Docs helping patients to surf the internet

[LinksEtc]

Tweeted by @joyclee

"The Google Doctor Is a Reminder of How Badly the Internet Does Real Medicine"
http://www.wired.com/2014/10/google-doctor-reminder-badly-internet-real-medicine/?utm_content=buffer0f71c&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

a Google search for nearly any health issue results in a cascade of SEO-optimized link bait—symptom lists and forums presided over by the uninformed. Instead of internet medicine, we have cyber-chondria.

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Tweeted by @charlesornstein

This 'Magic Pill' Can Make Patient Care Safer
http://www.healthleadersmedia.com/print/QUA-312416/This-Magic-Pill-Can-Make-Patient-Care-Safer

Candor and transparency from providers, rather than obstruction and defensive silence, is the only way the healthcare system will improve, says a report from the Lucian Leape Institute of the National Patient Safety Foundation.

And today, all too often, patients and families aren't told when an avoidable error caused them harm. Nor are they given support to deal with a tragic outcome. Or offered an apology. Or options for resolution. At least not in a timely way.

-----

"Shining a Light: Safer Health Care Through Transparency"
http://www.npsf.org/?shiningalight

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Tweeted by @picardonhealth

"Transparency about medical errors a 'magic bullet' that could help make heath care safer: report"
http://news.nationalpost.com/2015/01/22/transparency-about-medical-errors-a-magic-bullet-that-could-help-make-heath-care-safer-report/

Improving transparency around medical error is a potential "magic bullet"

The report warned, however, there are many barriers to increased openness, such as fear of harm to reputation, livelihood or pride; and the desire of some players in the system to maintain the status quo and "resist the sharing of information."

But deliberate withholding of information puts patients at risk and represents a "moral failure," the report said.

[LinksEtc]

Tweeted by @SusannahFox

"Life in the End Zone
A discussion of topical issues for anyone concerned with the final phase of life by Muriel R. Gillick, MD"
http://blog.drmurielgillick.com/2013/11/getting-off-drugs.html?m=1

So in those care planning meetings in the nursing home, if they ask nothing else, family members should ask "what drugs is mom on?" And that should be followed by "why is she on them?" and "are they helping?"

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



Tweeted by @dgmacarthur

"Of Course 23andMe's Plan Has Been to Sell Your Genetic Data All Along"
http://gizmodo.com/of-course-23andmes-business-plan-has-been-to-sell-your-1677810999

enticing customers to hand over their DNA sequences along with details of their lives in a questionnaire to build a giant database—one that academic researchers and biotech companies alike are, well, salivating over

&

"Surprise! With $60 Million Genentech Deal, 23andMe Has A Business Plan"
http://www.forbes.com/sites/matthewherper/2015/01/06/surprise-with-60-million-genentech-deal-23andme-has-a-business-plan/

One big question behind 23andMe's business model has always been whether customers will be happy or upset when they find out that they realize they have paid to be used in for-profit research projects. "I'm sure some people will feel great, no problem, and some will feel cheated," says Hank Greely, director of the Center for Law and the Biosciences at Stanford University. "

[LinksEtc]

Tweeted by @claychristensen

"The Transparency Trap"
http://hbr.org/2014/10/the-transparency-trap/ar/1

Here's the paradox: For all that transparency does to drive out wasteful practices and promote collaboration and shared learning, too much of it can trigger distortions of fact and counterproductive inhibitions. Unrehearsed, experimental behaviors sometimes cease altogether. Wide-open workspaces and copious real-time data on how individuals spend their time can leave employees feeling exposed and vulnerable.

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



Tweeted by @eliza68

Must consider unintended consequences of data transparency. Hospitals transfer complex patients to improve stats. Bernard Lo. #hdpalooza15

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Tweeted by @ElaineSchattner

"Disaster for the public as cancer treatments succeed!"
http://runningahospital.blogspot.com/2015/01/disaster-for-public-as-cancer.html

The actual story was about how many more people are living with cancer than years ago, with record survival rates.

&


"Medicine is an art and science"
http://blog.acpinternist.org/2015/02/medicine-is-art-and-science.html

Keep in mind that medical judgments are not right or wrong. Physicians on the same case may have differing judgments and recommendations. This is a typical scenario in the medical universe which can be vexing to patients and their family.

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Tweeted by @HealthNewsRev

"Improving the public dialogue about health care"
http://myemail.constantcontact.com/Raising-the-temperature-on-COI.html?soid=1102072836906&aid=okpie_gVFMM

It's another in a long history of TV networks placing their MD-journalists-contributors on the air in a conflict-of-interest situation.

