e-Patient Dave

Power to the Patient!

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Daily Digest: Life is 100% fatal, medical error stats, and more

“Life is 100% fatal“: I’m quoting myself there, and I’ve helped beloved family members navigate that final journey by holding their hand, and standing watch, as the light of their living selves flickered out. It’s a sacred human experience that’s become over-medicalized, particularly in the US. From the NY Times, written by a palliative care doctor, Ira Byock: “Dying Shouldn’t Be So Brutal”

Killer numbers: In a terrific post on Vox, Sarah Kliff, who’s built a solid reputation as a journalist who can break down complex statistical data into accessible information, tells us that we have miles to go before we’ve defeated the medical-error monster. “Medical errors in America kill more people than AIDS or drug overdoses. Here’s why.”

Doctors as family advocates: Dr. Pauline Chen makes a forceful case on the NY Times Well blog that doctors should advocate for their patients and families to get work policies in place, policies that let people get the time needed to care for sick family members. “Doctors as Advocates for Family Leave”

Why discharge instructions matter: On Forbes.com, a piece by Robert Szczerba on why care transitions, particularly from hospital to home, can present re-admission risk, and efforts to eliminate that risk. “Coming Home From The Hospital Is Actually More Dangerous Than You Might Expect”

Bad science, and how to spot it: Another post from Vox, this one by Susannah Locke, on how to spot weird (bad/fake) science reporting. Piece includes a great infographic, too. “15 ways to tell if that science news story is hogwash”

Dr. House of Cards: Wednesday humor comes from ZDoggMD – slightly funnier than placebo – and his mashup of House of Cards, Dr. Oz, and medical-science mayhem. “Dr. House of Cards: Oz vs. Underwood“

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Daily Digest: Speak up, stay safe + 6 Tuesday info-treats

Speak up, stay safe: How much do we love the fact that Consumer Reports is getting involved in the patient safety movement? We love it LOTS. One of the e-patients on the CU team, Kathy Day, is quoted in this piece that advises being proactive and persistent when you’re in the hospital. “The surprising way to stay safe in the hospital”

Physician, test thyself? Here’s a piece from the NY Times Well blog that asks if MDs are getting their own DNA tested. The author is an MD and bioethicist who breaks down the topic really well. “Doctor, Have You Had Your DNA Tested?”

Life is risk, act accordingly: Shared decision making, risk, and medicine. Dr. John Mandrola talks about doctors as “choice architects.” “The medical decision as a gamble”

Culture clash [WARNING: graphic topic]: The NY Times talks about a cultural norm in many countries, female genital mutilation, and how that’s showing up in western medical offices. “Effects of Ancient Custom Present New Challenge to U.S. Doctors”

Medicine as kindness: Einstein College of Medicine in New York CIty has a heartwarming story on their blog about Project Kindness. “For Patients, What Makes a Great Doctor?”

$500K+ for an EHR system, and they’re still faxing like it’s 1999: Both Dave and I are fierce advocates for frictionless data access for patients *and* clinical teams. We – all of us – still have a long way to go, sadly. “Doctors Find Barriers to Sharing Digital Medical Records”

Eat at your own risk: Dr. Brad Nieder, tagged as the Healthcare Humorist, with our Tuesday nugget of funny – since both Dave and I travel on the speaking circuit ourselves, we know from road food and regional diners and dives. “Americana in Los Angeles & Atlanta“

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Daily Digest: Is interop the Holy Grail?, science resisters, four more

Dave comment: I’m learning that Digest curator Casey has a taste for longer pieces than most internet articles. Take a peek at links that interest you. Here’s today’s selection.

The “holy grail” of frictionless data sharing: HITConsultant weighs in with an op-ed related to GMDD delivered, if you will. “Is Universal Health Data Platforms the “Holy Grail” of Interoperability?” (As we said last week, GMDD = Gimme My DaM Data, the cry of e-patients who want to have all their medical information. As the song says, “It’s all about me so it’s mine.”)

How to talk to science resisters: Here’s something from The Grist that tackles a tough issue: how to shift the thinking of parents who don’t want to vaccinate their kids. The Grist has been reporting on climate and environmental science since 1999, so they’re very familiar with the challenge of engaging with a “don’t confuse me with the facts” crowd: “How to talk to an anti-vaxxer”

In Let Patients Help I said “Information alone doesn’t change behavior,” which is very much on topic here. What can you say that will make any difference?

