Articles Posted in Doctor-Patient Relationship

consent-300x170Modern medicine has become so complex, bureaucratic, and forbidding that it’s little wonder that patients—already ailing—don’t grasp the risks and consequences of treatments they prescribe. Overwhelmed patients also don’t demand that doctors fully brief them.

And shame on physicians for failing to help patients more in this critical area of caregiving, two doctors have written in an excellent New York Times Op-Ed column. The doctors—Mikkael Sekeres, director of the leukemia program at the Cleveland Clinic, and Timothy Gilligan, director of coaching, Center for Excellence in Healthcare Communication, at the Cleveland Clinic—deserve credit for calling out colleagues while describing the vital health care concept of informed consent.

My firm has detailed information on this important patient right in health care (click here to see).

HouseGregoryHouse-276x300Doctors, nurses, and hospitals should stop ignoring colleagues who act like jerks because obnoxious physicians—think of  Dr. Gregory House, the TV internist—may hurt patients, especially in surgery.

Researchers, who published a study in the JAMA Surgery, looked at two years of quality care data from seven medical centers, involving 800 surgeons and 32,000 adult patients. They also had information on physicians with “unsolicited patient observations,” meaning complaints from those undergoing care and their friends and families.

Stat, the online health information site, summarizes what the researchers found:

breastIt’s described as an “aggressive, costly, morbid, and burdensome” surgery that often lacks “compelling evidence” that it contributes to patients’ “survival advantage.” So why are increasing numbers of women  deciding to have both their breasts removed when doctors detect early stage cancer in one breast?

New research, based on a questionnaire and follow-up with more than 2,400 women, recommends that surgeons be clearer and more direct about treatment options and outcomes with breast cancer patients. That’s because 17% of respondents said, incorrectly, that they think that removing the other healthy breast in a woman with cancer in one breast helps prevent the disease’s recurrence, while almost 40 percent said they didn’t know this procedure’s effects.

Researchers found that many women—including more than 40 percent of their respondents—with breast cancer contemplate the surgery known as contralateral prophylactic mastectomy (CPM), and that sufficient numbers of surgeons may not explain why it may be inappropriate for them. Their study has been published in the peer-reviewed Journal of the American Medical Association Surgery. As the Los Angeles Times reported:

newborninhospital_mhi_default-300x199Some new cautions have been issued on some key aspects of children’s health care. The federal government is increasing its warnings on anesthetic use for children and expectant moms, while a newspaper investigation is raising issues with common newborn screenings and their inconsistency and inaccuracy. Meantime, a health news site is adding to questions about a much-touted program to reduce head trauma harms in kids’ athletics.

FDA warnings on anesthetics for babies, expectant moms

Let’s start with the federal Food and Drug Administration cautions on “repeated and lengthy use of general anesthetic and sedation drugs” with children younger than 3 and pregnant women. The agency says it has been studying potential harms of these powerful medications for these two groups since 1999, and will label almost a dozen common anesthetics and sedation drugs with new warnings.

prescriptionAmong the plenty of worries when an older patient has to be hospitalized, here’s one to think about:  treating physicians and their ever-ready prescription pads which put patients at risk for serious side effects that can be worse than the problem they’re treating.

Kaiser Health News has continued writer Anna Gorman’s series on the woes that elderly patients experience when hospitalized, with her latest piece giving an eyebrow-raising look, from a pharmacist’s point of view, at the prescribing practices of MDs in hospitals.

As the drug expert observes, it all is “a bit alarming.”

Doctors who sexually abuse their patients too often get away with it because of weak oversight, sympathetic regulators, and their capacity to move around to elude punishment, a new investigation has found.

The Atlanta Journal Constitution says it spent months, scrutinized more than 100,000 medical board disciplinary orders from across the nation, and found too many disturbing instances where perverse physicians harmed patients but escaped punishment or received only a slap on the wrist.

ny-med-premiereHospital patients who are dying or in extreme duress should not have their privacy exploited by reality television camera shows, federal health care regulators now have made clear. They have just settled with a noted New York hospital on $2.2 million in penalties and fines for its role in cooperating with a celebrity doctor whose crews recorded for broadcast the last throes of a an elderly Manhattan resident fatally injured when hit by a garbage truck.

The dead patient’s family complained that neither he nor they gave the hospital permission to film during his unsuccessful emergency treatment. Further, they said repeated broadcasts of the reality TV show “New York Med,” headlined by Mehmet Oz (the heart surgeon-cum-TV show celebrity known as “Dr. Oz”), caused them great pain and distress, as well as invading their and their loved one’s privacy.

Federal authorities, who oversee patient privacy matters under the Health Insurance Portability and Accountability Act (HIPAA), finally agreed with the family years after they filed complaints, posting online this stance about patients’ protected health information (PHI):

patientThe answer is “yes,” according to a new study which  finds that medical students hold “fantastical” views about biological differences between blacks and whites, and this may result in blacks receiving less help in managing pain.

Another new piece of research finds that doctors communicate with black patients worse than whites about important end-of-life decisions.

Although minority patients long have suspected uneven quality of care, the issue has grown as demographic trends change America’s population, and the nation seeks to improve its health system to make it more effective, efficient, and less costly.

CR-TOC-Cover-05-2016California leads the nation in its number of practicing physicians─and some of those doctors are so awful they’re dangerous, Consumer Reports has found in its deep dive into state licensing boards and MD discipline. The magazine, in a cover story headlined “What you don’t know about your doctor could hurt you,” compiles some ghastly illustrations of bad doctors, including:

  • A pediatrician with a fetish who fondled the feet of patients’ moms during exams;
  • An ob-gyn who surgically removed the wrong ovary from a patient;

Getting a copy of your own medical records is supposed to be easy and inexpensive. It also can be essential for ensuring the best medical care. But many hospitals and doctors have made it difficult and pricey, and the federal government is now doing something to help patients.

Anyone with any kind of serious medical condition really needs to read their own records. I made this Step One of the advice in my book, The Life You Save: Nine Steps to Getting the Best Medical Care, and Avoiding the Worst. Reading your own records makes you an informed patient, helps doctors correct misunderstandings about your history, and ensures that you don’t get expensive duplicative tests because one provider doesn’t know the results of what another provider’s testing.

But many hospitals make access expensive. They charge patients per-page fees — in the DC area, typically in the 50-75-cents-per-page range — that add up quickly when a patient has any kind of complex or lengthy hospital stay with hundreds or thousands of pages of records.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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