Docs helping patients to surf the internet

[LinksEtc]

On Being A 'Difficult' Patient
http://content.healthaffairs.org/content/27/5/1416.full

In the clinical world, the term difficult is applied to a variety of patients: the noncompliant; the rude, abusive, and manipulative; the malingering; the mentally ill; the skeptical. In my case, I too frequently challenged my doctors with questions and too often chose a treatment that differed from what they'd recommended.

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"The myth of the difficult patient: Blame the system instead"
http://www.kevinmd.com/blog/2013/02/myth-difficult-patient-blame-system.html

Patients are called "difficult" by those in the health care world for many different reasons, but it seems that families of kids with special health care needs face this label more often than most. When someone tells me my patient's parent is being "difficult" what they often mean to say is, "time consuming," "asks too many questions," or "is too involved."

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Tweeted by @sjauhar

"When Health Ignorance Is Bliss"
http://www.theatlantic.com/health/archive/2014/10/when-health-ignorance-is-bliss/381370/

By avoiding the medical test, Walker is part of a phenomenon referred to as information aversion, or the "ostrich effect" (which comes from the myth that ostriches, when in danger, bury their heads in the sand).

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Tweeted by @ElaineSchattner

"Balancing the Patient Experience with Evidence-Based Medicine"
http://blogs.einstein.yu.edu/balancing-the-patient-experience-with-evidence-based-medicine/

Recently, Dr. Peter Kramer published an intriguing, well-written, but poorly reasoned and potentially dangerous "thought piece" in the New York Times. His article, "Why Doctors Need Stories," contains several logical flaws and erroneous arguments, but the overarching concept is a classic "straw man" argument.

[LinksEtc]

Tweeted by @SeattleMamaDoc

"Can a Patient Teach Medical School?"
http://33charts.com/2014/10/patient-teach-medical-school.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+33Charts+%2833+Charts%29

The Mayo Clinic announced that e-Patient Dave deBronkart would serve as the 2015 Visiting Professor

the patient voice in medical education has received recent attention from the education community through Stanford's Medical Education in the New Millennium

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Tweeted by @ElaineSchattner

@ePatientDave TY for pointing out that anti-patient rant. It's among the most offensive pieces I've read on pharma & health care priorities.

The Problem with Patient Power
http://www.forbes.com/sites/davidgrainger/2014/11/03/the-problem-with-patient-power/

Of course, like all such trends the importance of patient action groups will eventually fade. Once every possible cause has an equally well-oiled media machine, the impact of any individual special interest declines back to baseline.

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Tweeted by @rzeiger

"A conversation with Abraham Verghese"
http://stanmed.stanford.edu/2015spring/time-lines.html

I get impatient with physician essays that revolve around a physician encountering medicine as a patient, often for the first time. And with it comes suddenly this epiphany about life and the nature of medicine. And I always think, "Really? It took that experience for you to understand this?

a sense of this being hallowed ground. You're entering sacred space and given the great privilege to see people in distress and to treat.

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Tweeted by @Atul_Gawande

"The Importance of Sitting With Patients"
http://well.blogs.nytimes.com/2015/03/19/the-importance-of-sitting-with-patients/?_r=1

On some level, though, efficiency-empathy trade-offs are an inevitable and inherent tension in medicine — a function of busy hospitals with complex patients and limited personnel and resources. But I wonder also if this is a trade-off we too readily accept and whether the pendulum has swung too far toward the alter of efficiency.

&

"Less Medicine, More Health from Dr. Gilbert Welch"
http://www.beaconbroadside.com/broadside/2015/03/less-medicine-more-health-from-dr-gilbert-welch.html

I take great pleasure in introducing this very surprising video, based on an equally surprising (and highly entertaining) new book, Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care  by Dr. H. Gilbert Welch, who taught us all so much  in his last book, Overdiagnosed: Making People Sick in the Pursuit of Health.

[LinksEtc]

Tweeted by @WSJ

Should Companies Monitor Their Employees' Social Media?
http://online.wsj.com/articles/should-companies-monitor-their-employees-social-media-1399648685?mod=e2tw

It's becoming an increasingly important question. The number of people fired over social-media posts is rising, and many employers look closely at a job candidate's online presence before making a decision.

