Don’t you talk back to me! (Or, why this *isn’t* always advice worth taking!)

I think it was often the look on my face. I can’t really remember ever “talking back” to an adult, but it’s hard to imagine any kid not wanting to at some point. I suspect there must have been something on my face that indicated I wanted to “talk back” that caused my grandmother or my dad to shake a finger and issue that warning.

It turns out that there are some times though when talking back might actually be a good thing.

Many counselors are trained in a technique called mirroring, when they repeat back (sometimes paraphrasing, sometimes word for word) what their client has just said to them. While some people may experience that as annoying (is there an echo in here?), it can also be a way to demonstrate that a person has been listening. read more

Quality Health Care – Says Who?

Focus on Quality

What is “quality” in healthcare?

It turns out it depends on who you ask.

Doctors tend to view quality from a technical perspective – accuracy of a diagnosis, appropriateness of the treatment, and the outcome for the patient.

Payers (which includes Medicare and Medicaid, and commercial insurance) tend to focus on evidence-based medicine (documentation that a treatment or intervention works consistently) and cost-effectiveness.

These are the definitions we all hear about in the news. But it’s not often enough that the patient view of quality is discussed. read more

I’ll have some palliative care, please.

feel_better_smile_square_sticker-r468e6f0e34414ff2a364687dd3a55172_v9wf3_8byvr_324

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

Patient-centered care – you may need a buddy!

Buddies

A friend of mine was undergoing an outpatient surgery a few weeks ago. Once in a gown, and her IV started (not a power position for us as patients, by the way!) her surgeon stopped in before heading to the OR to scrub. Having already talked with the anesthesiologist, my friend also shared her concern with her surgeon that she has had really severe nausea with codeine-based pain relievers after surgery (I mean really awful – I’ve been there!) with me nodding along vigorously and asked for different post-op medication. Her young-ish (to us, anyway!) surgeon was patient and gracious in responding that all narcotic pain relievers cause stomach upset and she would provide an anti-nausea medication to take along with the codeine-based drug she preferred to prescribe. Before my friend could share that that she’d had anti-nausea medication before and it wasn’t particularly effective, the surgeon exited stage left to prep for surgery. read more