tag:blogger.com,1999:blog-22060761572480896882024-03-19T05:19:12.095-04:00The Doctor is ListeningAn emergency physician and author of When Doctors Don't Listen writes about what you need to do to get the best care possible.Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.comBlogger100125tag:blogger.com,1999:blog-2206076157248089688.post-73210006709299098052015-01-17T17:03:00.000-05:002015-01-17T17:03:04.900-05:00"Geography Should Not Be Destiny"<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">This week, I wrote about why I'm leaving the ER (for now) for public health: </span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://upload.wikimedia.org/wikipedia/commons/thumb/d/d7/National_Public_Radio_logo.svg/500px-National_Public_Radio_logo.svg.png" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://upload.wikimedia.org/wikipedia/commons/thumb/d/d7/National_Public_Radio_logo.svg/500px-National_Public_Radio_logo.svg.png" height="106" width="320" /></a></span></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.npr.org/blogs/health/2015/01/15/377286159/why-i-m-leaving-the-er-to-run-baltimores-health-department?utm_campaign=storyshare&utm_source=twitter.com&utm_medium=social" target="_blank">Why I Left the ER to Run Baltimore's Health Department</a></span></span></td></tr>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I also lay out my goals and vision in the Baltimore Sun:</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://essentials.baltimoresun.com/micro_sun/reinvention/images/masthead.gif" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://essentials.baltimoresun.com/micro_sun/reinvention/images/masthead.gif" height="70" width="320" /></a></span></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.baltimoresun.com/news/opinion/oped/bs-ed-leana-wen-20150114-story.html" target="_blank">Geography Should Not Be Destiny</a></span></span></td></tr>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I will be on this Blog infrequently from now on. Please follow us on our <a href="http://health.baltimorecity.gov/" target="_blank">website </a>and new blog, <a href="https://bhealthyinbmore.wordpress.com/" target="_blank">B'Healthy in B'More</a>! And on Twitter <a href="https://twitter.com/BMore_Healthy" target="_blank">@BMore_Healthy</a>.</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com411tag:blogger.com,1999:blog-2206076157248089688.post-69984750066336530262015-01-12T09:00:00.000-05:002015-01-12T21:22:32.598-05:00A New Year & New Adventures—A Farewell Message<style>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Dear Readers,</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><br />
<a href="https://s3.amazonaws.com/nixle/uploads/agency_logos/lg/user2018-1245257374-bchdlogo.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://s3.amazonaws.com/nixle/uploads/agency_logos/lg/user2018-1245257374-bchdlogo.jpg" /></a><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I am writing to share some exciting news: this Thursday, January
15<sup>th</sup> 2015, I will be joining the administration of Mayor Stephanie
Rawlings-Blake as the <a href="http://mayor.baltimorecity.gov/news/press-releases/2014-12-05-mayor-appoints-dr-leana-wen-baltimore-city-health-commissioner">Commissioner
of Health in Baltimore City</a>. In this role, I will be overseeing our agency
of 1,100 strong to lead the activities of the Health Department, which include
health promotion and disease prevention, aging and care services, environmental
health, animal control, and food safety.</span></span><br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">This is an amazing opportunity to serve and to combine my
passion for community engagement, public health, and patient-centered care to
help those who were most vulnerable. Baltimore faces many health disparities
that are rooted in poverty, violence, and substance abuse—but it’s also a city
with extremely committed civic and faith leaders, engaged community
organizations, strong foundation presence, and the longest continuous-serving
health department in the country that has an outstanding history of service and
innovation.</span></span><br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><br />
