Docs helping patients to surf the internet

[LinksEtc]

"The Value of Kindness in Healthcare"
http://www.thedoctorweighsin.com/value-kindness-health-care/

In all of the jillions of articles I have read and presentations I have attended on patient engagement, I do not believe I have ever heard the word "kindness" mentioned.

The patient left angry – the physician felt abused.  Kindness in healthcare has to go two ways.

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Tweeted by @TomVargheseJr

"A Simple Case Of Chest Pain: Sensitizing Doctors To Patients With Disabilities"
http://content.healthaffairs.org/content/33/10/1868.full

To my surprise, he took the number and called James to apologize. Stan then asked me to put together a seminar on disabilities for other trainees in our hospital. In the seminar's first session, medical students and residents began by discussing how they had also witnessed inappropriate behavior toward people with disabilities but were too afraid to speak up.

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"When baby is due, genetic counselors seen downplaying false alarms"
http://eye.necir.org/2016/03/06/genetic-counselors-downplaying-false-alarms/

Only after the Summersgills agonized over Kate's future and spent almost $2,000 more on another test were they satisfied that Limone was wrong — their baby was fine. And when they learned that Limone had a financial relationship with the company that makes the test, called MaterniT21 PLUS, they wondered whether money had influenced the counselor's advice.

-----------------------------------

Overkill
An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?
http://www.newyorker.com/magazine/2015/05/11/overkill-atul-gawande

Doctors generally know more about the value of a given medical treatment than patients, who have little ability to determine the quality of the advice they are getting. Doctors, therefore, are in a powerful position. We can recommend care of little or no value because it enhances our incomes, because it's our habit, or because we genuinely but incorrectly believe in it, and patients will tend to follow our recommendations.

The forces that have led to a global epidemic of overtesting, overdiagnosis, and overtreatment are easy to grasp.

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"Kindness in health care: missing in action?"
https://myheartsisters.org/2015/06/14/kindness-health-care/

What I do vividly remember, however, is a small but profound act of kindness later that day when I was brought to my bed in the CCU (the cardiac intensive care unit).

-----------------------------------



"How Kindness Became Our Forbidden Pleasure"

https://www.brainpickings.org/2015/07/13/on-kindness-adam-phillips-barbara-taylor/?utm_content=buffer9df24&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

We are never as kind as we want to be, but nothing outrages us more than people being unkind to us.

[LinksEtc]

Tweeted by @JoeBabaian

"HOW TO DECIDE? NAVIGATING PATIENT CHOICES IN HEALTH CARE"
http://hcldr.wordpress.com/2014/10/04/how-to-decide-navigating-patient-choices-in-health-care/

We've all been there – whether as a patient, a physician, a nurse, or an advocate – how do we make the right choice when faced with an important health care decision impacting ourselves or the person we are caring for?

-----------------------------------------------


Tweeted by @HeartSisters

"For patient engagement to work, we must have doctor engagement too"
http://medcitynews.com/2014/10/patient-engagement-work-must-doctor-engagement/#.VDPUfnPulbE.twitter

"Good for patients, good for society, not good for docs? Doesn't work," he said.

He made a persuasive case for why "change" will only work when a new solution works for all three circles. You can watch his entire presentation below.

-----------------------------------------------


Tweeted by @Skepticscalpel

"MRI Mishap Said to Cause Woman's Suicide"
http://www.courthousenews.com/2015/01/30/mri-mishap-said-to-cause-womans-suicide.htm

"The attractive force of the magnet pulled the wheelchair with such force that Laurie Reid was pulled into the device hitting it violently. After the violent impact of hining the MU machine, Ms. Reid was pinned by the wheelchair against the magnet causing her further and additional griivous injuries all over her body, including her face, head and skull, and with great physical pain and mental shock, anguish and suffering."

[LinksEtc]

"Why Giant Hospital Systems Might Be Getting it Wrong"
https://www.linkedin.com/pulse/why-giant-hospital-systems-might-getting-wrong-michelle-chaffee?trk=v-feed

High tech and low touch leaves patients feeling frustrated and afraid.

I realize, from working in large world class healthcare systems as well as small rural hospitals that there are often gaps in innovation in the smaller systems but there are advantages in having a team of people managing your care who know who you are and what you are there for.

