Docs helping patients to surf the internet

[LinksEtc]

How to be a "good" patient
http://myheartsisters.org/2011/08/09/how-to-be-a-good-patient/

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"My lowly beginnings as an empowered patient"
http://myheartsisters.org/2012/09/16/my-lowly-beginnings-as-an-empowered-patient/

But the research also found that patients in this empowered group are the most demanding but also the most rewarding. Although they may be more willing to change doctors, once they've found a person they can work with, they are more likely to stick with that health care provider.

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"Patient engagement as described by 31 non-patients"
http://myheartsisters.org/2014/07/06/patient-engagement-via-31-non-patient-voices/

You don't have to delve too far along into the other interviews here before bumping into big fat differences in how patients and non-patients answer identical interview questions about patient engagement.

---

"Here to Stay: What Health Care Leaders Say About Patient Engagement"
http://www.cfah.org/engagement/research/here-to-stay

[LinksEtc]

Tweeted by @AllenFrancesMD

"How Not To Talk To Someone Dying Of Cancer"
http://www.psychologytoday.com/blog/saving-normal/201409/how-not-talk-someone-dying-cancer

He should have entered the room with a bright smile and said something like: ":Congratulations. Great news: it's not your cancer causing these new problems. There are four different possible explanations.

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Tweeted by @ElaineSchattner

MT @DrRichardBesser @ThisWeekABC: Does your family know your on end-of-life wishes? Start a conversation theconversationproject.org

http://theconversationproject.org

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Tweeted by @kevinmd

"The evolving physician role in end of life decision making"
http://www.kevinmd.com/blog/2014/08/evolving-physician-role-end-life-decision-making.html?utm_content=bufferf1c11&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

"Students, you should never tell a patient of the diagnosis of cancer," pontificated our chief of surgery.  "You should protect them and not give them a fatal diagnosis.

The use of coordinated care with hospice and home health care is now allowing most patients to die where they wish — in their home or at least in a home-like environment.

[LinksEtc]

"What Drug Ads Don't Say"
http://www.nytimes.com/2016/04/24/opinion/sunday/what-drug-ads-dont-say.html?smid=tw-share&_r=1

the goal of drug companies is not to educate, but to sell products

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Tweeted by @CatchTheBaby

"Overwhelmed by patient load, many docs plan to cutback hours, services"
http://www.fiercepracticemanagement.com/story/overwhelmed-patient-load-many-docs-plan-cutback-hours-services/2014-09-16?utm_campaign=SocialMedia

More than 80 percent of physicians surveyed say they have reached their limit on how many patients they can see in a day and many plan to cut back on their services within the next three years by turning patients away or reducing their office hours.

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Tweeted by @ElaineSchattner

"The Famous Can Present a Minefield for Doctors"
http://www.nytimes.com/2014/09/22/nyregion/joan-rivers-treatment-seen-as-possible-example-of-vip-syndrome.html?smid=tw-share

Standing up to a V.I.P. patient can be difficult. Dr. Klitzman remembered once taking care of the daughter of a "household name" writer. "The household name was a very powerful presence and wanted things their way," he said. "It took more gumption than I usually had to stand up and say what was best for the patient."

[LinksEtc]

"How to get the answers you want from a survey"
http://skepticalscalpel.blogspot.com/2014/09/how-to-get-answers-you-want-from-survey.html

Judging from the way the questions are framed, I think the message will be clear.

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Tweeted by @lucienengelen

"Listen to patients first"
http://www.bmj.com/content/349/bmj.g5765

High death rates galvanised quality improvement and innovative change in one of the Netherland's largest hospitals, transforming it into a model for patient participation, reports Tessa Richards

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Tweeted by @drval

"Will Healthcare Reform Destroy The ePatient Movement?"
http://jordan-inmyhumbleopinion.blogspot.com/2014/09/will-healthcare-reform-destroy-epatient.html?m=1

Thus physicians become the steward of the population, allocating these resources as they see fit to benefit the community.

This version of healthcare is the complete antithesis of the ePatient movement.   Medical decisions are not inclusive, not patient centric, and not up for debate.

---

"Why I Hope to Die at 75
An argument that society and families—and you—will be better off if nature takes its course swiftly and promptly"
http://www.theatlantic.com/features/archive/2014/09/why-i-hope-to-die-at-75/379329/

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Tweeted by @TIME

"Why Dying Is Easier for Doctors"
http://time.com/3194806/why-dying-is-easier-for-doctors/

What's unusual about them is not how much treatment they get compared to most Americans, but how little. For all the time they spend fending off the deaths of others, they tend to be fairly serene when faced with death themselves. They know exactly what is going to happen, they know the choices, and they generally have access to any sort of medical care they could want. But they go gently.