&


A new MD-journalist asks, "Is there a role for the physician-journalist?"
http://www.healthnewsreview.org/2015/02/a-young-md-journalist-asks-is-there-a-role-for-the-physician-journalist/

Let me suggest that we put aside what might be insulting – to anyone.  Journalism's credibility – and the integrity of the information – is what's at stake. That's why journalism codes of ethics emphasize the phrase about avoiding conflicts real or perceived.

[LinksEtc]

Tweeted by @readersdigest

"What Your Doctor's Really Thinking (But Won't Say to Your Face)
35 things your doctor would tell you if he weren't worried about time, lawsuits, or hurting your feelings."
http://www.rd.com/health/wellness/doctors-thoughts/?utm_content=buffer76e5d&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer#.

When patients come in with three inches of printouts, I know I'm going to have a good conversation. But they've also almost always terrified themselves beyond need.

I'd like to see more patients have more empathy for doctors.

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



Tweeted by @Atul_Gawande

"Popping the Question"
http://pulsevoices.org/index.php/archive/stories/451-popping-the-question

Then I remember a visiting palliative-care physician's words about caring for the fragile elderly: "We forget to ask patients what they want from their care. What are their goals?"

As new as our doctor-patient relationship is, I feel emboldened to tackle the big, unspoken question looming over us.

Her husband died peacefully at home, and it felt like the right thing for everyone.

"John liked you," she says.

[LinksEtc]

Tweeted by @HeartSisters

Misdiagnosis: the perils of "unwarranted certainty"
http://myheartsisters.org/2012/01/08/unwarranted-certainty/

Specialists in particular, are known to demonstrate unwarranted clinical certainty. They have trained for so long that they begin too easily to rely on their vast knowledge and overlook the variability in human biology.

Specialists are susceptible to diagnosis momentum: once an authoritative senior physician has fixed a label to the problem, it usually stays firmly attached because the specialist is usually right.

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


Tweeted by @Skepticscalpel

"When Patients Kill Doctors: The Horrifying Murder Of Michael Davidson"
http://tinyurl.com/nzdw7tc

We don't know much about Stephen Pasceri, the fifty-five-year-old man who shot Davidson and killed himself in an exam room afterward.

What we do know is that Pasceri was frustrated with the American health care system.

doctors will live in a little more fear of their patients

[LinksEtc]

Tweeted by @Farzad_MD

"Doctors Tell All—and It's Bad
A crop of books by disillusioned physicians reveals a corrosive doctor-patient relationship at the heart of our health-care crisis."
http://www.theatlantic.com/magazine/archive/2014/11/doctors-tell-all-and-its-bad/380785/

Physicians at times were brusque and even hostile to us (or was I imagining it?).

why it has become so difficult for so many doctors and patients to communicate with each other

Even the most frustrated patient will come away with respect for how difficult doctors' work is.

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Tweeted by @drval

In case you missed it. Twitter chat re wearable tech and the MD-pt relationship summarized here: storify.com/colin_hung/per... #hcldr @Colin_Hung

https://storify.com/colin_hung/personal-health-data-and-doctor-patient-relationsh

[LinksEtc]

Tweeted by @kfatweets

"Health Literacy"
http://www.health.gov/communication/literacy/#overview

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



Tweeted by @RANDCorporation

Making It More Difficult to Sue Physicians for Malpractice May Not Reduce 'Defensive Medicine'
http://www.rand.org/news/press/2014/10/15.html?utm_source=rand_social&utm_medium=hootsuite_rand&utm_campaign=hootsuite_rand_social

"Physicians say they order unnecessary tests strictly out of fear of being sued, but our results suggest the story is more complicated."

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



Tweeted by @HeartSisters

Ouch. "To put it bluntly, med school grads are too scientific, don't know how to take care of patients" wp.me/pBQAA-1bT @mellojonny

---

"Everyday ethics"
https://abetternhs.wordpress.com/2015/01/22/everyday-ethics-2/

The most interesting work about what it means to be a 'good doctor' is being carried out be Charlotte Rees and Louise Montroux who are studying medical students conceptions and experiences of professional behaviour. Unsurprisingly perhaps, students tend to think about professionalism in terms of individual character and action, rather than more general terms, such the GMC 'Duties of a Doctor' or the succinct 2005 Royal College of Physicians definition of professionalism

[LinksEtc]

