Sunday, February 24, 2008

Patient Is a Virtue

Diagnosis: Patient Is a Virtue
Published: February 24, 2008
When faced with a tricky set of symptoms, making a determination — and doing it quickly — saves a life.

(How lucky for the patient that he was also a doctor!)

"...He explained his thinking to the patient, who listened, nodding. As he moved toward the door, the doctor-patient couldn’t resist adding one more possibility to the list: “Could I have dissected my aorta?” he asked. The aorta is the thick, muscular blood vessel that delivers oxygenated blood from the heart to the rest of the body. Sometimes the inner lining of the artery can get torn — often from a spike in blood pressure. When that happens, blood pours into the tear, creating a separate channel between the inner layers of the vessel and the outer muscular wall. This new channel can compress the arteries leading off the aorta, starving the tissues they normally feed."

Tuesday, February 19, 2008

Have You Ever Been in Psychotherapy, Doctor?

Published: February 19, 2008
A curious thing happened to one of my psychiatric residents not long ago. One of his patients caught him off guard with a challenging question: “Have you ever been in psychotherapy yourself?”
"...Psychiatrists who have had the humbling experience of therapy themselves know something of what it feels like to be a patient — the sense of frustration, anxiety and dependence it entails.
As such, they can better understand the emotional reactions patients have to their illness — and to their doctors.
I don’t know about you, but that sounds like the kind of psychiatrist I would want taking care of me."

When Doctors Become Patients

A new book talks about what happens when doctors navigate the medical system as patients.
Published: February 8, 2008
From the article:
"When doctors get sick, they discover fissures in the health system that they didn’t know existed. They learn that seemingly small annoyances they never paid attention to as doctors — like long waiting times or a broken television in a hospital room — really are a big deal when you are the patient. Even doctors who thought of themselves as compassionate recognize they can do better once they experience life as a patient."

Monday, February 18, 2008

Patient Portals: Not the Open Floodgates Physicians Fear

Studies suggest messaging raises patient satisfaction without any corresponding increase in workload.
America College of Surgeons Surgery News 02/08
See page 2.

Miracle Workers? Why we expect doctors to do the impossible

"Even today, in our high-tech, accountability-obsessed and, supposedly at least, patient-empowered times, the oldest of all relations between patient and physician — that of supplicant to shaman — continues to exert its authority. This may not seem sensible if the only valid criterion for judging the doctor-patient relationship is the use that is made of scientific data and clinical findings. But good doctors want to treat their patients, not just their patients’ diseases, and certainly most patients want to be treated as human beings, not cases. Viewed from that perspective, the elevated expectations patients bring to the consulting room may be for the best."
From the New York Times Magazine, 17.2.2008

Includes elements of the doctor-patient relationship

Books on Doctors as Patients and a few on the Doctor-Patient Relationship