Tag: doctor

Do you have an Advance Directive?

Everyone deserves the right to make their own decisions about their health. But sometimes we may found ourselves in certain circumstances in which we are unable to do so, such as during a coma, terminal illness, or serious injury. An important way that we can communicate our decisions during these times, however, is by having an “advance directive” in place.

Advance directives are written, legal documents that outline your decisions regarding medical care when you are unable to make them. They assist doctors and caregivers in making medical decisions on your behalf, and they can be written at any age.

There are several types of advance directives:

Health care power of attorney (also called “durable power of attorney for health care” or “health care proxy”). This is a type of advance directive in which you appoint a person you trust to make medical decisions on your behalf when you are unable to do so. This may be a family member, partner, or friend.

Living will. This is a written, legal document that outlines your wishes for certain medical or end-of-life care treatments. These may range from mechanical ventilation to tube feeding, to even organ and tissue donations.

Do-Not-Resuscitate Orders (DNR). This order informs health care providers not to perform CPR if your breathing or heart were to stop.

While advance directives are not required, it may be a good idea to have one in place so that you can have peace of mind knowing that you’re in control of your health care in the event that you are unable to make decisions for yourself.

It should be noted that state requirements regarding advance directives, such as living wills, may vary, so be sure to check your local state laws if you decide to create one for yourself. Also, be sure to keep a copy of your living will for yourself, as well as provide copies to family members, health care providers, and your health care power of attorney. Advance directives can be changed at any time, but just be sure to redistribute copies as necessary.

For more information about advance directives, check out the following resource links:

Advance Care Planning | UNC Health Care: UNC Medical Center

Living Wills and Health Care Powers of Attorney | North Carolina Bar Association

Living Wills and Advance Directives for Medical Decisions | Mayo Clinic

References:

Advance care directives. (2017, September 5). Retrieved from https://medlineplus.gov/ency/patientinstructions/000472.htm

Advance directives. (2017, July 24). Retrieved from https://medlineplus.gov/advancedirectives.html#summary

Creating advance directives. (2014, November 11). Retrieved from http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303?pg=2

Living wills and advance directives for medical decisions. (2014, November 11). Retrieved from http://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303

 

Dr. Clinton vs. Dr. Trump

By: Shauna Ayres MPH: Health Behavior candidate 2017

Who would you rather have as a doctor? Hillary Clinton? Or, Donald Trump? Yale researchers found that primary care physicians address politically sensitive health issues different depending on political affiliation. They surveyed 20,000 primary care physicians across the nation to obtain their political affiliation and professional recommendations for nine patient vignettes. These vignettes highlighted real-life situations related to abortion, marijuana, helmet use, obesity, cigarette use, alcohol use, depression, sex work, and firearm safety. Republicans and Democrats did not significantly differ regarding helmet use, obesity, cigarette use, alcohol use, depression, and sex work. However, Republican were more concerned about abortion and marijuana use, and Democrats were more concerned about firearm safety (Hersh, 2016). This makes sense as these health issues are the most hotly-contested, politically-charged health topics right now in the US.

What does this mean as a patient? Should a doctor’s political affiliation be a factor when a patient is determining who will provide them healthcare? Do patients have a right to know their doctor’s political leanings? The research suggests that in respect to politicized health issues, patients should be cognizant of their doctor’s reactions and recommendations, and if necessary, seek a second opinion. There is no algorithm for healthcare and what works for one patients, does not mean is will work for another. I would argue the most important factors in a patient-doctor relationship are mutual respect and trust, not necessarily political homogeneity.

What does this mean as a doctor? Should a doctor disclose his/her political affiliation to patients? Researchers suggest that doctors should be aware of their political biases on health issues. Doctors should attempt to provide the best treatment in the interest of each patient and not in the interest of a political agenda. Likewise, doctors who cannot do this should recommend that patients seek a second opinion or direct patients to informational resources with depoliticized facts, recommendations, and healthcare options.

Political bias in healthcare is not to be feared or overly criticized, just recognized and responsibly examined by both the provider and patient. After all, doctors are humans just like the rest of us.

Remember to vote next Tuesday, November 8th!

 

Resources:

Cummings, M. (2016, Oct 4) Care differs if your doctor is a democrat or republican. Futurity. http://www.futurity.org/politics-doctors-patients-1262862-2/

Hersh, E. D., & Goldenberg, M. N. (2016). Democratic and republican physicians provide different care on politicized health issues. Proceedings of the National Academy of Sciences of the United States of America, doi:201606609 [pii]

mHealth Vitals

If you are like the average American, you use your phone for just about everything: setting an alarm to wake up every morning, checking the daily news and weather; navigating a new area, playing games, texting, and occasionally taking to someone!  Most Americans also utilize their phones for health reasons.

