Articles Posted in Doctor-Patient Relationship

clown-246x300Social media have become a “circus” for some plastic and cosmetic surgeons to clown around in unprofessional ways, including: videos in which one doctor has cradled fat removed from a tummy-tuck like an infant and put a baby face on it using a Snapchat filter. Other costumed surgeons have posted visual displays of themselves dancing before surgery and showing off on camera procedures or with tissues they have removed.

The abuses have become so bad that faculty and students from Northwestern University’s medical school, after researching incidents online, have published a prospective social media code of ethics for plastic surgeons, calling for its adoption by specialists at their next major meeting.

Robert Dorfman, one of the Northwestern students and an author of the draft ethics proposal,  has described plastic surgery’s social media landscape “like the Wild West out there, with no guidelines or rules.” Clark Schierle, senior author of the guidelines, a plastic surgeon, and a medical school faculty member, has observed that practitioners in the field are “uniquely drawn to social media because we tend to do more marketing and we are a visual specialty.”

tats-300x192Could pediatricians accomplish what many parents cannot? Can they talk to rebellious youths about the body adornments that are  all the rage now, and get kids to consider the health risks and long-term issues surrounding trendy tattoos, piercings, and body scarring?

In case you’ve fallen like Rip Van Winkle into a long doze or you’re senior enough to even understand the Washington Irving reference, tats and body jewelry worn in created openings and roughing up the skin to make interesting patterns all have become so common among the young that those who go without such au trendy beauty measures may now even be the outliers among their peers.

There isn’t good data on body scarring but the public opinion experts at the Pew Research Center found in 2010 that 38 percent of 18- to 29-year-olds had at least one tattoo, and 23 percent had “piercings in locations other than an earlobe.”

records-300x200Although patients can protect their own health by getting copies of their medical records, few consumers get them, and fewer still take advantage of the federal government’s push to make records easily  available electronically, one of Uncle Sam’s big public protection agencies reports.

The U.S. Government Accountability Office also warns that tumult in the nation’s health care system, notably in Congress’ roller-coaster deliberations to repeal and replace the Affordable Care Act, aka Obamacare, may disrupt patients’ relationships with caregivers. That makes it even more vital for consumers to have their health records.

The Association of Health Care Journalists deserves a tip of the cap for pointing to the GAO blog, where experts note that the ACA had supported a national push to get doctors and hospitals to adopt electronic health records with the aim of providing patients and caregivers more access and transparency about these crucial materials.

overdose-300x225Taken from a most favorable point of view, Big Pharma and doctors tried to address a big physical problem for patients when they pushed ahead in recent years with potent painkillers. But now, it’s those troubled Americans’ mental health woes that  officials may need to deal with to better battle what has become an epidemic of opioid drug abuse.

It’s a crisis that may worsen still and claim as many as 650,000 lives in the next decade, says the online health information site, Stat, which consulted 10 leading experts to develop its forecast.

Stat and other news organizations also have reported on newly published research showing the depths of the mental health challenges of those who abuse opioid drugs, with adults with a mental illness each year receiving more than half of the 115 million opioid prescriptions in the United States.

Diverse_doctors_3-300x201Some new research studies suggest ways to find a good doctor by focusing on demographics. Older doctors who have reduced their caseloads may not be an optimal choice, one study suggests, while another finds that, for seniors sick enough to be hospitalized, women MDs excel. And doctors who are immigrants can be solid patient choices, a third study reports.

Let’s be clear: These studies are observational, and they focus on select measures of care. But they are based on big data, analyses of hundreds of thousands and even millions of cases. Your own individual experience with a clinician counts a ton, and must never be ignored. A doctor with a brilliant resume, golden accomplishments, and a sterling reputation can still treat you badly, even blunder with your care.

Still, after examining three years of data on more than 700,000 admissions and the outcomes of 19,000 doctors, researchers from Harvard Medical School and prominent Boston-area hospitals found that as MDs aged, mortality rates of their hospitalized patients climbed. For doctors younger than 40, the rate was 10.8 percent, while for those older than 60, it hit 12 percent.

https://www.protectpatientsblog.com/wp-content/uploads/sites/69/2017/04/hpv-vaccine-uptake-infographic.__v100248120-216x300.jpgMore Americans ages 18 to 59 may be infected with the human papilloma virus (HPV) than previously had been known, with 1 in 4 men and 1 in 5 women carrying high-risk strains, federal experts say.

The new findings from the Centers for Disease Control and Prevention may become a key part of campaigns to get more parents to vaccinate youngsters against HPV infections. They have been found to cause cervical cancer and have been tied to cancers of the throat, anus, and male and female reproductive organs.

HPV-related cancers are on the rise, and it is concerning that the CDC found that almost half of Americans’ are infected. But public health leaders have confronted ignorance and adult prudery—by physicians, public officials, and parents—as they try to get boys and girls, ages 11 and 12, inoculated and protected against the virus.

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.

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