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

Emergency

Emergency. Dictionary.com defines it this way: “a sudden, urgent, usually unexpected occurrence or occasion requiring immediate action. “

In my healthcare experience lifetime, perhaps nothing has changed more than the role of the hospital emergency room. In my youth the hospital had two roles: caring for very ill or post-surgery patients needing nursing care until they could be released home, and attending to accidents (think someone getting their hand injured by machinery or being in an auto accident).

As a variety of things have changed in our healthcare system over the years, there are some common beliefs about emergency rooms that we should take a closer look at. read more

Your Decisions Matter… Or Do They?

Healthcare Directives and Planning

The call came late on a Thursday. The husband of a long married couple had suffered a stroke 2 weeks earlier. He had lost the ability to swallow and the doctor at the hospital had urged surgery to place a feeding tube directly to his stomach before transferring him to a skilled nursing facility, where it was expected he would remain for the rest of his life.

By his wife’s report, she didn’t feel she had been given an option; the doctor simply told them this was the next step in his care so he could be discharged from the hospital. Now in the skilled nursing facility she had time to see the situation more clearly and realized this wasn’t what her husband had told her he wanted if he was in this situation. read more

Before you jump in…Re-thinking preventive health screening

deep-end

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”

knee-exam

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