Doctors don't like it, but e-Patients - concerned and engaged health researchers and partners - are here, and more are coming.
And - unlike physicians of today - they haven't been educated by the pharmaceutical corporations.
There will be a lot, my friend.
More than can be counted.
How many?
Like the stars.
~ DANCES WITH WOLVES
Slideshow
e-Patients.net
e-Patients PDF
Saturday, February 20, 2010
Tuesday, December 22, 2009
NYT: Holding Doctors Accountable for Medical Errors
From the article:
"Q. Has this erosion of trust had a detrimental effect on the patient-doctor relationship?
A. The chaos of everyone doing things their own way is incredibly dangerous, and it is that chaos which gets in the way of the relationship. You can make health care better, safer and less expensive while strengthening the core of the patient-doctor relationship. You can standardize certain parts of care based on clear evidence, which will free up doctors to focus on those pieces of the health care puzzle where there is no data — those issues that are uniquely human and that require judgment, expertise and empathy.
The challenge, though, is to standardize care in a way that will improve safety while retaining the parts that make medicine human. The last thing we want to do is to regiment empathy or to create something so regulated that doctors cannot do something nuanced or innovative for patients.
Q. What are the roles of patients and of doctors in the patient safety movement?
A. If I were a patient or a loved one, I would do what everyone recommends — have a loved one by your side, look for signals that a hospital is safe, check that a physician is board certified. But I am also intensely ambivalent about how responsible patients should be for safety and the prevention of error. Medical mistakes are our bad. Why should patients bear the responsibility to receive the right medication or to have the correct leg amputated? When I get on a plane, I don’t worry about safety and errors.
As for doctors, patient safety can’t happen if physicians aren’t smack in the middle of it. We can either facilitate safety or we can stand its way. We will stand in its way if we embrace our historical approach to these problems, if we instinctively engage in finger-pointing, if we aren’t willing to listen to others.
We have a huge role in creating the kind of environment where people will feel comfortable questioning anything that seems strange or out-of-place and where doctors are open to different opinions from others.
As doctors, we have to admit first that we don’t deliver care that is of the quality and safety our patients deserve. Then we have to get past our professional arrogance. We don’t have the answers to all of these issues, and we have to be open to others who may have the answers or who can approach it from different angles."
Link
"Q. Has this erosion of trust had a detrimental effect on the patient-doctor relationship?
A. The chaos of everyone doing things their own way is incredibly dangerous, and it is that chaos which gets in the way of the relationship. You can make health care better, safer and less expensive while strengthening the core of the patient-doctor relationship. You can standardize certain parts of care based on clear evidence, which will free up doctors to focus on those pieces of the health care puzzle where there is no data — those issues that are uniquely human and that require judgment, expertise and empathy.
The challenge, though, is to standardize care in a way that will improve safety while retaining the parts that make medicine human. The last thing we want to do is to regiment empathy or to create something so regulated that doctors cannot do something nuanced or innovative for patients.
Q. What are the roles of patients and of doctors in the patient safety movement?
A. If I were a patient or a loved one, I would do what everyone recommends — have a loved one by your side, look for signals that a hospital is safe, check that a physician is board certified. But I am also intensely ambivalent about how responsible patients should be for safety and the prevention of error. Medical mistakes are our bad. Why should patients bear the responsibility to receive the right medication or to have the correct leg amputated? When I get on a plane, I don’t worry about safety and errors.
As for doctors, patient safety can’t happen if physicians aren’t smack in the middle of it. We can either facilitate safety or we can stand its way. We will stand in its way if we embrace our historical approach to these problems, if we instinctively engage in finger-pointing, if we aren’t willing to listen to others.
We have a huge role in creating the kind of environment where people will feel comfortable questioning anything that seems strange or out-of-place and where doctors are open to different opinions from others.
As doctors, we have to admit first that we don’t deliver care that is of the quality and safety our patients deserve. Then we have to get past our professional arrogance. We don’t have the answers to all of these issues, and we have to be open to others who may have the answers or who can approach it from different angles."
Link
Tuesday, December 8, 2009
Patient Empowerment in Medicine
Many medical professionals are often years behind in their reading; understandably they don't like empowered patients.