------------------------


Tweeted by @joyclee

"Letting Go
What should medicine do when it can't save your life?"
http://www.newyorker.com/magazine/2010/08/02/letting-go-2

In ordinary medicine, the goal is to extend life. We'll sacrifice the quality of your existence now—by performing surgery, providing chemotherapy, putting you in intensive care—for the chance of gaining time later. Hospice deploys nurses, doctors, and social workers to help people with a fatal illness have the fullest possible lives right now.

You'd think doctors would be well equipped to navigate the shoals here, but at least two things get in the way.

----------------------------------------


Tweeted by @99u

"How to Get Over Your Fear of Conflict"
http://99u.com/workbook/33301/how-to-get-over-your-fear-of-conflict

Conflict can be awkward and uncomfortable. So many of us avoid it and cover up our frustration with a smile.

You create relationships that are neither authentic nor constructive.

[LinksEtc]

Alternative reality: Patients who spurn chemo for natural remedies
What oncologists do – and say – when their patients choose holistic treatments over conventional care
http://www.fredhutch.org/en/news/center-news/2016/05/patients-spurn-chemo-natural-remedies.html

But physicians have a responsibility to go beyond listing the best treatment choices, acknowledging their awareness of alternative medicine and then simply telling cancer patients, "We respect the wishes of competent adults, so it's up to you to decide," said bioethicist Dr. Arthur Caplan of the NYU Langone Medical Center.

"I think that's wrong," Caplan said. "I think we should not be as fearful in mainstream medicine of offering strong opinions about what's the best course.

---------------------------------------------


Tweeted by @KathEvans2

Should demonstrating empathy be an #AlwaysEvent? @pauljebb1 Here's how to m.youtube.com/watch?index=1&;... HT @CarterBernie @6CsLive @Damian_Roland

"RSA Shorts - The Power of Empathy"
https://m.youtube.com/watch?index=1&list=PLMo9vqiZPs0RQa_kypIS3tchANZa-MJGO&feature=share&v=1Evwgu369Jw

------------------------------------


Tweeted by @DionneLew

"Venting anger is poisonous (here's how to deal with it)"
http://linkis.com/beyourwholeself.com/aI1Bw

"If they hadn't have done that, I wouldn't be angry." (They genuinely believe this.)

Psychologists recommend you address the source of conflict in a non-confrontational way

People talk about empathy easily enough but it's a different kettle of fish when you've got to practice it in real time.

[LinksEtc]

Tweeted by @CUsafepatient

"The Empowered Patient Coalition Launches New Website To Help You Navigate the Health Care System"
http://safepatientproject.org/posts/5334-the-empowered-patient-coalition-launches-new-website-to-help-you-navigate-the-health-care-system

Many of us in the patient safety world have heard the term "patient engagement," but what does that term really mean?

--------------------------


Tweeted by @amcunningham

The ethics of health organisations monitoring social media #justiceforlb #nhssm #hcsm ...inkinginmedicaleducation.blogspot.com/2014/10/the-et...

Warning - some language in links
http://wishfulthinkinginmedicaleducation.blogspot.com/2014/10/the-ethics-of-health-organisations.html?spref=tw

Sara obtained this memo today through a Freedom of Information request. It details how Sara's blog had been monitored by the comms team from as soon as they were aware of it in March 2013 shortly after his admission to the unit. It specifically mentions this post in May 2013 just over half way through Connor's admission, where Sara described her distress at realising that Connor had a seizure but not being able to convince the staff that this was the case. Last week Sara was told by the Chairman of the Board that there had been no monitoring of her blog.

[LinksEtc]

"Facebook Health? Thumbs Down"
http://www.informationweek.com/healthcare/patient-tools/facebook-health-thumbs-down/a/d-id/1316358??itc=edit_in_body_cross%20

While I'll post the occasional complaint about a headache or flu on my Facebook feed, I am uncomfortable about entrusting Facebook (under any name) with deeper insight into any medical information beyond the odd ache or pain.