Tweeted by @GilmerHealthLaw

What articles/blogs would you add? Teaching Doctors wp.me/p1sgji-gJ #medx

"Teaching Doctors"
https://healthasahumanright.wordpress.com/2015/01/12/teaching-doctors/

I bring articles and blog posts and other materials to help them understand the patient experience and, at times, to understand my complex health history (for more often than not, they need help with even the definition of some of my illnesses)

Tweet response for @GilmerHealthLaw


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


"What happens when patients know more than their doctors? Experiences of health interactions after diabetes patient education: a qualitative patient-led study"
http://bmjopen.bmj.com/content/3/11/e003583.full

interactions within the health system following patient education could be fraught

Patients who have in-depth knowledge of their condition encounter problems when their expertise is seen as inappropriate in standard healthcare interactions, and expertise taught to patients in one branch of medicine can be considered non-compliant by those who are not specialists in that field.

[LinksEtc]

Tweeted by @MountSinaiNYC

"...Variation ... is What Plagues Healthcare"
http://blog.mountsinai.org/blog/variation-is-what-plagues-healthcare/

"The surgical method obviously involves more pain and scarring for patients, along with a higher rate of infection. The likely reason patients agree to undergo surgery when they could have a polyp removed endoscopically is they simply do not know better."

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


Tweeted by @Skepticscalpel

"Readmissions: Sometimes it's the patients"
http://skepticalscalpel.blogspot.com/2014/10/readmissions-sometimes-its-patients.html

Since doctors get blamed for just about everything, some would say that patients who take suppositories by mouth or eat an orange filled with insulin do so because they were not properly taught by their doctors (or nurses).

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


Tweeted by @HeartSisters


"I rang the bell again. No one came."
http://myheartsisters.org/2015/02/22/er-no-one-came/

In Emergency, staff phoned a cardiologist to describe my condition. His response was relayed to me by the Emergency physician: 'You can stay in the Emergency Department overnight but we will NOT give you a nitroglycerin infusion' (in spite of that letter from my treating physician with instructions to do so). 'We will not give you a holiday.

I really am on my own.

[LinksEtc]

Tweeted by @amcunningham

health communities and disclosure - fabulous #medx panel from @colleen_young @MeredithGould @SusannahFox @pamressler youtube.com/watch?v=rBdYLh...

---

"Communicating the experience of illness in the digital age"
https://m.youtube.com/watch?v=rBdYLhiucnE


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



Tweeted by @foodanddruglaw

Is It OK for Doctors to "Google" Patients?
http://www.scientificamerican.com/article/is-it-ok-for-doctors-to-google-patients/

Although anecdotal reports highlight some benefit (for example, intervening when a patient is blogging about suicide), real potential exists for blurring professional and personal boundaries.

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



Tweeted by @EricTopol


How Hypochondriacs Say 'I Love You'
http://www.nytimes.com/2015/02/22/style/how-hypochondriacs-say-i-love-you.html?_r=0

The evening I convinced my boyfriend that he had leprosy defined a moment in our relationship that I can best describe as glorious.

I took more photos of the small red bumps and typed "rash" into Google images for the 10th time. That's how a hypochondriac says, "I love you."

https://mobile.twitter.com/EricTopol/status/569534697744642050/photo/1

[LinksEtc]

Tweeted by @HeartSisters

Doctors who aren't afraid of "Medical Googlers"
http://myheartsisters.org/2012/10/02/doctors-unafraid-of-medical-googlers/

So – sorry to the other physicians who disagree – but a great many of your patients are perfectly capable of researching their illness and in short order, knowing more about it than you do.

&


"Tessa Richards on the BMJ Patient Partnership"
https://m.youtube.com/watch?feature=youtu.be&v=ykxd9cWcFyE


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



Tweeted by @ElaineSchattner

"Visualizing the patient-doctor relationship"
https://www.flickr.com/photos/33863277@N05/16267883255/in/photostream/

[LinksEtc]

What doctors really think about women who are 'Medical Googlers'
http://myheartsisters.org/2009/08/19/med-google/

One study found that many physicians rate the know-it-all Googler as somewhere between "frustrating" and "irritating".

"Some doctors felt that these patients were 'overly assertive, undermined their authority, and did not show sufficient trust' in their health care provider."

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


Tweeted by @jburns18

"Doctors' muddled statistical knowledge may harm patients"
http://necir.org/2015/01/16/doctors-muddled-statistical-knowledge-may-harm-patients/

When asked to calculate the probability that a positive screen result was actually correct, the majority of doctors surveyed at one Boston hospital got that number wrong.