[LinksEtc]

"Preventing Overdiagnosis: Plenary Three - Allen Frances"
https://m.youtube.com/watch?v=sMBeiENDqT4

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


AAAAI - Choosing Wisely


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



Tweeted by @DrVes

"American College of Cardiology removes one of its choosing wisely recommendations in light of recent evidence"

http://doctorrw.blogspot.com/2014/09/american-college-of-cardiology-removes.html?utm_content=buffer9da1c&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

We must be very cautious about putting something on the "do not" list. I think the campaign has been a little hasty in some of its recommendations.

Is it wrong that this cracks me up?


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



Tweeted by @sgreene24

"How Are We Today? Study Lets Patients Help Write Medical Notes, Google Doc Style"
http://commonhealth.wbur.org/2015/01/our-open-notes-medical-records

what if you could not just see your doctor's medical notes but actually comment on them and contribute to them?

That's the next step, says Jan Walker, co-director of the "OpenNotes" project and a researcher at Beth Israel Deaconess and Harvard Medical School. With a new $450,000 grant from The Commonwealth Fund, researchers plan to develop and test "OurNotes," an interface that will invite patients to contribute to their own medical notes.

[LinksEtc]

"Internists, Specialists Lack Knowledge About FDA Drug Approval Process"
Tara Haelle
April 12, 2016
Medscape

"Physicians tended to overestimate the minimum evidence of efficacy required of new drugs," write Aaron S. Kesselheim, MD, JD, MPH, from Brigham and Women's Hospital in Boston, Massachusetts, and his colleagues. "Similarly, many misinterpreted the term breakthrough—believing these drugs were supported by stronger evidence than required by the statute."

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


"Patient Experts, the Maker Movement, and Online Communities"
https://medium.com/@joyclee/patient-experts-the-maker-movement-and-online-communities-ef5b192cebf2#.r43mlvy74

In our commentary, we discuss a variety of challenges, including safety issues, legal liability issues, regulatory issues, and possible disparities in healthcare access to CGM and mobile technology, but perhaps one of the biggest challenges lies at the intersection of technology and culture.

Healthcare stakeholders, it is time to embrace not only new technologies (mobile technology and social media) but a new participatory culture, which welcomes patients as partners for achieving innovation and transformation inside the healthcare ecosystem.

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Tweeted by @MountSinaiNYC

"Many Parents Use Online Ratings to Pick a Pediatrician, Study Finds"
http://tinyurl.com/lgsgszr


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"This Restaurant Wants to Be the Worst Rated on Yelp, and the Reviews Are Indeed Hilarious"
http://www.adweek.com/adfreak/restaurant-wants-be-worst-rated-yelp-and-reviews-are-indeed-hilarious-160299

The site sent Botto Bistro a threatening little letter, but Cerretini refuses to back down, claiming he's attracting higher-paying customers who are quite loyal. Not to mention, damn funny.

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Tweeted by @RichDuszak

"Be wary of doctor-rating sites: Column"

"Best physicians aren't always the ones who have high satisfaction rates among patients."

http://www.usatoday.com/story/opinion/2014/09/14/kevin-pho-doctor-ratings-medicine-health-patient-satisfaction-column/15340309/

In a survey by Emergency Physicians Monthly, 59% of emergency physicians said patient satisfaction surveys increased the amount of tests they ordered.

[LinksEtc]

What a great idea!

Tweeted by @HopkinsMedicice

"Radiation Watchdogs"
http://tinyurl.com/qeajr6k

Part of the new model Huisman will test—good anecdotal evidence that it's working already exists—turns on pediatric radiologists. He sees them as gatekeepers, questioning the need for every CT scan ordered and offering advice on radiation-free alternatives. "A two-minute conversation in the hallway can mean the difference between an ultrasound and a CT," he says.

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I've seen education campaigns aimed at parents to consider risks-benefits (http://www.imagegently.org), but to have a medical professional act as that safety/perspective/alternative advocate is such a good idea.

Before I became kind of a pain-in-the-bu** strong-advocate mom, I'm pretty sure that I agreed to too many radiological tests (the docs were insisting that the tests were needed) ... some of them were probably necessary, but could some have been avoided?  There's nothing that I can do about this now, what's done is done, but this is one of my biggest regrets regarding medical stuff for dd.