---------------------------


Tweeted by @charlesornstein

"Prescription Database Privacy Case Heads For Legal Showdown"
http://www.informationweek.com/healthcare/security-and-privacy/prescription-database-privacy-case-heads-for-legal-showdown/d/d-id/1316452?page_number=2

"You're weighing two very important interests: Is the government being [allowed] to do [a] proper investigation when it's called for?" Or are citizens' right to privacy being trampled, said Fenton. "It's not only physician rights. It's not only issues related to IT. It's patient rights. It's consumer rights. It's right to privacy. It's government intrusion."

[LinksEtc]

Tweeted by @hhask

Excerpt From 'Being Mortal ... '
http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/47973

Now, more than a decade after I first told Mr. Lazaroff's story, what strikes me most is not how bad his decision was but how much we all avoided talking honestly about the choice before him. We had no difficulty explaining the specific dangers of various treatment options, but we never really touched on the reality of his disease.

-------------------------------------


Tweeted by @JBBC

"For patients, knowledge is power"
http://medcitynews.com/2014/10/patients-knowledge-power/#.VC5r7pkNUPc.twitter

What patients think, or even know, what they're entitled to know about their own medical record and what physicians and health systems think a patient should have access to continues to vex both sides of the equation, but the scale is tilting more toward a patient-focused mentality, even among regulators.

[LinksEtc]

Tweeted by @LizSzabo

"40,000 suicides annually, yet America simply shrugs"
http://www.usatoday.com/longform/news/nation/2014/10/09/suicide-mental-health-prevention-research/15276353/

The nearly 40,000 American lives lost each year make suicide the nation's 10th-leading cause of death, and the second-leading killer for those ages 15-34.

----------------------


Tweeted by @HeartSisters

When doctors can't say: "I don't know"
http://myheartsisters.org/2014/01/03/when-doctors-cant-say-i-dont-know/

And Dr. Stuart Foxman suggests offering this reassuring bit of truthfulness to patients:

"I don't know – but I'll do my best to find out for you."

[LinksEtc]

Tweeted by @JBBC

'Instagram for Doctors': Avoiding the Dangers of Social Media in Healthcare
http://jarrardinc.com/2014/09/instagram-doctors-avoiding-dangers-social-media-healthcare/

Ever wonder what your doctors and nurses talk about at the water cooler? Well, grab a paper cup and some Emetrol, because a new app is transporting medical chatter from hospital hallways to mobile devices.

The word "HIPAA" began echoing in my head.

--------------------------------------


Tweeted by @HealthcareWen

"MD slang not just disrespectful, it can kill"
http://www.thesudburystar.com/2014/10/11/md-slang-not-just-disrespectful-it-can-kill

Mental health patients are more likely to be misdiagnosed, less likely to be screened for cancer and diabetes, more likely to die and to die at a younger age because their problems are undetected or neglected.

conversations have to take place even if they are uncomfortable.

"I believe from honest talk comes good things," said Goldman.

[LinksEtc]

Tweeted by @HeartSisters

"Researchers openly mock the 'myth' of women's unique heart attack symptoms"
http://myheartsisters.org/2011/11/01/researchers-dispute-womens-unique-heart-attack-symptom/

There seems indeed to be little if any "confusion" among women that chest pain is their predominant heart attack symptom.

That's why I despair when I hear of these potentially misleading pronouncements from experts, who are then widely quoted in the media.

----------------------


Tweeted by @DrDuaneAllergy

Why Doctors Are Sick of Their Profession
American physicians are increasingly unhappy with their once-vaunted profession, and that malaise is bad for their patients
http://tinyurl.com/n75nnva

All too often these days, I find myself fidgeting by the doorway to my exam room, trying to conclude an office visit with one of my patients. When I look at my career at midlife, I realize that in many ways I have become the kind of doctor I never thought I'd be: impatient, occasionally indifferent, at times dismissive or paternalistic.

[LinksEtc]

Tweeted by @HeartSisters

Doctors: the patient I'll never forget
Steven is on his fourth liver transplant; Nigel has operated on him 10 times. Four doctors and their extraordinary patients tell their stories
http://www.theguardian.com/society/2014/oct/11/doctors-the-patient-i-will-never-forget

When other medical staff couldn't find a solution, Professor Heaton took charge. I wasn't going to argue – I was just looking for anything. I owe him my life. He's had to put in a huge amount of hard work to keep me alive. He is amazing – it's as simple as that.