Caveat “precision”: “Precision medicine” is a hot topic, given President Obama’s announcement from the White House Jan. 20. (SPM president Nick Dawson was there – see his post on e-patients.net) on Jan. 30. Former SPM president Michael Millenson has been writing about healthcare for decades, and offers up a fact-based caution against letting genomic testing companies brand themselves as offering “precision medicine” without the science to support that claim. “Breast Cancer Tests Betray ‘Precision Medicine’ Branding”

Will healthcare spending drop or soar? Dr. Peter Ubel, MD and behavioral scientist, asks a question on Forbes that’s been rising in the cost-of-care circles where both Dave and I engage: is healthcare spending slowing, or “Is Healthcare Spending About To Accelerate?”

Questioning Medical Protocol: Randi Oster is an aerospace engineer, and the mom of a son with a chronic illness. In a post on the Engaging Patients blog, she shares a story that illustrates how the steep learning curves every e-patient navigates work best in tandem with an open mind and a sense of humor. “Questioning Protocol, a Family’s Perspective”

Funny Monday: I (Casey) am a longtime TV geek. Not just watching it, producing it. So I can weigh in with a professional POV, TV-wise and e-patient-wise, with a must-watch recommendation: HBO’s “Getting On,” set in a southern California extended-care facility. LA Weekly agrees with me. “HBO’s ‘Getting On’ Has What It Takes to Be a Truly Important Show”

 

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Daily Digest: Truck-stop family medicine (LOVE this!) and 5 more

TGIF, friends! Here’s our Friday Festival of Fun for e-patients and health policy wonks far and near.

Keeping family medicine alive – at a truck stop: Rob Marsh MD of Raphine, Virginia, was named Country Doctor of the Year in 2014. Where does he practice? At a truck stop. What was his gig before country-doctor? The US Army’s Delta Force. “Virginia doctor tries truck-stop medicine to keep family practice alive”

#GMDD (“Gimme my DaM data”), Irish edition: It seems that patients everywhere are struggling to figure out the data-access issue. Our friends in Ireland are having the same conversation that we’re having here in the US. From the Irish Times: “Medical Matters: Charting progress: who owns patients’ medical notes?”

Kindness training in medical school: A core driver of transforming medicine, and the healthcare delivery system, is medical school. The Wing of Zock blog, published by the Association of American Medical Colleges, is a great source for insights on transformation in academic medicine. Kindness training in medical school? Why … YES. “Kindness Beyond Curriculum”

Patient Portal ideas: One of the blogs that’s chock full of discussion about all things health IT is HITECHAnswers – here’s a short post with some ideas for patient portal. Which in our experience have yet to be delivered in truly meaningful ways, to patients or clinical teams. “Searching for Creative Patient Portal Solutions”

Change at the FDA: FDA Commissioner Dr. Margaret Hamburg is moving on. She’s faced many challenges well – compounding pharmacy safety, Ebola.  Here’s hoping her successor will also bring a special focus on tech, because tech is the biggest enabler patients have had since the internet itself. NYTimes: “FDA Commissioner Dr Margaret Hamburg to Step Down”

Doctor By Day, Comedian By Night: For your Friday funny-bone, here’s a doctor who’s become a movie star. Usually, it’s an actor playing a doctor who becomes a movie star. Ken Jeong started as an internist with an off-hours comedy habit. You might know him from his breakout performance in “The Hangover.” Here’s his “my big break” story from NPR: “Doctor By Day, Comedian By Night“

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Daily Digest: Thursday, February 5, 2015

Hello, Thursday – here’s your dose of ePatient vitamin-D-for-Digest!