Some doctors don't like patients who challenge them. Such patients take time and make a doctor work hard. Most doctors want to be considered the authority - even if it kills you.
If you see annotations in your medical file - "patient is getting information from the internet" - it is probably time to move on for the sake of your health and wellness.
Link
Some doctors don't like patients who challenge them. Such patients take time and make a doctor work hard. Most doctors want to be considered the authority - even if it kills you.
If you see annotations in your medical file - "patient is getting information from the internet" - it is probably time to move on for the sake of your health and wellness.
Link
Pristiq for Menopause?
If you are a middle-aged woman and your primary care physician or endocrinologist is offering you antidepressants for symptoms, this article
on the marketing of Pristiq may explain why.
Make sure you have your thyroid checked... menopause troubles may be myxedema.
on the marketing of Pristiq may explain why.
Make sure you have your thyroid checked... menopause troubles may be myxedema.
Thursday, November 19, 2009
Teenage Children and Other Abnormalities - Laughable Excerpts from Actual MD Notes
Teenage Children and Other Abnormalities - Laughable Excerpts from Actual MD Notes
This list is reproduced from MDs' actual writings on charts, published in the Mpumalanga Hospital Register (South Africa), courtesy of Veven Bisetty.
It contains a memorable thyroid notation.
Note: This information may not have been evaluated by the FDA.
This list is reproduced from MDs' actual writings on charts, published in the Mpumalanga Hospital Register (South Africa), courtesy of Veven Bisetty.
It contains a memorable thyroid notation.
1. The patient refused autopsy.
2. The patient has no previous history of suicides.
3. Patient has left white blood cells at another hospital.
4. Patient’s medical history has been remarkably insignificant with
only a 11 kgs weight gain in the past three days.
5. She has no rigors or shaking chills, but her husband states she was
very hot in bed last night.
6. Patient has chest pain if she lies on her left side for over a year.
7. On the second day the knee was better, and on the third day it disappeared.
8. The patient is tearful and crying constantly. She also appears to
be depressed.
9. The patient has been depressed since she began seeing me in 1993.
10. Discharge status: Alive but without my permission.
11. Healthy appearing decrepit 69-year old male, mentally alert but forgetful.
12. Patient had waffles for breakfast and anorexia for lunch.
13 She is numb from her toes down.
14. While in ER, she was examined, X-rated and sent home.
15. The skin was moist and dry.
16 Occasional, constant infrequent headaches.
17. Patient was alert and unresponsive.
18. Rectal examination revealed a normal size thyroid.
19. She stated that she had been constipated for most of her life,
until she got a divorce.
20. I saw your patient today, who is still under our car for physical therapy.
21. Both breasts are equal and reactive to light and accommodation.
22. Examination of genitalia reveals that he is circus sized.
23 The lab test indicated abnormal lover function.
24. Skin: somewhat pale but present.
26. Large brown stool ambulating in the hall.
27. Patient has two teenage children, but no other abnormalities.
Note: This information may not have been evaluated by the FDA.
Monday, October 26, 2009
What Exactly Are They Teaching in Medical School?
What Exactly Are They Teaching in Medical School?
Dateline: 05/05/97
In the May/June issue of Health magazine, there's a familiar but frightening story. The article by Barbara Bailey Kelley describes a woman who had constant fatigue, constipation, constantly feeling cold and difficulty swallowing. According to the article, this group of symptoms had the woman "hopping from doctor to doctor. None could identify a medical problem." Three years after her symptoms appeared, the woman was checked into a hospital, where a coterie of specialists -- an allergist, heart specialist and psychiatrist -- examined her. The psychiatrist wondered if she was suffering from depression. After a battery of tests which, WHEW, finally included a thyroid-stimulating hormone (TSH) test, they FINALLY discovered that she was very hypothyroid, in fact, her thyroid had almost shut down completely.
Okay, calling Dr. Kildare! Marcus Welby! The entire staff of St. Elsewhere, Chicago Hope and ER! Where are the doctors who recognize thyroid disease's symptoms quickly?
On an AOL chat a few weeks ago, a group of us were speculating what would happen if a woman with a basketball-sized goiter walked into the ER at "ER." We decided she'd be told she was stressed out, and sent home with a prescription for Prozac, AND a big fat bill from the emergency room (that her insurance company would probably deny!!!) Now how bout that storyline for dramatic tension? (Of course we all agreed we'd keep the goiter if it meant George Clooney'd be our endocrinologist!)