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Tweeted by @ashishkjha

"The Supreme Court will hear King. That's bad news for the ACA."
http://theincidentaleconomist.com/wordpress/the-supreme-court-will-hear-king-thats-bad-news-for-the-aca/

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Tweeted by @kevinmd

"When patients seek a second opinion: It's not about you"
http://www.kevinmd.com/blog/2014/11/patients-seek-second-opinion.html

Clinicians cannot and should not claim "ownership" over their patients. We are here to provide — treatment, information, assurance, and comfort.

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Tweeted by @charlesornstein

"Emails reveal nursing home lobbyists pressuring state on lawsuits"
http://m.wtae.com/news/emails-reveal-nursing-home-lobbyists-pressuring-state-on-lawsuits/31218066

An expert in government ethics said the emails reveal an overly cozy relationship between the nursing home lobby and the state's nursing home regulators who are supposed to be protecting the public.

[LinksEtc]

Tweeted by @DrVes

"Naturally Occurring Peer Support through Social Media: The Experiences of Individuals with Severe Mental Illness Using YouTube."
http://tinyurl.com/n8ptjzw

Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain.

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Tweeted by @lucienengelen

"Speechless for manifesto to change healthcare."
https://www.linkedin.com/today/post/article/20141027155246-19886490-speechless?_mSplash=1

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Tweeted by @Atul_Gawande

http://www.bbc.co.uk/programmes/b04sv1s5

The surgeon and writer Atul Gawande argues that better systems can transform global healthcare by radically reducing the chance of mistakes and increasing the chance of successful outcomes.

&

The podcast for my third BBC Reith Lecture on the Future of Medicine is now up! bbc.in/1vzFl1H

http://www.bbc.co.uk/podcasts/series/reith

In the 2014 Reith Lectures series, entitled The Future of Medicine, Dr Atul Gawande examines the nature of progress and failure in medicine. The first programme will be available to download on Tuesday 25 November.

[LinksEtc]

Tweeted by @AllergyNet

Dr Google: 1) Disregard if anonymous 2) Check primary source 3) Check author qualifications 4) Discuss with your medical doctor

&

Dr Google: Child's death via online advice. Reported by @iEMPharmD @Nadia_EMPharmD

"Inspiring Change Through Social Media: Our Moral Responsibility in 140 Characters or Less"
http://empharmd.blogspot.com.au/2015/10/inspiring-change-through-social-media.html

One of the cases presented featured a bizarre and tragic case of hyperacute sodium toxicity in a pediatric patient occurring as a result of the caregiver administering a sea salt slurry as homeopathic therapy for constipation. The caregiver followed instructions posted on the website livestrong.com, and as the case unfolded with the consequential effects occurring in this patient, we were captivated by the recounted events leading to the untimely death of the patient.

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Tweeted by @EricTopol

"When Medical Apps Do More Harm Than Good"
Replacing clinic visits with smartphones can be a risky move. Here's why.

http://www.motherjones.com/environment/2015/01/medical-apps-not-helping

Most health apps, though, are classified as "informational" or "entertainment" to escape FDA oversight. But their marketing talk can send confusing signals.

For now, it's consumer beware.

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Tweeted by @pash22

How social media can change health professional education via @amcunnningham slideshare.net/amcunningham/h... via @SlideShare

---

http://www.slideshare.net/mobile/amcunningham/how-social-media-can-change-health-professional

[LinksEtc]

Tweeted by @DrLeanaWen

Giving the Doctor a Second Chance
http://well.blogs.nytimes.com/2014/10/23/giving-the-doctor-a-second-chance/?_php=true&_type=blogs&_php=true&_type=blogs&ref=health&_r=1

Though "objective" measures of "quality" abound in medicine these days, getting meaningful feedback is actually quite rare. Getting it directly from a patient, rather than on a spreadsheet from an institution, is rarer still.

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Tweeted by @SusannahFox

Can this ad campaign get people in Belgium to stop Googling their symptoms? wapo.st/1u6F3ne (HT @etkeld)

"Can this ad campaign get people in Belgium to stop Googling their symptoms?"
http://www.washingtonpost.com/news/to-your-health/wp/2014/11/11/can-this-ad-campaign-get-people-in-belgium-to-stop-googling-their-symptoms/


#GoodLuckWithThat

[LinksEtc]

Tweeted by @SusannahFox

"Viewing patient engagement through the lens of pathology"
http://mobihealthnews.com/37608/viewing-patient-engagement-through-the-lens-of-pathology/

The key to cracking patient engagement isn't better kinds of technology, it's understanding patients better.