[LinksEtc]

Tweeted by @HeartSisters

A preposterous decision! #ESMO2014 Cancer Congress bans media, nurses, pt advocates from Exhibits/Symposia biotechstrategyblog.com/2014/08/esmo-2... via @JBBC

http://biotechstrategyblog.com/2014/08/esmo-2014-cancer-congress-bans-press-nurses-and-patient-advocates-from-exhibits-and-symposia.html/

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Tweeted by @kevinmd

"Vulnerability is a virtue in medicine"
http://www.kevinmd.com/blog/2014/09/vulnerability-virtue-medicine.html

If physicians opened themselves up emotionally to every patient they would simply not be able to cope. Although the thought might be nice, the idea that physicians are superhuman is incorrect. Doctors make mistakes, experience heartache, and need outlets to express themselves.

This authenticity is what is most important in the physician-patient relationship.

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

[LinksEtc]

"7 ways patients can help reduce medication errors"
http://www.kevinmd.com/blog/2014/08/7-ways-patients-can-help-reduce-medication-errors.html?utm_content=buffer42af1&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

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

Tweeted by @JediPD

"Tyranny of Perfection
Why do doctors have such a high rate of suicide?"

http://tinyurl.com/kx2a75e

covering all aspects of your patient's health, following up on every test result, battling with documentation, navigating insurance company hurdles and administrative mandates. You are exhorted to be cost-effective, time-efficient, patient-centered, and culturally competent. You must be conscious of patient satisfaction and quality indicators. You must avoid liability but not over-order tests. You must document extensively but not keep patients waiting. You must comply with every new administrative regulation and keep up your board certifications. And you must of course achieve those all-important "productivity measures."

 


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


Tweeted by @hhask


"Why Bad Doctors Are Like Bad Writers: The Curse Of Knowledge"
http://www.forbes.com/sites/larryhusten/2014/09/27/why-bad-doctors-are-like-bad-writers-the-curse-of-knowledge/

When the host interrupted and asked him to explain the work more clearly, he seemed genuinely surprised and not a little annoyed. This is the kind of stupidity I am talking about.

Call it the Curse of Knowledge: a difficulty in imagining what it is like for someone else not to know something that you know.

[LinksEtc]

Tweeted by @hhask


"The Unholy Alliance between Organized Medicine and Government: A Father's Quest for Truth and Justice in Public Health Care"   (Canada)
http://thepatientfactor.com/canadian-health-care-stories/the-unholy-alliance-between-organized-medicine-and-government-a-fathers-quest-for-truth-and-justice-in-public-health-care/

Unlike their motto "We speak for the dead to protect the living", Arnold found that they weren't saying very much at all.

The lack of transparency and accountability spurred Arnold to submit an appeal to the Health Professions Appeal and Review Board (HPARB), a government administrative tribunal that reviews CPSO decisions for "adequacy and reasonableness".

"The government knows you're up against a brick wall," Arnold says, "financially you can't compete."

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Tweeted by @allergyPhD

10 commandments of evidence-based blogging (and other forms of research writing too!) @FoodAllergy #fablogcon pic.twitter.com/KZRTUDdrE3

https://mobile.twitter.com/allergyPhD/status/515920575110586368/photo/1

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Tweeted by @hhask

"A Qualitative Analysis of Physician Perspectives on Missed and Delayed Outpatient Diagnosis: The Focus on System-Related Factors"
http://www.ingentaconnect.com/content/jcaho/jcjqs/2014/00000040/00000010/art00004

Background: Delayed and missed diagnoses lead to significant patient harm. Because physician actions are fundamental to the outpatient diagnostic process, a study was conducted to explore physician perspectives on diagnosis.

Concerns about health system structure and providers' interactions with one another and with patients far exceeded discussion of the cognitive factors that might affect the diagnostic process. The results suggest that, at least in physicians' views, improving the diagnostic process requires attention to the organization of the health system in addition to the cognitive aspects of diagnosis.

[LinksEtc]

Tweeted by @amcunningham

Humour helps health professionals to cope. But is more needed? And if so, what?

"MEdIC Series | The Case of the Backroom Blunder"
http://www.aliem.com/medic-series-case-backroom-blunder/#comment-1609378519

Dr. Elliott had seemed so nice and sympathetic to the family... was that all pretend? A fake show of sympathy?! Now Trevor was angry.

Black humour has been used as a coping strategy for stressful or traumatic events. Is this appropriate in a patient-centered care world?