Social workers are superb participatory medicine practitioners. They get it. Here’s a post from The Social Work Helper with a nifty little virtuous-cycle quadrant image that outlines how, and why, the e-patient movement matters. “The E-Patient Movement”

Our friends over at The Incidental Economist noticed an item in the White House’s proposed budget related to the agricultural use of antibiotics. With the rise of antibiotic resistant bacteria, why are we still pumping antibiotics into cattle, pigs, and chickens to “promote their growth”? Modern farming practices promote growth just fine. The science of ag antibiotics, and why it should stop: “Agricultural antibiotics in the President’s budget request”

Cui bono (Latin, to whose benefit) in healthcare reform? Sarah Kliff has an interesting answer after studying insurance stock earnings reports. Health plans have far outstripped the S&P 500 for the last five years. “Health insurer stocks have crushed market averages since Obamacare passed”

Stephen Wilkins is a health policy thinker whose home on the web is something he calls the Mind the Gap Academy. He posted something on LinkedIn that is a pretty tight list of the Top 10 things a clinician can do to foster patient engagement. No tech required. “The Ten Commandments Of Patient Engagement”

The American College of Physicians (ACP) – the 2nd largest physician organization in the US, after the American Medical Association (AMA) – has jumped in to the pharma price fight with both feet. They announced this week that they were signing on to the Campaign for Sustainable RX Pricing. Here’s a piece from CNBC with the details: “Doctors group joins fight against ‘skyrocketing’ drug prices”

We love the internet. We wouldn’t be here talking to you if we didn’t. However, the Wild Wild Web can be a challenging place for advocates of all stripes. When I (Casey) came across a post on the Guardian’s site recently, it prompted me to put up a post about trolls on one of my own blogs. Here you go, weigh in with your thoughts. “Advocacy, trolls, and threats – oh my!”

Last but not least, our humor break for today, in which Dr. Grumpy ponders Zen and the art of cough drops. “Cough Drops“

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Daily Digest: Wednesday, February 4, 2015

Happy Wednesday! Or, as we used to call it in the cube farm, Hump Day. Here’s today’s edition of must-reads –

  1. If you listen to the rising tide of discussion about the cost of care, one of the things that’s -supposed- to help curb that hockey stick upward trajectory is technology. So we found it interesting when we tripped over this piece asking if patients have to pay for portal access. I (Casey) say “no” – you? “Should providers charge patients for portal access?“
  2. Man the battle stations – the White House wants Medicare to be able to negotiate pricing with pharma. Since the introduction of Medicare Part D, CMS has been specifically prohibited to negotiate drug pricing with pharmaceutical companies. This could get loud. “Obama administration seeks to negotiate Medicare drug prices“
  3. The Disneyland measles outbreak, suspected to be accelerated by parents who have refused the MMR vaccine for their children, has raised a lot of heated discussion all over everywhere. I (Casey) almost died from measles when I was 9 years old, the same year (1962) that Roald Dahl, the author of “Charlie & the Chocolate Factory” and other classics, lost his 7 year old daughter, Olivia, to measles. In 1988, he begged parents to avoid the heartache he himself had suffered by vaccinating their kids against measles. “Read Roald Dahl’s Powerful Pro-Vaccination Letter (From 1988)“
  4. Speaking of science, both Dave and I are big fans of evidence based medicine. We both believe, and work toward daily, the idea that health and science literacy is a core piece of helping improve patient experience, and patient participation, in the healthcare system. So we’re big fans of the Cochrane Collaboration, which analyzes and publishes scientific evidence aplenty. Here’s their 2014 “greatest hits” page: “Best of the Cochrane Library: 2014 in review“
  5. I (Casey) produce a podcast series for the Society of Hospital Medicine, which gives me the chance to talk to smart hospital clinicians every month. SHM has a great blog, The Hospital Leader, which I recommend to anyone interested in healthcare. Here’s a recent post, pointing up the idea that we all have to think differently, sometimes at the drop of a stethoscope. “The Shield“
  6. From the “how surprising … well, not really” desk, here’s a recent piece by Elisabeth Rosenthal in the New York Times about the snowbirds of Florida, and the growing savviness that retirees are starting to display when it comes to “doctor’s orders.”  “Medical Costs Rise as Retirees Winter in Florida“
  7. And here’s today’s humor break, what we’re calling “Doc Rob vs Dr. Oz, film at 11” – it’s from our good friend Dr. Rob Lamberts’ “Musings of a Distractible Mind” blog, and it tells the story, in tweets, of how Rob responded to the “Dr. Oz’s Inbox” tweetchat (that turned into something of a PR disaster for Oz) last November. “Dr. Rob’s Inbox“