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZIfUUkM9DyjGIwy55D4ANGWiRromI3zyBtvpgs0ddgLhRBxvFWhbKGv27cVtWy8EKARUnF8k4O6DxgsZoz2KvlfuERQlr7Iqm_RvvXWen19ylWmor3IWM3hF1k6UPdPKB_HIgl98mO38/s1600/The+doctors+2.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZIfUUkM9DyjGIwy55D4ANGWiRromI3zyBtvpgs0ddgLhRBxvFWhbKGv27cVtWy8EKARUnF8k4O6DxgsZoz2KvlfuERQlr7Iqm_RvvXWen19ylWmor3IWM3hF1k6UPdPKB_HIgl98mO38/s1600/The+doctors+2.jpg" height="112" width="200" /></a><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-SDj69h8vs3lwmBoiCz6NLy983_HTEbn12HxRC4c0MWdLy96GlD5MKR2EfTMOI5Z2wxWDhTFnY8F-bw0tKAr0l_LD2gHd0QrBPX3da1pIjki7B1PuJu2wOx5p9bN1rAD64h6P2wtIX5I/s1600/TEDMED+small.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg-SDj69h8vs3lwmBoiCz6NLy983_HTEbn12HxRC4c0MWdLy96GlD5MKR2EfTMOI5Z2wxWDhTFnY8F-bw0tKAr0l_LD2gHd0QrBPX3da1pIjki7B1PuJu2wOx5p9bN1rAD64h6P2wtIX5I/s1600/TEDMED+small.jpg" height="133" width="200" /></a><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">My last couple of years at George Washington University have
been fantastic. I’ve loved teaching residents and students and providing care
in our ER; serving as Founding Director of Patient-Centered Care Research;
leading a new collaboration between GW and Kaiser Permanente on social mission
and health policy with my mentor Dr. Fitzhugh Mullan; and researching and
speaking about paradigm changes in healthcare reform (including <a href="http://www.ted.com/talks/leana_wen_what_your_doctor_won_t_disclose">a
talk on Who’s My Doctor</a> and our transparency campaign that is now on
TED.com). While I’m sad to leave my inspiring students and extraordinary colleagues,
I am honored and humbled to be selected to this new role to fight for health
equity and social justice.</span></span><br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Thank you for following this blog for the last two years and
advancing our common vision that patients, families, and providers can work
together to be empowered to better health. I will be continuing to comment on
public health and healthcare transformation on my Twitter account <a href="http://www.twitter.com/drleanawen">@DrLeanaWen</a> and <a href="https://www.facebook.com/DrLeanaWen?ref=hl">Facebook site</a>. We will
also be featuring announcements and guest posts at the official Baltimore City
Health Department Twitter <a href="http://www.twitter.com/bmore_healthy">@BMore_Healthy</a>
and <a href="https://www.facebook.com/BaltimoreHealth?ref=ts&fref=ts">BCHD Facebook
page</a>.</span></span><br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Ten years ago, I wrote an <a href="http://www.nytimes.com/2007/04/29/opinion/29wat-wen.html?_r=0">essay for <i>The New York Times</i></a> that began with a
quote by the Reverend Dr. Martin Luther King, Jr., that injustice anywhere is a
threat to justice everywhere. I end this blog (for now) with another quote by
Dr. King, as it explains my core vision and drive: “Of all the forms of
inequality, injustice in healthcare is the most shocking and most inhumane.”</span></span><br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Thank you for all that you have done and continue to do. Please
join me in this next chapter to fight against injustice and to improve health
and well-being.</span></span><br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Sincerely,</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><br />
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Leana Wen, M.D. M.Sc.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span>
<!-- Blogger automated replacement: "https://images-blogger-opensocial.googleusercontent.com/gadgets/proxy?url=http%3A%2F%2F3.bp.blogspot.com%2F-QLV6KfI9_5w%2FVKbdTuL0dBI%2FAAAAAAAABFs%2FYFVMjt8whbU%2Fs1600%2FThe%252Bdoctors%252B2.jpg&container=blogger&gadget=a&rewriteMime=image%2F*" with "https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgZIfUUkM9DyjGIwy55D4ANGWiRromI3zyBtvpgs0ddgLhRBxvFWhbKGv27cVtWy8EKARUnF8k4O6DxgsZoz2KvlfuERQlr7Iqm_RvvXWen19ylWmor3IWM3hF1k6UPdPKB_HIgl98mO38/s1600/The+doctors+2.jpg" -->Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com455tag:blogger.com,1999:blog-2206076157248089688.post-24783770940129860742014-12-16T06:11:00.001-05:002014-12-16T06:11:30.244-05:00Listen to Who's My Doctor on NPR's TED Radio Hour
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Since my TEDMED talk on the importance of transparency in
medicine was <a href="http://www.ted.com/talks/leana_wen_what_your_doctor_won_t_disclose">featured
on TED.com</a> last month, I have had an overwhelming number of responses. The
majority were very positive. Hundreds of people encouraged us to keep going,
and a lot wanted to know how they could participate: as transparent doctors and
