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

Health Insurance: Test Your IQ

What you don’t know might cost you!

The air has already gotten a bit crisper on some of my morning walks. While that may mean apples and candy corn for some, it also signals open enrollment for health insurance for many of us.

We have the most complicated healthcare system in the world, largely because of the role insurance plays. Insurance is a legal contract and for non-attorneys, the language is crazy-making if you even read the fine print (and most of us don’t).

Knowing even a few key things about health insurance can make the difference between feeling in control and finding yourself facing unexpected bills. read more

Hospital Discharge: Could it be a bit more hospitable?

I may be one of the few people on the planet who invested my second language studies in Latin. And yes, it probably would have been more practical to study a language people actually speak!

While having a working knowledge of Latin has been helpful for crossword puzzles, at other times my intellectual curiosity simply gets the best of me. A recent call about a hospital discharge experience piqued my curiosity about where the words “hospital” and “patient” and come from. Hospital comes from the Latin word “hospes,” which essentially means a guest or stranger. It’s also the root for words like hostel, and hospitality. “Patient” comes from the Latin word “patior,” to suffer. So from these Latin roots it’s easy to understand why we might consider hospitals to be “a special place of care for guests/strangers who are suffering.” read more

Short term health insurance….A horse (of course) or Mr. Ed?

It looks like a horse. It smells like a horse. It rides like a horse. It must be a horse, right? Well, maybe, unless it’s the Famous Mr. Ed. For those of you too young to remember, Mr. Ed was a talking horse who could only be heard by his owner, and was a bit of a troublemaker. He looked like a horse, but he didn’t behave like one.

I found myself thinking about him when I saw this sign posted at an intersection a few weeks ago. Health insurance is health insurance is health insurance, right? Not if you were Melissa.* read more

Is that what I said? That’s not what I meant! Now what? Part 2

You took the time to prepare for your visit with your doctor. You asked your doctor to explain her observations with words you understand, you told her what you thought you heard, and she confirmed it.

You request a copy of you medical record or log onto your patient portal a few days later, and read your doctor’s notes. You see an error, maybe your birthdate or your medications are wrong, or there’s something there you know you didn’t say, or the doctor didn’t say to you. And now it’s there in back and white. read more

Is That What I said? That’s not what I meant!

You might remember a children’s game from long ago called “Telephone:” Someone thought of a message and whispered it to the person next to them, who whispered it to the person next to them and so on. The last person would repeat what they heard out loud and it was always met with giggles and shouts because it rarely bore any resemblance to the initial message.

In effect any time we share information, there are two things in play: not just what we say, but also how the listener hears/interprets it. In theory it’s the responsibility of both parties to make sure that “communication,” a shared understanding, has occurred, but in the case of giving our medical history there are some very real barriers to that happening. read more