"One of the ways we're trying to change that paradigm is to change the way our clinicians are thinking about this from 'What's the matter with you?' to 'What matters to you?'"

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Tweeted by @nprnews

"The 2 Things That Rarely Happen After A Medical Mistake"
http://www.npr.org/blogs/health/2014/11/21/365213963/the-2-things-that-rarely-happen-after-a-medical-mistake?utm_campaign=storyshare&utm_source=twitter.com&utm_medium=social

Patients who suffer injuries, infections or mistakes during medical care rarely get an acknowledgment or apology, researchers at the Johns Hopkins University School of Medicine report.

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Tweeted by @hhask

"Questions the FDA May Soon Address in Response to Recent "Superbug" Outbreaks Linked to GI Endoscopes"
http://endoscopereprocessing.com/2015/01/questions-fda-may-soon-address-response-recent-superbug-outbreaks-linked-gi-endoscopes/

This Seattle newspaper's article reported for the first time that neither the hospital's officials nor the Department of Public Health Public Health (Seattle and King County, Seattle, WA) — which, along with the federal Centers for Disease Control and Prevention (CDC), had assisted the hospital's investigation of the cause and source of its CRE outbreak beginning in 2012 — informed the more than 30 impacted patients (and their families) that this deadly outbreak was the cause of their infections and may have contributed, at least in part, to 11 patient deaths.

[LinksEtc]

Tweeted by @IanJohnPereira

"Social Media - Appropriate Use by Physicians"
http://www.cpso.on.ca/policies-publications/positions-initiatives/social-media-appropriate-use-by-physicians#11

Refrain from establishing personal connections with patients or persons closely associated with them online, as this may not allow physicians to maintain appropriate professional boundaries and may compromise physicians' objectivity.  It is acceptable to create an online connection with patients for professional purposes only.

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Tweeted by @JacquieGS

"6 warning signs that online health information may be unreliable"
http://doctorsbag.net/2014/11/25/6-warning-signs-that-online-health-information-may-be-unreliable/

This doesn't mean that other websites are always unreliable, but it's good to find out who is sponsoring or paying for a commercial website (.com or .com.au) before relying on the information. You particularly want to know if the information favors the sponsor.

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Tweeted by @Allergy

"Google adds fact-checked medical information to search"
http://www.theverge.com/2015/2/10/8010673/Google-health-data-knowledge-graph

internet-assisted hypochondriacs have been around for years now

We worked with a team of medical doctors (led by our own Dr. Kapil Parakh, M.D., MPH, Ph.D.) to carefully compile, curate, and review this information

The company doesn't want the liability of even pretending to replace doctors, but instead will give sniffling, aching, or sneezing users a starting point to carry out more research.

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Tweeted by @Paulflevy


"Dear Mayo, Did you approve this ad?
http://runningahospital.blogspot.com/2015/02/dear-mayo-did-you-approve-this-ad.html

Observers want to know:  Does this nonalphabetic list represent Mayo Clinic's view of the most likely, highest priority, or most recommended approach to this disease?

[LinksEtc]

Tweeted by @JBBC

"How can social media improve oncology care?"
http://www.oncologypractice.com/fileadmin/content_pdf/co/CO_july_212_Thompson_Feature2.pdf

Many physicians have been hesitant to join social media for real and imagined concerns. However, despite such concerns, the Mayo Clinic has embraced social media because "our patients are doing it, so this is where we need to be."

From reading all of the dry documentation discussing social media, you'd struggle to come away with any real sense of why it's so exciting and engaging.

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Tweeted by @DrVes

"Intent To Tweet And A Failure Of Communication"
http://www.forbes.com/sites/larryhusten/2014/11/24/intent-to-tweet-and-a-failure-of-communication/?utm_content=bufferb9b93&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

In this antiquated view, the whole point of social media is to amplify the size of the megaphone that the editors already have.

They take the "social" out of "media" and leave most people with... well, little or nothing.

[LinksEtc]

Tweeted by @NEJM

"Public Trust in Physicians — U.S. Medicine in International Perspective"
http://www.nejm.org/doi/full/10.1056/NEJMp1407373

We found that, as has been previously reported, public trust in the leaders of the U.S. medical profession has declined sharply over the past half century.