-----

"MEdIC Series: The Case of the Backroom Blunder – Expert Review and Curated Commentary"
http://www.aliem.com/medic-series-case-backroom-blunder-expert-review-curated-commentary/

Although argot may be useful to reduce physician and trainee anxiety, there is no question that slang or argot is often unprofessional[6]. The real issue is what to do when one hears it.

expectations are unfair and unrealistic. Each one of these traits is a skill that needs to be developed, nurtured and mentored over time.

[LinksEtc]

Tweeted by @Aller_MD

"An electronic revolution in the doctor's bag"
http://www.bbc.com/news/magazine-29376437

And it raises the question: What does this do to the professional - does the doctor become a coach, a servant or an adviser - what will the new role be?"

"The role of the doctor, ironically, must be to go back to the bedside," he says. "To be an interpreter of symptoms - so we can learn every possible aspect of what the patient is feeling and experiencing - then input the information into an iPad and come out with a list of all potential diagnoses."

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


Tweeted by @theNPSF

"October Is Health Literacy Month"
http://hosted-p0.vresp.com/803409/b2347847e6/ARCHIVE

Developed by health literacy experts, the Ask Me 3 program encourages patients and families to ask the following key questions of their providers to better understand their health conditions and what they need to do to stay healthy:

What is my main problem?
What do I need to do?
Why is it important for me to do this

[LinksEtc]

Tweeted by @drlynnwilson

"The physician's role and empathy – a qualitative study of third year medical students"
http://www.biomedcentral.com/1472-6920/14/165/

This study suggest that the described inhibitors of empathy may originate in the hidden curriculum and reinforce each other, creating a greater distance between the physician and the patient, and possibly resulting in decreased empathy.

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


Tweeted by @amcunningham

"Loss of innocence"
http://www.cfp.ca/content/49/10/1275.full.pdf

Empathy draws me closer to patients. However, I am afraid of the disappointment when bad news arises.

Should I be more distant as a defence to keep me sane?

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


Tweeted by @JBBC

"Listening to patients with cancer: using a literary based research method to understand patient-focussed care"
http://tinyurl.com/mbpj48y

Patients often held different views from those traditionally held by physicians of what constitutes health and good outcomes.

[LinksEtc]

Tweeted by @JBBC

"Dr. Anonymous – Blogger, Podcaster, Early Adopter"
http://www.getsocialhealth.com/dr-anonymous-blogger-podcaster/

One of the original physician bloggers, Mike started blogging in 2005 under the nom de plume of "Dr. Anonymous." As Mike recounts, pre-HIPAA physician blogging was generally under the radar using pseudonyms to allow physicians the ability to speak their minds and "rant" against the system.

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


Tweeted by @theNPSF

"End-of-life care needs concrete reforms, not sweeping rhetoric"
http://www.bostonglobe.com/opinion/editorials/2014/09/27/dying-america-end-life-care-needs-concrete-reforms-not-sweeping-rhetoric/07idtEnnwhQAvIoGb1hINN/story.html?event=event25

HOW TO obtain proper end-of-life care and die with dignity is a conversation topic that most patients and their doctors would prefer to postpone as long as possible. It is also a politically fraught issue

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


Tweeted by @tessajlrichards

"Should patient groups be more transparent about their funding?"
http://www.bmj.com/content/349/bmj.g5892

Patient groups often shout loudly for access to drugs but are quieter about their links to industry. Sophie Arie and Chris Mahony ask whether this is acceptable given increasing demands for transparency elsewhere in medicine

[LinksEtc]

Tweeted by @99u

"The Most Important Skill for Great Leaders? Trustworthiness."
http://99u.com/articles/32883/the-most-important-skill-for-great-leaders-trustworthiness

The question "Can I trust you?" is always on our minds whenever we interact with other people (particularly when we meet them for the first time) though we usually aren't consciously aware of asking it.

It's amazing how much I trust some of you FASers.   

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


Tweeted by @JBBC

"Social media and online health services: A health empowerment perspective to online health information"
http://www.sciencedirect.com/science/article/pii/S0747563214004063

This study investigates how differences in the use of online health information and social media affect the use of online health services.

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


Tweeted by @DrVes

"From Blogging to Tweeting to Facebook"
http://tinyurl.com/o995tth

In Anne Ellis' (Allergy & Immunology, Department of Medicine) Medical Grand Rounds talk1, she zeroed in on this topic. Anne points out that the use of social media in health care has changed the face of research and the way that clinicians interact with patients.