--------------------------------


Tweeted by @subatomicdoc

"Wearer be warned: your fitness data may be sold or used against you"
http://theconversation.com/wearer-be-warned-your-fitness-data-may-be-sold-or-used-against-you-31283?utm_content=buffer38c51&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

People may be denied credit, housing, employment or insurance, for example, if their medical data were readily accessible.

[LinksEtc]

Tweeted by @HeartSisters

"You've done the right thing by coming here today"
http://myheartsisters.org/2014/10/12/you-have-done-the-right-thing-by-coming-here-today/

Thinking back as an inexperienced Emergency Department doctor and an exhausted GP, particularly before I had children of my own, I have no doubts that I left parents feeling bad about wasting my time.

Whether we are seeking medical help for ourselves or for our children, how doctors and nurses respond to our concerns can have a profound impact on our sense of being competent healthcare decision-makers.

-------------------------------------------


Tweeted by @Skepticscalpel

"Six Sigma vs Ebola14 Responses"
http://thehealthcareblog.com/blog/2014/10/12/six-sigma-vs-ebola/

Allow me to make a more modest proposal. Find three physicians and three nurses, professionally orthodox, yes I do mean old school, and liberally endowed in common sense, who are illiterate in modern managerial speak.

Be afraid. Very afraid. Not of Ebola, but of the fragility and costs of medicine

[LinksEtc]

Tweeted by 99u

"Struggling to Explain? Say It like They're Twelve."
http://99u.com/workbook/32973/struggling-to-explain-say-it-like-theyre-twelve

Have you ever met with blank stares when trying to explain a difficult concept?

--------------------------------


Tweeted by @AACMaven

"Fear of Vaccines Goes Viral"
http://www.nytimes.com/2014/10/12/nyregion/fear-of-vaccines-goes-viral.html?_r=0

Within the American Academy of Pediatrics there has been a rancorous debate about whether doctors should see un-immunized patients, and the academy's position has leaned toward an inclusive approach. But, Dr. Horwitz said, "we were spending a lot of time talking to parents who weren't immunizing and who were terribly ill informed.

[LinksEtc]

Tweeted by @WSJ

"Genetic Testing for Alzheimer's—Without Revealing the Results
Doctors Find Ways to Examine DNA Without Telling Patients Their Odds for Inherited Diseases"
http://online.wsj.com/articles/genetic-testing-for-alzheimerswithout-revealing-the-results-1413221509?mod=e2tw

Last year, the American College of Medical Genetics recommended that incidental findings of 56 genes representing several conditions must be disclosed to patients. The guideline sparked a firestorm in the genetics community about whether doctors should ignore a patient's right to say no and why these genes should be the ones for mandatory disclosure.

------------------


Tweeted by @hhask

"Hospital Restores 'Butt-Slapping' Surgeon's Privileges
Is hospital more focused on its bruised bottom line?"
http://www.outpatientsurgery.net/outpatient-surgery-news-and-trends/general-surgical-news-and-reports/hospital-restores-butt-slapping-surgeon-s-privileges--10-07-14

St. Joseph's Hospital Health Center in Syracuse, N.Y., which took a big financial hit after suspending high-volume, "butt-slapping" orthopedic surgeon Michael Clarke, MD, has decided to restore Dr. Clarke's privileges.

[LinksEtc]

Tweeted by @HeatherM211

"With Electronic Medical Records, Doctors Read When They Should Talk"
http://mobile.nytimes.com/blogs/well/2014/10/13/with-electronic-medical-records-doctors-read-when-they-should-talk/?ref=science

This man had by then recounted the long story of his bad leg to three separate teams of doctors and nurses. I was the 14th interrogator by my count, and despite my standard opening gambit ("I know you've been over this before") I was the one to flip his switch: The patient ordered me and my team out of his room and pulled the covers over his head.

-----------------------


Tweeted by @joyclee

"Flipping the Concept of Health Literacy
Patient problem or healthcare problem?"
https://medium.com/@joyclee/flipping-the-concept-of-health-literacy-189edea1f31c

We all know that the "operating system" and "user experience" of healthcare is complicated and problematic; yet we expect the user to adapt to our impossible to navigate systems and respond to our difficult to understand communication tools. If the user fails to master our obtuse system, we label them as having low "health literacy" (check out over 7000 articles published on the topic in Pubmed!).