Julie C. Lumeng, an expert …

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We should not care about Regina Benjamin’s weight

Patient
July 27, 2009

Regina Benjamin has impressive qualifications to become our next Surgeon General. She’s a primary care physician in Alabama who has spent considerable time treating the poor. Certainly a better choice than celebrity neurosurgeon Sanjay Gupta.

regina-benjamin But it’s unfortunate that there has been so much controversy about her weight.

Rob Lamberts has the best take I’ve read on the issue, and he …

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Cursing can kill pain, I swear

Patient
July 24, 2009

Maybe those who scream obscenities while in pain are onto something.

MedPage Today writes about a study showing that those who swore had an increased pain tolerance, along with an increased heart rate. This is similar to the proverbial “fight or flight” response that can help mitigate actual pain.

Researchers asked a group of undergraduate college students submerge one of their hands in freezing cold water. One group was …

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Rahul Parikh on the KevinMD Live Q&A: Tuesday, July 21st at 10:30pm Eastern

Patient
July 19, 2009

Pediatrician Rahul Parikh will be my next guest on the Live Q&A.

Dr. Parikh blogs at sWell at Open Salon, and is a contributor to the Los Angeles Times and San Francisco Chronicle. He touches upon a wide variety of issues, including, health care reform, educating the public on the mythical link between vaccines and autism, and commenting on Oprah’s medical endorsements. In fact, his opinion on Oprah …

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Why are hospitals offering nurses free plastic surgery?

Patient
July 13, 2009

Is there pressure for nurses to look more like models?

The answer appears to be yes, in Prague. Citing an article in The New York Times, plastic surgeon Chris Hess (via Better Health) notes that nurses in that region are “under enormous pressure to look good in a society where attractiveness is often as highly prized as clinical skills.”

And according to this Czech nurse, “We were always taught that …

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Why is it so difficult to get an appointment with your doctor?

Patient
July 6, 2009

Most patients complain about the time they have to wait to see a physician.

Not only the time between an appointment and the office visit, but once there, the time it takes to actually see someone.

After internist Jan Gurley breaks down the numbers, it’s easy to see why. Primary care doctors, on average, have patient panels averaging 2,500 patients or so. Assuming full-time working doctor who only takes …

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Reader take: Moral hazard, and whether patients should consider cost in their health care decisions

Patient
June 30, 2009

The following is a reader take by an anonymous medical student.

One of the ideas that comes up in the search for explanations of high healthcare costs is the so-called “Moral Hazard”—the idea that insured patients are more likely to agree to unnecessary procedures because they don’t pay for them directly. Not everyone thinks it is real—does a patient have the medical knowledge to make an informed decision? …

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How patients can annoy their doctors

Patient
June 24, 2009

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?

Patient
June 23, 2009

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

Patient
June 18, 2009

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?

Patient
June 17, 2009

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?

Patient
June 16, 2009

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?

Patient
June 16, 2009

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?

Patient
June 15, 2009

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?

Patient
June 14, 2009

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

Patient
June 14, 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

Patient
June 12, 2009

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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