How to be a good patient

How to be a good patient
From Dr. Rob

"...This handout was posted in our exam rooms.

We want you to get the best care possible in this office and hope to care for you for many years to come. If there is anything we can do to give you better care, please let us know. Yet there are some expectations we have for our patients. We ask that you read the list below and do your best to abide by these suggestions..."

Is cybermedicine turning us into a nation of expert patients?

Is cybermedicine turning us into a nation of expert patients? University of Glasgow
Issued: Tue, 11 Mar 2008 11:01:00 GMT
"Researchers from Manchester Business School and The University of Glasgow are undertaking an in-depth study into the impact of cybermedicine, such as virtual health communities and self-help sites, on face-to-face healthcare.
Funded by the NHS National Institute of Health Research Service Delivery and Organisation Programme, the research responds to the rise of the “expert patient” – who uses cybermedicine to self-diagnose – and the decline in the deference traditionally linked to professional judgement."

Seinfeld on Doctors

From Jerry Seinfeld's stand-up routine...

(and enacted by someone on YouTube...)

How to Handle a Medical Crisis

Time, Wednesday, Jul. 11, 2007 By Alice Park

One medical crisis is certainly enough to turn your world upside down. But imagine living through four of them. That's what Jessie Gruman did, with admirable resilience and laughter.

The 53-year-old social psychologist has turned her history into a practical and accessible guidebook, AfterShock, for people who are going through the same things she did — confusion, fear, and emotional seesaws — every time a doctor gave her devastating news about her health. Founder and director of the Center for the Advancement of Health, a non-partisan institute that helps patients get reliable information about their medical care, Gruman talks to TIME about her experiences and provides advice about how to weather medical storms...

Gruman's Common Sense Help for Getting Through the First 48 Hours

1. This is a crisis. Treat it as one.
Don't try to go on as though nothing is happening to you. Don't go to work for at least 48 hours, and cancel you social engagements until you get your feet back under you.

2. Protect Yourself
Talk if you want to talk, cry if you feel like it. There is no particular benefit or harm in either. Stop searching for information online if it is confusing or frightening. You will have time to learn more later.

3. Don't rush to resolve your treatment plan
The only task you must accomplish during the first 48 hours is to make sure you have set up the next doctor's appointment.

4. Eat
Even if you aren't hungry: you don't need a hunger headache. Drink, too. Water, for sure. Coffee or tea? Whatever you are used to. A little Scotch? Sure (but not the whole bottle).

5. Rest
Emotional stress is exhausting. If you can nap, do it. If you are agitated, get up and walk around the block. If nothing else, it'll remind you that the world is carrying on in spite of your news.

6. Breathe

7. Move around

8. Remember: You will not always feel like this.

—From AfterShock, by Jessie Gruman, PhD, Walker & Co., 2007.

Is There Hardening of the Heart During Medical School?

Is There Hardening of the Heart During Medical School?

Physician-Patient Relationship

Academic Medicine. 83(3):244-249, March 2008.
Newton, Bruce W. PhD; Barber, Laurie MD; Clardy, James MD; Cleveland, Elton MD; O'Sullivan, Patricia EdD

Abstract:
Purpose: To determine whether vicarious empathy (i.e., to have a visceral empathic response, versus role-playing empathy) decreases, and whether students choosing specialties with greater patient contact maintain vicarious empathy better than do students choosing specialties with less patient contact.

Patient Fired by Doctor

Patient fired by her doctor

CARLY WEEKS

From Friday's Globe and Mail,
February 29, 2008 at 8:56 AM EST

"Ms. Matthews' case illustrates the difficulty many people with mental illness have functioning in society. But it also highlights the grey area in doctor-patient relationships that can emerge when a patient is seen to refuse treatment, be unco-operative or display other behaviour that causes friction.

The Canadian Medical Association has guidelines governing the relationship between doctors and patients and says that patients should have the chance to find a new family doctor before a physician terminates treatment.

However, doctors in Canada have the right to stop seeing patients at their discretion, particularly if a patient is difficult or won't accept treatment, said Jeff Blackmer, executive director in the CMA's office of ethics."

Patient Is a Virtue

Diagnosis: Patient Is a Virtue

By LISA SANDERS, M.D.

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."

Have You Ever Been in Psychotherapy, Doctor?

By RICHARD A. FRIEDMAN, M.D.
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.

By Tara Parker-Pope

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."

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

Prevent wrong side surgery

Wrong-sided surgery happens more often than you think. Here is an article published by the New York Times this week and please take a moment to read the following tips in case you have a surgical procedure in the near future.

1. You and your surgeon should agree on exactly what will be done during the operation.
2. Ask to have the surgical site marked with a permanent marker and to be involved in marking the site. This means that the site cannot be easily overlooked or confused (for example, surgery on the right knee instead of the left knee).
   
3. Ask questions. You should speak up if you have concerns. It's okay to ask questions and expect answers that you understand.
   
4. Think of yourself as an active participant in the safety and quality of your health care. Studies show that patients who are actively involved in making decisions about their care are more likely to have good outcomes.
   

How to talk to a doctor

Know what to ask — and how and when to ask it - from USAToday
http://www.usatoday.com/printedition/life/20071203/yourhealth03.art.htm

Worthless blogs

Aside from the different currencies that blogs may provide (information, happiness, comfort, etc), there is now an application that puts a price-tag on blogs. This application is based on the hypothesis that traffic is not a good measure of what blogs are but that conversation, as represented by links and indexes like Technorati, represent a more accurate view of the value of a blog. By using the application to estimate value, this blog, Im-Patient, is worth $0.00. But its lack of monetary value may incline people to believe that 'just because' this blog isn't worth anything, it is not worth at all.

What is your perspective on this issue? Is this blog of value to you?

My blog is worth $0.00.
How much is your blog worth?

Know when it's time to fire your doctor

Know when it's time to fire your doctor

From Dr. Jerome Groopman, based on "How Doctors Think"