Dr. Elaine Schattner's notes on becoming educated as a patient
Dr. Elaine Schattner's notes on becoming educated as a patient
© Elaine Schattner, 2009, 2022 By : Template Sell.
Today a short article in the NY Times, New Kidney Transplant Policy Would Favor Younger Patients, draws my attention to a very basic problem in medical ethics: rationing. According to the Washington Post coverage, the proposal comes from the United Network for Organ Sharing, a Richmond-based private non-profit group the federal government contracts for allocation […]
There’s a new study out on mammography with important implications for breast cancer screening. The main result is that when radiologists review more mammograms per year, the rate of false positives declines. The stated purpose of the research,* published in the journal Radiology, was to see how radiologists’ interpretive volume – essentially the number of […]
Last week I considered the relationship between the Prince Albert and his speech therapist in The King’s Speech. One aspect I wanted to explore further is why the future king initially insisted on calling the practitioner “doctor.” In real life, now, patient-doctor relationships can be topsy-turvy. This change comes partly a function of a greater […]
On Friday the New York Times reported that surgeons are performing far too many open breast biopsies to evaluate abnormal mammogram results. A new American Journal of Surgery article analyzed data for 172,342 outpatient breast biopsies in the state of Florida. The main finding is that between 2003 and 2008, surgeons performed open biopsies in an operating room – as opposed to less invasive, safer biopsies with needles – in 30 percent of women with abnormal breast images.
I was truly surprised by this should-be outdated statistic, which further tips the mammography math equation in favor or screening.
The FDA recently identified a link between breast implants and a rare form of lymphoma. From today’s report in the New York Times: When talking to patients about a rare type of cancer linked to breast implants, plastic surgeons should call it “a condition” and avoid using the words cancer, tumor, disease or malignancy, the […]
From an article in today’s New York Times on hiring discrimination against people who smoke: “There is nothing unique about smoking,” said Lewis Maltby, president of the Workrights Institute, who has lobbied vigorously against the practice. “The number of things that we all do privately that have negative impact on our health is endless. If […]
Today I came upon a Jan 24 op-ed, A Fighting Spirit Won’t Change Your Life by Richard Sloan, PhD, of Columbia University’s Psychiatry Department. Somehow I’d missed this worthwhile piece on the sometimes-trendy notion of mind-over-matter in healing and medicine. Sloan opens with aftermath of the Tucson shootings: …Representative Giffords’s husband describes her as a […]
Today’s Times reports on our nation’s students’ poor science test results. The results are bleak: only 34% of fourth graders scored at a “proficient” level or higher; just 30% of eight graders scored at a proficient level or higher; 21% of twelfth graders scored at a proficient or higher level in science. The mega-analysis, prepared […]
A few years ago I started writing a book on what it was like to be a cancer patient and an oncologist. This morning I came upon this section on second opinions: Is it OK to get a second opinion? Definitely. And there’s no need to be secretive about it, or to worry about hurting […]
I wish that more physicians would speak out in favor of stricter gun control laws. Firearms present a public health issue in the U.S. According to the CDC, over 12,000 Americans die each year from homicide involving firearms. The number of non-fatal gunshot wounds requiring hospital care approximates 48,000 per year.
This is an unusual entry into a discussion on the limits of patient empowerment. In late December the Times ran a story, beginning on its front page, about a portrait in the Metropolitan Museum of Art by Diego Velázquez, the 17th Century Spanish painter. The news was that the tall representation of the teenage Prince […]
The Obama administration will cut a new Medicare provision to compensate providers for discussing end-of-life care, according to the New York Times. This is an unfortunate reversal. Too-often, doctors fail to have these discussions with their patients. This happens for many reasons including some physicians’ discomfort with the topic, their not wanting to diminish patients’ […]
Three recent stories lead me to my opening topic for the year: the value of open-mindedness. This characteristic – a state of receptiveness to new ideas – affects how we perceive and process information. It’s a quality I look for in my doctors, and which I admire especially in older people. Story #1 – on […]
This morning I toured Google’s new Body Browser. The trip wasn’t as easy as I’d envisioned; I got sidetracked on my way, having to update my Web browser before entering. The site requires an advanced Web browser, like Chrome beta or Firefox 4.0, to accommodate 3-D graphics.
Update accomplished, I forged into Google-woman’s frame. (There is no man available, as yet.)
Regular readers of this blog know that I’m not into rants. Complaining is rarely constructive, I know. But I spent the afternoon sorting through a 2-month stack of medical bills and correspondences related to those. Despite the fact that I consistently pay bills on time, we received threatening notices from local hospitals for payments they […]
In his latest New Yorker piece The Truth Wears Off, Jonah Lehrer directs our attention to the lack of reproducibility of results in scientific research. The problem is pervasive, he says: …now all sorts of well-established, multiply confirmed finding have started to look increasingly uncertain. It’s as if our facts were losing their truth: claims […]
Some weeks ago I discovered Happy’s hilarious Xtranormal videos on his anonymous blog. Yesterday I laughed watching the Hospitalist vs the ER: — I can’t tell you much about who the Happy Hospitalist is. His is one of the few anonymous blogs I read. Based on the apparent relevance of cars and parking lots in […]
— (and to Other Physicians, Division Chiefs, Hospital Administrators and Everyone Else With Responsibilities for Other Humans): Yesterday I started but didn’t complete a post on the interesting concept of the Decline Effect. I got caught up with several extra-ML responsibilities that kept me busy until very late last night, which became morning before […]
A perspective in this week’s NEJM considers the Emerging Importance of Patient Amenities in Patient Care. The trend is that more hospitals lure patients with hotel-like amenities: room service, magnificent views, massage therapy, family rooms and more. These services sound great, and by some measures can serve an institution’s bottom line more effectively than spending […]
Here’s a partial list of why some thoughtful, articulate patients might be reluctant to mention symptoms to their doctors:
1. Respect for the doctor – when the patient feels what he’s experiencing isn’t worth taking up a physician’s time, what I’d call the “time-worthy” problem;
2. Guilt – when the patient feels she shouldn’t complain about anything relatively minor, because she’s lucky to be alive;
3. Worry – when patient’s anxious or afraid the symptoms are a sign of the condition worsening, and so
