The Newsday investigation: “Three Long Island doctors selected to lead a committee that recommends the drugs two Suffolk hospitals stock for patients accepted tens of thousands of dollars from pharmaceutical companies while serving on the advisory panel.”
“The doctors — affiliated with John T. Mather Memorial and St. Charles hospitals in Port Jefferson — accepted about $125,000 from drugmakers between 2009 and 2013, company records show.” They… ” received most of the payments for speeches promoting the companies’ drugs…”
The New York Times article included the following vignette:
“According to the nurse’s note, the patient had received a clean bill of health from his regular doctor only a few days before, so I was surprised to see his request for a second opinion. He stared intently at my name badge as I walked into the room, then nodded his head at each syllable of my name as I introduced myself.
Have you ever wondered what your physician should say to you if a medical error by another physician is identified?
A New England Journal of Medicine article focused on this question.
“Although a consensus has been reached regarding the ethical duty to communicate openly with patients who have been harmed by medical errors physicians struggle to fulfill this responsibility …”
A major source of emotional and spiritual suffering among patients who are nearing the end of life is the abandonment they feel when they stop being cared for by a physician to whom they have become attached.
The New York Times article noted “’I can tell you, it happens all the time and it breaks the heart of patients and families and oncologists,’ said Dr. Diane Meier, director of the Center to Advance Palliative Care at Mount Sinai’s Icahn School of Medicine in New York City.”
A conundrum: go to your local community hospital or an academic medical center?
An article in Becker’s Hospital Review reported on a study published in Health Affairs which “raised questions about whether hospitals’ reputations match the quality of care they provide. The study examined the differences between high-price and low-price hospitals and found the more costly providers were the clear winners in U.S. News & World Report rankings, which are partly (32.5 percent for the Best Hospitals 2013-14) based on their reputation with specialists. However, low-price hospitals performed better on certain outcomes-based readmissions and patient safety measures, such as postoperative blood clots. If high-price hospitals tend to have better reputations, the study raises the question of whether there’s a disconnect between how hospitals are perceived and how they perform and whether reputation should play a part in lists such as Truven Health Analytics’ 100 Top Hospitals, Becker’s Hospital Review’s “100 Great Hospitals” and U.S. News’ Best Hospitals.”
The New York Times article reported this vignette.
“A close family friend with cancer had gone to see him (a renowned physician) some years back. When the friend started asking questions about the treatment plan, the doctor had stopped him midsentence, glared at him and said, “If you ask one more question, I’ll refuse to treat you.”
“What could I do?” the friend later said. “He’s the best, and I wanted him to take care of me, so I shut up.”
The New York Times article addressed this concept by stating “That it is seldom the reality, however. Deception in the doctor-patient relationship is more common than we’d like to believe. Deception is a charged word. It encapsulates precisely what we dread most in a doctor-patient relationship, and yet it is there in medicine, and it often runs both ways.”
Then a vignette:
We used to hear that male pediatricians do not wear ties to prevent the spread of infection.
Recently an article in the New England Journal of Medicine “issued new guidelines to help prevent infection transmission through healthcare personnel attire outside the operating room,” while acknowledging “role of clothing in cross-transmission remains ‘poorly established.’”
Among the recommendations, published in Infection Control and Hospital Epidemiology:
An article in Becker’s Hospital Review reported that hospital interns generally failed to use “five key communications strategies, including introducing themselves, explaining their role in the patient’s care, touching the patient, asking open-ended questions such as ‘How are you feeling today?’ and sitting down with the patient. The five actions are components of what is termed ‘etiquette-based medicine,’ as described in a 2008 New England Journal of Medicine article by Michael W. Kahn, MD.”
“With internal medicine in particular, especially these days, it’s about chronic medical problems and chronic care, where much of what we need to do is motivate the patient to provide self-care and self-management to improve their health over the long term … You can’t do that if you’re not connecting with the patient very well.”
I ask this question to every clinician examining me, doing a procedure on me, or drawing blood from me. Physicians. Dentists. Phlebotomists. Radiology techs. PTs.
And I prefer they wash their hands in front of me. Proper hand washing is the single most effective preventive medicine measure.
A Bloomberg News article explained why it is important to remind clinicians to wash their hands. “Physicians shouldn’t take offense. We all can benefit from reminders about the basics. Years of education and expertise don’t mean that medical professionals aren’t human, and may sometimes forget a step in even routine procedures.”