Tom, a doctor friend, recently told me he was reprimanded by Michael, his hospital’s medical chief of staff, after two patients lodged complaints against him.
One instance involved a man whom Tom informed of a cancer recurrence. When the man cried, Tom put his hand on the man’s knee, attempting to comfort him. However, the man didn’t find it comforting. He said nothing to Tom but complained to administration, stating that …
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Across the United States at least forty people die each day from overdosing on opioids like Vicodin, codeine, heroin, and oxycontin. Seven percent of drivers who died in car crashes last year were found to have prescription opioids in their systems — seven times more than in 1995.
Considering these alarming rates of overdosing and DUIs, this is serious business. Authorities view it in their traditional way: the problem is drugs. …
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During our lifetimes, the role of physician has been shrinking, from healer to technician.
You’ve probably seen the famous painting, Doctor and the Doll, done by Norman Rockwell in 1929. It depicts an old country doc listening with his stethoscope to the heart of a doll held up to him by a worried little girl. Today there’s no time for such play, and no pay for it, either.
The gradual transformation of …
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A long time ago, when I was interning in an emergency department, several ambulances arrived at once from the site of a bombing. They unloaded three victims plus a mass of assorted limbs. As I placed an endotracheal tube in one patient, the awfulness suddenly hit me: These people had probably been sitting peacefully at home only a half-hour earlier, and now they were a mass of gore. Overwhelmed, I …
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Psychosomatic. I learned not to use that word forty years ago, after I’d told a patient her malady might be psychosomatic in origin. She turned red, jumped up, and on her way out said, “I hope you fall into an open manhole and die!”
Well, maybe I should’ve been more circumspect. I hadn’t realized until then that people can understand “psychosomatic” in a different way than I do. I’d meant what …
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If you attended medical school, you learned in week one that American health care started becoming scientific in 1910, with the publication of the Flexner Report. Before then, only some medical schools were authentic while many others were anything from carnival booths to outright frauds.
Abraham Flexner, a respected educator, had been hired by industrial barons John D. Rockefeller and Andrew Carnegie, who were determined to bring health care out of …
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Pretend you’re a 30-year-old woman who’s 34 weeks pregnant. You develop a cough while cleaning a dusty room. You put up with it for several days. After a week you realize the cough has kept you from sleeping and is creating pain in your rib cage. Time, you think, for medical attention.
That should be an easy thing to do. After all, you have health insurance, and you’re articulate and assertive. …
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Many of us harbor an archaic view of what health care is, so let me offer a little history. During the past century, it’s changed from Healthcare 1.0 to 2.0, and now it’s Healthcare 3.0.
In the early twentieth century, Healthcare 1.0 was a service, though it amounted more to personal contact than effective medicine. At best, medications and procedures were hit-and-miss, so doctors relied heavily on their relationship with their …
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Contributors on this site regularly recommend improved doctor-patient communication. Indeed, that’s one reason I’m a devoted reader. But we need to articulate exactly what “communication” is.
When I ask colleagues about that word, they usually define it as what they say to patients. I can’t argue with that. Yes, we need to express ourselves clearly and simply. But communication includes much more.
The occasional complaints I hear from patients about their care …
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I know a wise old forester. Ask him any question and he’ll answer, “Well, now, it depends on what you want.”
“Should we clear this underbrush or just leave it?” It depends on what you want.
I realize this can explain any choice we’ve made: that is, we have what we have because, at some level, that’s what we want. In that light, let me discuss electronic medical records.
EMRs can be wonderfully …
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In my practice of facilitating cancer support groups, all I do is listen to patients and their families. Consequently, I hear much about the nature of their care. They generally speak favorably about its technical aspects, and indeed these are often awesome. But when they complain, it’s uniformly — and I mean one hundred percent — about communication.
One man has been trying to get an appointment with a pulmonologist for …
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My friend Jeremy went to an emergency room with belly pain, and soon learned he’d been blessed with a kidney stone. The staff summoned a urologist, but none was available, so they sent him home with a pain prescription. Continuing nevertheless to writhe in agony, Jeremy phoned urologists and learned to his dismay there were only three in the region who accepted his insurance, and none at all in his …
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The acronym “MI” has traditionally meant myocardial infarct, or heart attack. Recently it’s taken on a new, more salubrious meaning: motivational interviewing.
A growing number of docs are practicing this technique, which amounts to listening to patients to help them recognize their internal sources of behavior. Boston’s NPR affiliate, WBUR, describes typical MI interventions in which doctors, instead of demanding that patients stop smoking or drinking or overeating, gently …
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Medical schools traditionally admit pre-med students who are science nerds, and later wonder why their graduates aren’t well-attuned to their patients’ emotions.
The Icahn School of Medicine at Mt. Sinai Hospital in New York City hopes to correct that. It now operates a program, called “Hu-Med,” that admits humanities majors. They’re selected after their sophomore college year, and don’t even need to take …
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If I had groused two years ago that we were getting doctored to death, you would’ve thought me obtuse. When I claim today, though, that every head bump doesn’t need an MRI, you get it.
There’s a growing buzz about Americans receiving too much health care. In fact, overtesting and overtreatment are the main source of health care’s amazing expense. You can …
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