Manrai believes that as more new medical tests enter the market, doctors must become more attuned to the complicated statistics behind a test's reliability.

[LinksEtc]

Tweeted by @amcunningham

Excellent via @francesbell - ethical decisions are rarely one-off but an ongoing process bbc.co.uk/programmes/b04... #ukmeded

---

"Inside the Ethics Committee"
http://www.bbc.co.uk/programmes/b04brpdk


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



Tweeted by @ESchattner

"The Last Checklist"
http://thehealthcareblog.com/blog/2015/10/17/the-last-checklist/

Checklists should supplement, not supplant, the dignity, caring, trust, and kindness that every patient needs.

Only by being hospitalized oneself, or spending hour and hours at the bedside of someone close to you, can you grasp that miserable combination of anxiety, frustration, boredom, discomfort, fear, and uncertainty that rolls through a hospitalization in seismic waves.

[LinksEtc]

Tweeted by @DrVes

"Ebola, Twitter, and misinformation: a dangerous combination?"
http://www.bmj.com/content/349/bmj.g6178.long?utm_content=buffer7d7e0&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer

Most tweets and retweets contained misinformation, and misinformation had a much larger potential reach than correct information

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


Tweeted by @AllenFrancesMD

"A SECOND OPINION"
http://relationalwelfare.com/2015/01/06/a-second-opinion/

It was easy to assume that patients would trust me from the outset. Why shouldn't they? I had so many qualifications. But one of the strongest themes to emerge on Patient Opinion is that people build, or lose, their trust in you from the tiny fragments of evidence available

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



Tweeted by @theNPSF

How about sharing our Ask Me 3 video with patients for #healthliteracy Month? youtu.be/B3EB-icaNKQ #ptsafety

https://m.youtube.com/watch?v=B3EB-icaNKQ&feature=youtu.be

[LinksEtc]

"6 reasons why doctors grieve differently"
http://www.kevinmd.com/blog/2015/09/6-reasons-why-doctors-grieve-differently.html

we are mostly pretty good at maintaining "professional distance." We "hmm" and "ah" and convey genuine care and connection, but then walk out the door and start fresh with the next patient.

our usual relationship with death is geared to be disengaged from any emotional buy-in

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


"When Healers Get Too Friendly"
http://well.blogs.nytimes.com/2013/11/11/doctors-boundaries-with-patients/?_r=1

In a 1981 talk to an audience of physicians, Dr. Seldin deplored "a tendency to construe all sorts of human problems as medical problems" and thus within doctors' duty and purview to fix. If it isn't "relief of pain, prevention of disability and postponement of death," Dr. Seldin said, why then, doctor, leave it alone!

In the opposite corner stands Dr. Gordon Schiff of Harvard's Brigham and Women's Hospital, who was issued an official reprimand a few years ago for egregious boundary crossing

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


Dealing with non-medical factors that impact health


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


"maintaining boundaries with patients"
http://www.cpso.on.ca/CPSO/media/images/Maintaining-Boundaries.pdf

Medical care can be compromised because objectivity diminishes to the same degree that feelings – both positive and negative – develop between a patient and a doctor.

However, the nature of the physician-patient relationship is such that the physician must take the responsibility for maintaining boundaries.

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


"The intimacy gap between doctors and patients"
http://www.kevinmd.com/blog/2015/03/the-intimacy-gap-between-doctors-and-patients.html

What separates doctors and patients is a disjointed and unnatural version of intimacy that in no way mirrors the important bonds that we form in real life non-medical relationships.

They had not gained this right through hours of conversation, years of support, or acts of selflessness.

The physician remains stone-faced, objectively detached.

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


Yes, yes ... really am backing off ... but something was still bugging me ... so I googled it b/c that's what I do  ...

I think that I may have a bit of transference going on ... CM & our doc remind me of each other ... how interesting & intriguing ...

don't want to mess things up for dd, so I will have to nip that in the bud ...

online support & non-med relationships very different from doc-pt relationships.

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


Tweeted by @helenbevan

Teaching the Rx (doctor's prescription) narrative: story as medicine. An outstanding slide deck from @JBBC slideshare.net/ennoconn/teach...

---

http://www.slideshare.net/ennoconn/teaching-the-rx-narrative-story-as-medicine-53209513?utm_source=slideshow&utm_medium=ssemail&utm_campaign=upload_digest

Slide 36

Physicians have been taught in medical school that they must keep the patient at a distance

the emotional burden of avoiding the patient may be much harder

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



This boundaries topic is interesting.  Not sure what I think.  Many mixed feelings.