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Tweeted by @DrVes

"How Medical Care Is Being Corrupted"
http://www.nytimes.com/2014/11/19/opinion/how-medical-care-is-being-corrupted.html?_r=0&utm_content=buffer4170f&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

WHEN we are patients, we want our doctors to make recommendations that are in our best interests as individuals.

Insurers, hospital networks and regulatory groups have put in place both rewards and punishments that can powerfully influence your doctor's decisions.

[LinksEtc]

Tweeted by @charlesornstein

Profiting from confusion. MT @onceuponA: "You've heard of HealthCare.gov. Now meet HealthCare.com" wapo.st/1w5q9hs

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"You've heard of HealthCare.gov. Now meet HealthCare.com"
http://www.washingtonpost.com/blogs/wonkblog/wp/2014/10/24/youve-heard-of-healthcare-gov-now-meet-healthcare-com/

But health care advocates say there is the potential for massive confusion among consumers trying to find the government's official site. Users who wind up there by mistake could miss out on subsidies that most would receive if they were shopping on HealthCare.gov

[LinksEtc]

Tweeted by @2morrowknight

"23% increase in defamation actions as social media claims rise"
http://www.theguardian.com/media/greenslade/2014/oct/20/medialaw-social-media?CMP=share_btn_tw

Thomson Reuters points out that these cases can be brought against the individuals responsible for creating the defamatory material - who may be unaware of the potential legal implications of their actions - rather than against the websites hosting the content.

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Tweeted by @igrande

"Parents May Be Liable for What Their Kids Post on Facebook, Court Rules"
http://blogs.wsj.com/law/2014/10/15/parents-may-be-liable-for-what-their-kids-post-on-facebook-court-rules/

The Georgia Court of Appeals ruled that the parents of a seventh-grade student may be negligent for failing to get their son to delete a fake Facebook profile that allegedly defamed a female classmate.

[LinksEtc]

Tweeted by @subatomicdoc

'Patient engagement': a pernicious, presumptive powerplay?
http://www.linkedin.com/today/post/article/20141024091637-3248988--patient-engagement-a-pernicious-presumptive-powerplay?_mSplash=1

To speak of one's activities as being part of a 'patient engagement' initiative conveys the reassuring secondary meaning of 'something being built', or 'something getting done' that is seldom borne out in fact.

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Tweeted by @ARJalali

"Patients often hate when doctors tell them the truth"
http://www.theguardian.com/commentisfree/2014/nov/25/patients-often-hate-when-doctors-tell-them-the-truth

A US study found that nearly three quarters of patients with advanced, incurable cancer believed that chemotherapy was being given with curative intent.

In other words, the more honestly you deliver bad news, the poorer your patient satisfaction ratings – sobering news indeed in an era of increasing measurement of metrics and accountability.

[LinksEtc]

"Twitter and Facebook can affect the doctor-patient relationship"
http://www.kevinmd.com/blog/2010/06/twitter-facebook-affect-doctorpatient-relationship.html

Discuss with patients the need to document doctor-patient communication in the medical record.

But what happens to the doctor-patient relationship? So I say, lets not be so stymied by legalism that we are afraid to befriend our patients.

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



Tweeted by @charlesornstein

"Are Doctors Exposing Heart Patients to Unnecessary Cardiac Procedures?"
http://www.usnews.com/news/articles/2015/02/11/are-doctors-exposing-heart-patients-to-unnecessary-cardiac-procedures

Federal investigators were so struck by the hospital's high catheterization rates that they launched a probe of its catheterization laboratory. Last spring, the hospital agreed to pay the government $41 million to settle allegations that, between 2006 and 2011, the hospital submitted millions of dollars' worth of "false claims" to Medicare and Medicaid for performing angioplasties and implanting stents in "numerous" patients who did not need them, according to an FBI press release. The settlement terms allowed the hospital to deny wrongdoing in the case.

[LinksEtc]

"Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice"

http://library.fsmb.org/pdf/pub-social-media-guidelines.pdf

Section Two
An Appropriate Physician-Patient Relationship

These examples highlight the importance of proper boundaries within the physician-patient relationship. Even seemingly innocuous online interactions with patients and former patients may violate the boundaries of a proper physician-patient relationship.

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Tweeted by @nprnews

"Why The ER Doctor Asks Patients What's Happening At Home"
http://tinyurl.com/ozc9ck7

If you could spend a day in the ER hearing patients like I do, I think you'd see in a way that you might not have before that health doesn't exist in a vacuum.