  • 64% of American adults now own a smartphone of some kind.
  • 62% of smartphone owners have used their phone in the past year to look up information about a health condition.
  • More than half of patients use a healthcare mobile app; 59% of them do so to prepare for a doctor’s visit.
  • Of those using mobile apps, 55% do so to remind them to take their medication.
  • An estimated 15% of Americans own a Fitbit or similar activity tracker; more than 80% say the device keeps them motivated to stick to their exercise routine.
  • Only 7% own an Apple Watch; of those, 41% bought it for health/fitness reasons.

Click here to check out the 49 best health apps of 2015.health app

Text source: MobileSmith; Photo source: pixabay; staticflickr

A Step in the Right Direction

Mobile fitness trackers are becoming increasingly popular around the world. Parks Associates approximated that 13.6 million fitness trackers were sold in 2013 and project 121 million to be sold in 2018. A Stanford University School of Medicine article, Integrating Mobile Fitness Trackers Into the Practice of Medicine, highlights interests among physicians and other healthcare professionals about utilizing personal fitness tracking data collected with these devices to help them improve and customize patient care during and between doctors’ visits. The benefits of such technologies are encouraging, however the limitations must be reduced before clinical applications can be widely adopted.

Benefits of mobile fitness trackers:

+ Users are motivated to adopt a healthier lifestyle

+ Social networks linked with devices provide platforms for like-minded users to connect

+ Environments of sustainability and accountability are established enabling users to reach and maintain health goals

Limitations of mobile fitness trackers:

– Devices are not regulated by any one organization or agency

– Accuracy of measurements are unconfirmed

– Measurement metrics (e.g. number of steps) may not reflect true health status

As either a user of fitness trackers or a healthcare professional, what are other benefits and limitations you have noticed and how do you see fitness trackers being used in the future?

Photo source: Wikipedia

 

Stethoscopes get a tech upgrade

The word doctor probably brings a stereotypical picture to mind—white coat, stethoscope, and maybe a clipboard with patient files. However technology is changing that picture. You may have noticed that more doctors are utilizing tablets and “filing” or saving notes to electronic health records (EHR) to reduce paperwork, costs, and error, as well as to increase productivity and access to health history. But what about that stethoscope? Yes, technology is changing this classic instrument too.

Eko Devices, a company based at UC-Berkeley, has developed a digital stethoscope, called Eko Core, that detects heart rhythms, uses Bluetooth to stream sounds to a smartphone app, and then transmits the data to a patient’s EHR. This allows doctors to record detailed data for immediate or later review while continuing to provide care to a patient. In addition, the investment of the device and software are infinitesimally small in comparison to costly EKG machines currently used. This savings would permit more heart screenings and potentially earlier detection of life-threatening heart defects.

The next step is to develop a Shazam-like application that could detect abnormalities and alert doctors in real time. These high-tech stethoscopes are currently being used in small practices, teaching hospitals, and locations utilizing other mHealth technologies, such as remote or rural areas. Eko Devices co-founder and chief operating officer, Jason Bellet, summed up the incredible potential of Eko Core when interviewed by mHealth News, “Imagine bringing the ears of a Johns Hopkins cardiologist to a small village in Africa or even a remote clinic in Montana.”

What other medical devices could be technologically updated?

Images source: Blogspot.com and J.Wexler via Bing.com

Woman Holding Bouquet of Daisies

I’m sorry, here’s a check

It’s been known for some time that when a doctor makes a medical mistake and apologizes to the patient the odds of that patient opting to sue the hospital decrease.  This particular form of health communication saves money by reducing the cost to hospitals, doctors, and healthcare organizations of defending themselves against lawsuits and settling cases with large payouts to patients and patients’ families when a mistake has been made in treatment or diagnosis.

What hasn’t been happening even in the face of that knowledge is a sea change in how medical practitioners do business.  Some of it’s probably cultural; for many doctors, admitting a mistake is difficult emotionally as well as professionally, and many institutions find it tough to believe (often because their attorneys counsel them against it) that admitting wrongdoing won’t make it more likely a patient will sue since they now have an admission of fault.

But with last month’s announcement in Massachusetts that the medical society there and several large-scale healthcare organizations are implementing a policy that institutionalizes the practice of admitting fault and apologizing for it, perhaps a culture change will trickle down.  The Roadmap to Reform’s official name for the new policy is “Disclosure, Apology and Offer.”  Doctors will be empowered to make offers to patients of some financial compensation for the mistake on the spot.  The University of Michigan Health System did something similar about a year ago, and published a report in the Annals of Internal Medicine showing that it did, in fact, save money and make for happier patients.

Doesn’t it seem intuitive? Imagine that you were a patient, and your doctor came to you and said, “You should know I made a mistake—I apologize, and here’s how we’re going to fix it, and I’d like to offer you a chunk of money to make up for it.” Do you think maybe you’d feel less angry than if you found out about the mistake on your own?  And your doctor never responded to your calls asking for an explanation?  And you had to get a lawyer to get anyone to acknowledge that you’d been hurt?