In any case, doesn't it seem like anyone who's spent more than five minutes reading anything about thyroid disease would have a problem recognizing the familiar litany of symptoms the poor woman in the article described? In fact, I sometimes have to watch about becoming too evangelical myself when friends say, "you know, I've been feeling a bit tired and run-down lately, and..."
"COULD BE YOUR THYROID!!!" I announce.
Continues at Link
Dateline: 05/05/97
In the May/June issue of Health magazine, there's a familiar but frightening story. The article by Barbara Bailey Kelley describes a woman who had constant fatigue, constipation, constantly feeling cold and difficulty swallowing. According to the article, this group of symptoms had the woman "hopping from doctor to doctor. None could identify a medical problem." Three years after her symptoms appeared, the woman was checked into a hospital, where a coterie of specialists -- an allergist, heart specialist and psychiatrist -- examined her. The psychiatrist wondered if she was suffering from depression. After a battery of tests which, WHEW, finally included a thyroid-stimulating hormone (TSH) test, they FINALLY discovered that she was very hypothyroid, in fact, her thyroid had almost shut down completely.
Okay, calling Dr. Kildare! Marcus Welby! The entire staff of St. Elsewhere, Chicago Hope and ER! Where are the doctors who recognize thyroid disease's symptoms quickly?
On an AOL chat a few weeks ago, a group of us were speculating what would happen if a woman with a basketball-sized goiter walked into the ER at "ER." We decided she'd be told she was stressed out, and sent home with a prescription for Prozac, AND a big fat bill from the emergency room (that her insurance company would probably deny!!!) Now how bout that storyline for dramatic tension? (Of course we all agreed we'd keep the goiter if it meant George Clooney'd be our endocrinologist!)
In any case, doesn't it seem like anyone who's spent more than five minutes reading anything about thyroid disease would have a problem recognizing the familiar litany of symptoms the poor woman in the article described? In fact, I sometimes have to watch about becoming too evangelical myself when friends say, "you know, I've been feeling a bit tired and run-down lately, and..."
"COULD BE YOUR THYROID!!!" I announce.
Continues at Link
Sunday, October 25, 2009
Planetree: Patient-Centered Care
Patient-Centered Care Awareness Month
"Patient-Centered Care Awareness Month is an international awareness-building campaign that occurs every October to commemorate the progress that has been made toward making patient-centered care a reality and to build momentum for further progress through education and collaboration. Hospitals and health care organizations around the world are encouraged to celebrate by empowering patients, strengthening their patient-centered practices, and publicly proclaiming to their patients and communities their commitment to patient-centered care.
For the past two years, health care organizations around the United States, Canada and the Netherlands have celebrated Patient-Centered Care Awareness Month. In addition, fourteen state governors commemorated the month signing proclamations officially recognizing the importance of patient-centered care to their states’ citizens.
What is “Patient-Centered Care”?
Although the phrase “patient-centered care” is defined and used in a variety of ways, the essential theme is the importance of delivering healthcare in a manner that works best for patients. In a patient-centered approach to health care, providers partner with patients and their family members to identify and satisfy the full range of patient needs and preferences.
Organizations practicing patient-centered care recognize that:
A patient is an individual to be cared for, not a medical condition to be treated.
Each patient is a unique person, with diverse needs.
Patients are partners and have knowledge and expertise that is essential to their care.
Patients’ family and friends are also partners.
Access to understandable health information is essential to empower patients to participate in their care and patient-centered organizations take responsibility for providing access to that information.
The opportunity to make decisions is essential to the well-being of patients and patient-centered organizations take responsibility for maximizing patients’ opportunities for choices and for respecting those choices.
Each staff member is a caregiver, whose role is to meet the needs of each patient, and staff members can meet those needs more effectively if the organization supports staff members in achieving their highest professional aspirations, as well as their personal goals.
Patient-centered care is the core of a high quality health care system and a necessary foundation for safe, effective, efficient, timely, and equitable care."
Link - at the bottom of the pagte you can download their patient-centered care Toolkit.
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