As the Internet becomes ever more ingrained in our lives, it increasingly affects the way patients interact with each other and with their doctors. They can more easily learn about conditions, treatments, and providers and can find the solace and support of others in similar circumstances.
Web-based services serve a range of important needs. For example, two social media sites, CaringBridge and CarePages, allow supporters near and far to read journals in which patients post updates of their condition. Outlets like these allow patients and their families to post information on a real-time basis concerning sometimes-critical conditions. Among the posts are pleas for group prayer, requests for advice or support from others who have been down the same path, and descriptions of the frustrations of dealing with illness. This avenue for communication can be an invaluable help.
Websites such as WebMD and sites maintained by many hospitals provide detailed information about medical conditions and potential treatments. The ability to research a diagnosis with ease increases patients’ independence and autonomy because it frees them from the need to call their doctor with every question.
Although the Supreme Court ruled that Obamacare’s Medicaid expansion could not be mandatory for states, as of now, the governors of 24 states and the District of Columbia have decided to go along. (New Jersey’s Governor Chris Christie announced yesterday that he would be the 24th.)
But the question remains: will more individuals covered by Medicaid result in more individuals actually receiving medical care?
It is estimated that the Medicaid expansion could provide coverage for up to 15.1 million people who are currently uninsured. While this effort will help achieve the goal of reducing the number of uninsured individuals in the United States, it is unclear how the medical community will accommodate the increased number of patients seeking treatment.
I was at my annual check-up and my physician asked me, “Do you exercise regularly?” I looked down sheepishly and said, “Well, uhh, law school doesn’t give me much free time. So I don’t exercise as much as I probably should. But I bike everywhere in the city, at least two miles a day, five days a week.”
My doctor looked at me through narrowed eyes and scoffed, “There is no excuse for lack of regular exercise. Biking throughout the city does not count. Weight-bearing exercise is especially important for petite women. You need to get yourself to the gym.”
I was so humiliated by this interaction that I left the appointment telling myself that in the future, I will just tell her that I exercise four times a week, both weight-lifting and running, whether or not it’s true. But should I have to lie to feel comfortable talking to my physician?
“Treating the whole person includes mental health care.” That statement was the title of a commentary written by the American Medical Association president, Jeremy A. Lazarus. Dr. Lazarus recognized that physicians can best treat their patients if they integrate mental health and mental illness into overall medical care.
A recent Johns Hopkins University study indicated that this integration is far from complete. The study, which surveyed the US News and World Report top 18 hospitals nationwide in 2007, found that only 44% maintained most or all of their psychiatric records electronically, only 28% made psychiatric records accessible to non-psychiatric physicians, and only 22% did both.
The study also showed that mental health record integration has promise – of the 18 hospitals surveyed, those that shared mental health records with non-psychiatrist physicians had significantly lower readmission rates for 2,000 psychiatric patients.
Did you know that an item discarded as medical waste after your baby is born could save someone’s life? Cord blood from the placenta and your baby’s umbilical cord is filled with blood-forming cells that can be used in transplants for patients with leukemia, lymphoma, and many other life-threatening diseases. Thousands of people worldwide are searching for a lifesaving marrow or cord blood donor each and every day. Just by donating your baby’s cord blood after birth, you could save a person’s life.
While some patients in need of a transplant are eligible for an autologous transplant in which the patient receives his or her own stem cells that were collected before transplant, many patients require an allogenic transplant from another individual. Some patients are fortunate to find a match in a relative, often a sibling; however, seven out of ten patients look to an unrelated donor, usually a perfect stranger, to save their lives. And currently, six out of ten patients never find a matching donor. But, you could help change those odds.
It is up to the patient’s physician to determine whether cord blood, peripheral blood, or bone marrow is the best type of transplant for the patient’s condition. Cord blood is especially useful for minority patients because it is more difficult to find a bone marrow match for patients with diverse racial or ethnic backgrounds.
How to define when life begins is a question that has plagued societies for centuries. Some view this question in light of religious beliefs whereas others approach it from a purely scientific perspective. Regardless of how the question is framed, it is apparent that varying opinions abound.
Many argue as a religious dictate that personhood begins at conception. Some scientists point out in response that many fertilized eggs never become babies. It is also difficult to determine exactly when conception occurred because sperm can survive in a woman’s body for several days, and it may take several more days for a fertilized egg to implant itself on the wall of the uterus.
In the face of religious and scientific debates, the law is called upon to respond. And its responses are not always consistent.
Everyone likes to complain about how much money doctors make. Many people hear the word “physician” and equate it with a mansion, BMW, and lavish vacation. But physicians don’t make nearly as much as you think.
After finishing high school, physicians spend a minimum of 11 years in training. Specialized physicians train even longer, sometimes for as long as 20 years. These are years spent making no money while in school, or making very little money during residency and fellowship. And by the time these individuals are “real” physicians, they are already in their mid-to-late thirties and have spent years struggling financially to support themselves and their families.
During the three to seven years of medical residency, physicians in training who abide by the maximum 80-hour-work-week mandated by the Joint Commission make approximately $11 an hour before taxes. Some residents impermissibly work over 100 hours a week, which makes their hourly wage even lower. Many residents travel to numerous different hospitals, cover the cost of their own gas, and even have to pay for parking at the hospitals where they work. Residents pay hundreds of dollars to attend conferences to improve their knowledge in their area of practice and thousands of dollars to study for and take licensing exams.
“Do everything you can, doctor. Do anything it takes to save him.”
These are the unfortunate pleas that too many patients and their families make when dealing with terminal illness and end-of-life decisions. While the use of advance directives helps alleviate this problem by informing doctors in advance about a patient’s end-of-life wishes, there is still an underlying belief that medicine can cure everyone, even those people with the most terrible prognoses.
But doctors die differently than their patients. They often don’t want the fancy treatment, the life-prolonging chemotherapy, or the 2-hour-long cardiac resuscitation (CPR). They know the consequences, and they just say no.