Infectious disease specialist Dr. Abigail Zuger muses in her December 10th NYTimes essay about how to calculate the number of patients doctors can see in one day--and still deliver high-quality, compassionate care.
If someone cried out to you for help, would you whip out your cell phone and film it?
For this series on the time pressures on today's clinicians, let's look at the evolving culture in which they work.
On September 28th I began a series, Saving Time, to talk about a great challenge in modern medicine: the time pressures on clinicians who strive to provide expert and compassionate care to each patient.
Compared to 30 years ago, routine tasks consume increasing amounts of time:
My September 15th post in response to Penicllin Allergies Overblown introduced the problem of physicians over-prescribing broad-spectrum antibiotics when penicillin would be the more appropriate drug.
When you saw this post's title, what did you think you'd be reading about? Erectile dysfunction? Emergency Departments?
My August 14th post responds to Scientists Seek to Rein in Diagnosis of Cancer, in which Tara Parker-Pope discusses the recommendations of an NCI panel that some premalignant conditions should be renamed to remove the word "cancer" or "carcinoma." The move was prompted by concerns about patients being over-diagnosed and over-treated, a problem for both Healthy Survivors and public health.
For some people, the issue is money. Increasing the use of tests and treatments helps those on the prescribing/delivering side and hurts patients and insurance companies footing the bill. They object to lobbyists and politicians having any say in determining what's best for patients.
As a Healthy Survivor, I believe the fundamental issue is captured by a Memorial Sloan Kettering oncologist, Dr. Norton: "...doctors do need to focus on better communication with patients about precancerous and cancerous conditions. He...tells patients that even though ductal carcinoma in situ may look like cancer, it will not necessarily act like cancer — just as someone who is “dressed like a criminal” is not actually a criminal until that person breaks the law.
I've devoted much of my writing life to demonstrating how substituting one word or phrase can make a world of difference to patients. Yet I still believe that changing the language cannot replace effective communication.
If dealing with the uncertainty and high stakes of a potentially life-threatening disease that requires life-altering treatment, nothing replaces the time-consuming weighing of risks and benefits for the individual and developing a personalized plan of action.
A rose is a rose, but is a cancer a cancer?
I can feel afraid. But if I act afraid, the terrorists win.
What could be wrong with IBM's supercomputer "Watson" helping physicians care for patients?
On the NYTimes Well Blog, 21-year-old Emma Pierson eloquently shares the impact of having learned she carries the BRCA1 mutation, a finding associated with a 98% chance of developing cancer in her lifetime. You'll read how...
What does a Healthy Survivor do about the constant news coverage of the Connecticut massacre?
A front-page story in today's Science Times poses a provocative question in the rapidly changing world of medical diagnostics: Can computer software ever replace physicians to ensure timely, correct diagnoses?
Dr. Nuland opens Chapter 2 of How We Die saying, "No one dies of old age, or so it would be legislated if actuaries ruled the world." Later in the chapter he introduces a perspective on aging that can serve Healthy Survivors well.
Until recently, if I saw someone who had lost excess weight, without hesitation I'd say something positive like, "Wow, you look terrific!"
After a cancer diagnosis, patients ask, "What should I eat? What foods should I avoid?
The answers found in magazines and offered by clinicians and purveyors of alternative therapies often paint a confusing picture of contradictions.
In my last post, I introduced the Choosing Wisely™ campaign, an effort by clinicians to avoid overuse or inappropriate use of tests and therapies. Obviously, a successful campaign would save lots of money. But the campaign is motivated by a higher goal that reflects the mission of Healthy Survivorship.
Did you know that when you take a generic drug, you essentially forfeit the ability to sue the company making the drug for damages if you experience an adverse event?
The preceding four posts on grief and acceptance set the stage for a closer look at how patients can be Healthy Survivors at the end-of-life. In other words, how can you both get good care and live as fully as possible after a diagnosis of terminal disease?
In yesterday's post, I shared my reaction to a rant found on a cancer-related listserv. I explained my concerns regarding such expressions of anger, disappointment and frustration.
So what are Healthy Survivors to do if, for example, they learn they had not received important information about aftereffects of treatments they received?
The FDA revokes approval of Avastin for breast cancer. What's a survivor to do?
Now let's look at the players who influenced the FDA's decision to revoke approval of Avastin for breast cancer. The complex process requires a book-length manuscript to fully explain. Rather than abandon my effort, here are the bare bones:
To judge the FDA's recent revocation of approval for Avastin for breast cancer, let's go back to basics. What is the job of the FDA?
What we call ourselves impacts how we see ourselves. So I was intrigued but not surprised when I heard a new word to add to my survivorship lexicon: metavivor.
An interesting press release from the University of Texas supports my long-standing contention that it is better to ask a patient, "How are things?" than to ask "How are you?"
My recent posts have discussed some of the difficulties of modern medical decision-making in the context of PSA testing for prostate cancer. A new book by Harvard oncologist Jerome Groopman and Harvard endocrinologist Pamela Hartzband offers help to Healthy Survivors: Your Medical Mind: How to Decide What is Right for You.
While the furor over PSA testing plays out in the media, my sympathies lie with men newly diagnosed with prostate cancer . At the end of the day, the patient has to decide what to do.
A message about the value of PSA tests in healthy men creates problems that might have been avoided with a better choice of words.
One of the purposes for this blog is to bring attention to high-quality resources to help educate and empower Healthy Survivors.Today I'm shining the spotlight on CURE. Not only is this a superb magazine for cancer survivors and their caregivers, it is also free.
If a picture is worth a thousand words, this 17-minute video by Eric Slade Productions is worth at least an undecillion (1 followed by 36 zeros).
Yesterday I offered the opening comments for the Dallas Lymphomathon. Here's an excerpt:
My last post offered tips for recognizing stigma. My key message was that Healthy Survivors have a right to choose whether or not they advocate to destigmatize the disease that has become part of their life.
Today I'll tackle the challenge of dealing with this stigma.
In my April 11th post, I refer to an article in Women's Day titled, "The Stigma of Illness."
Stigma can keep patients from becoming Healthy Survivors, so let's talk about dealing with stigma in healthy ways.
How can patients who feel stigmatized become Healthy Survivors?
In 2006, leaders in the state of Washington created the Health Technology Assessment (HTA) program to evaluate the cost-effectiveness of various medical therapies. With our country facing a huge budget deficit, what could be better than determining which treatments are worth paying for?
After people have a heart attack, stroke or joint replacement, rehab is a routine part of their recovery plan. Cancer survivors, too, can have significant musculoskeletal issues during and after the acute illness. Yet cancer rehab programs are few and far between. Why is that?
Yesterday I was in Washington, D.C. to participate in the inaugural meeting of ASCO's Cancer Survivorship Committee. [ASCO is the American Society of Clinical Oncology.] While the specifics of the meeting are confidential, I'd like to share two things: