Ever wondered why « Primary Care Physicians « have vanished?
By Nicolette Francey Asselin
In a book called “A Monster Chase,” Marion Stahl presents a story that gets to the bottom of our shortage of physicians today. In the analysis of the book, one will find the many positions of prominent spokesmen on the issues presented in this book. Read
At the age of 28, my patient was already a war-weary veteran of leukemia.
When his cancer was diagnosed, we treated him with a multi-drug cocktail of chemotherapy over months, first with more intensive regimens that sidelined him from being able to work, and then with milder medicines.
His leukemia came raging back, though, so we treated him again, this time with one of the new, expensive immunotherapies that has been approved recently by the Food and Drug Administration. These are not curative, but in his case eliminated enough of the leukemia to enable him to receive a bone-marrow transplant, which did have the potential of curing him. cont
Going to the doctor isn’t most people’s favorite activity. But it is part of staying healthy (the other major parts are what you eat and how much you exercise). So you may as well get the most out of it. As a doctor I often get asked by friends and family how to make the most of a medical visit. Here’s my advice, and it’s basically the same whether you are the patient, or a family member or a caregiver of the patient.
I mean that quite literally. Yes, it hurts, but it is also destroying me, the me as I was without a bad elbow, a happily balanced collection of parts all working modestly, silently, efficiently toward a common good. Kidneys, liver, knees, elbows — what a great team we were. I put my hands in my pockets without wincing, typed without thinking, sat at work judiciously evaluating everyone else’s distress. Cont
There was absolutely no way around it. She was dying. I gave her a few hours at best, with maximum pedal to the metal intensive medical care. Paramedics had picked up this homeless woman after she collapsed under a bridge in Oakland, Calif. Her heart had completely stopped. She had died under that bridge. But the paramedics had somehow pulled her back, with a jump-start to her heart. And then brought her right to my service in the intensive care unit.
I let out a huge sigh as I picked up the next chart in clinic. “Chief complaint: Behavioral concerns” was typed out on the top of a thick packet of papers. My young patient was sitting on the exam table comfortably. His parents sat stoically with furrowed brows in the chairs next to him. They were nervous, rigid, clearly concerned.“What’s been going on?” I asked. Apparently he had been acting out at his elementary school. I sifted through the papers, chock full of documentation from teachers, detailing his behavior. He was on the verge of expulsion. His parents expressed understandable frustration to me given his remarkably normal behavior at home.
I gathered my history per usual, directing my questions toward him as he swung his legs back and forth on the exam table. I did not seem to be getting anywhere when I happened to ask, “Is anyone at school making fun of you?”
In an age in which terrorism, natural disasters, illnesses, shootings, and wide-scale industrial errors and accidents are occurring with increasing frequency, there is a tremendous need to develop ways to cope with the aftershocks. Post-traumatic illnesses are on the rise, and we need to find new ways to curtail and prevent their rise. Building resilience has become an important topic. In this story, I tried to illustrate the ways our family dealt with a personal tragedy. Cont
Extracting medical care from the health care system is all too often an expensive exercise in frustration. Dr. Eric Topol says your smartphone could make it cheaper, faster, better and safer.
That’s the gist of his new book, The Patient Will See You Now. Lots of people are bullish on the future of mobile health to transform health care, but Topol gets extra cred because of his major medical chops: Former head of cardiology at the Cleveland Clinic and present director of the Scripps Translations Science Institute in La Jolla, Calif.