Making Hard Medical Decisions

Back in the glory days of black and white television, Dr. Welby walked into a hospital room, provided a diagnosis, and told his patient what to do. As patients insisted on more of a role in decisions that affect them, often we now find ourselves in the position of our physicians providing options and asking (rather than telling) us what we want to do.

On the one hand, shared decision making is an important part of informed consent. On the other though, many patients find themselves thinking, “I’m not a doctor. How could I know what’s best for me?” read more

I’ll have some palliative care, please.

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Huh? Although medical care has certainly become incredibly specialized, whenever I’ve suggested that a client consider asking for a palliative care consult, the first response is “What’s that?” or a close second “I’m not dying, why would I want that??”

In our current environment in many cases palliative care and hospice are often provided as one service, and not the continuum of services from which palliative care as a stand alone is beginning to emerge.

The Association for the Advancement of Palliative Care defines it this way: “Palliative care, and the medical sub-specialty of palliative medicine, is specialized medical care for people living with serious illness. It focuses on providing relief from the symptoms and stress of a serious illness—whatever the diagnosis. The goal is to improve quality of life for both the patient and the family.” read more

Before you jump in…Re-thinking preventive health screening

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An advertisement arrived in my mail recently from a local hospital system offering a special promotion on  “heart disease, stroke, and aneurysm prevention package testing.” The tests included were extensive, and the mailing screamed not to wait to schedule these “life-saving screenings.” And, by the way, these tests are normally valued at over $2100 but were offered through this promotion for the low, low price of $179.00! My doctor has never mentioned most of these tests to me, but I found myself wondering about the state of my arteries and heart and whether having these tests might not be a good idea. read more

“Feeling the love” vs. “Feeling the trust”

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A year ago, my 27-year old son injured his knee playing soccer. After months of conservative treatment and continued pain, an MRI showed a fracture in the cartilage in his knee, an uncommon problem for a person his age.  We worked together to prepare for his appointment with a well-referred orthopedic surgeon, and my son took good notes.

He called to tell me that two surgical options had been recommended, both FDA approved, one more “typical” and one more “experimental.”  In fact, the doctor enthusiastically offered participation in a clinical study on the newer procedure, which from his experience he believed showed potential for longer lasting results. Still, both procedures were going to require significant recovery and rehabilitation, and the experimental procedure may or may not be covered by our insurance. read more