as patients.<span> </span>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Many asked about how they could find a transparent doctor in
their area. Our website is not robust enough for a geographical search
function, and it contains a small fraction of the doctors who have signed the <a href="http://www.ipetitions.com/petition/total-transparency-manifesto">Total
Transparency Manifesto</a>. We are open to working with nonprofits and
developers on improving Who’s My Doctor to make it more user-friendly.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJBMj6YAG-hASpO7Qo8RtfBf4Oc92qhrTECd8fB4IDwu5KS4CVdN2w-UaKr-sXIoJHUM7ELVA-iyq13dfuvwnS1-dDPFm0R_5Ej2w4ahyMnfU9Ym8dQQ3Gj8LsFak_Y4qIhxxQ2hu1om4/s1600/IMG_1620.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhJBMj6YAG-hASpO7Qo8RtfBf4Oc92qhrTECd8fB4IDwu5KS4CVdN2w-UaKr-sXIoJHUM7ELVA-iyq13dfuvwnS1-dDPFm0R_5Ej2w4ahyMnfU9Ym8dQQ3Gj8LsFak_Y4qIhxxQ2hu1om4/s1600/IMG_1620.jpg" height="200" width="150" /></a>In the meantime, Who’s My Doctor is fortunate to have
captured the attention of someone who I’ve secretly admired for a long time:
NPR radio host Guy Raz. You may have heard of Guy’s work as host of All Things
Considered. Since March 2014, he has been the host of NPR’s TED Radio Hour. As
a TED nerd and NPR faithful, I download these excellent podcasts every week. Some
of my recent favorites have been the <a href="http://www.npr.org/programs/ted-radio-hour/351538855/the-source-of-creativity?showDate=2014-10-03">Source
of Creativity</a> featuring (among others) Sting and <a href="http://www.npr.org/programs/ted-radio-hour/255743572/overcoming?showDate=2014-06-13">Overcoming</a>.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I had the privilege of meeting Guy at TEDMED; he is as
energetic and charismatic in person as he is on air. I was flattered when he
invited me to be interviewed on TED Radio hour—but quite astounded and not a
little bit embarrassed when he revealed that <a href="http://www.npr.org/programs/ted-radio-hour/368757408/courage?showDate=2014-12-12">the
topic of this session was “courage”.</a> The other people interviewed in this
episode are war journalist Janine Di Giovanni, human rights litigator Kimberley
Motley, former CEO Margaret Heffernan.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
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<tr><td style="text-align: center;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><a href="http://www.npr.org/programs/ted-radio-hour/368757408/courage" imageanchor="1" style="margin-left: auto; margin-right: auto;" target="_blank"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhNqjy8o-1bfwE3LyUH3WVctHj1EV3-99_4Xsl710pi-X65VFUM3AhdQhu3Y8m-2wvaGrOF11Ac7aX6Gnf614Y8r6SAWglVrUr7ki5-OrceLKBtBkuJa-LyFTDoCLjiPjamiFFGvsQJOg0/s1600/TED.jpg" height="114" width="320" /></a></span></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><a href="http://www.npr.org/programs/ted-radio-hour/368757408/courage" target="_blank">TED Radio Hour: Courage</a></span></span></td></tr>
</tbody></table>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">What we’ve done in Who’s My Doctor is important, but hardly
courageous! Having been a patient and caregiver, I know how frightening it is
to be in the position of extreme vulnerable, when you or a loved one are ill.
Dealing with these stressful situations is what takes real courage; Who’s My
Doctor is our attempt to level the playing field.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Whatever your thoughts are on transparency in medicine, I
hope you will listen to <a href="http://www.npr.org/programs/ted-radio-hour/368757408/courage?showDate=2014-12-12">Guy’s
masterful interview</a>, where he created a narrative out of my story and the
stories of Janine, Kimberley, and Margaret. I look forward to your comments.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com387tag:blogger.com,1999:blog-2206076157248089688.post-44774465108251310922014-11-30T00:28:00.002-05:002014-11-30T00:28:38.939-05:00Life in an Urban ER<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I wrote <a href="http://www.npr.org/blogs/health/2014/11/29/365503118/why-the-er-doctor-asks-patients-whats-happening-at-home" target="_blank">a piece for NPR</a> about the patients we see in an urban ER,
and how every day is a reminder that health doesn't exist in a vacuum.
</span></span><div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"> </span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Even in the time-limited setting of the ER, it's important for
providers to understand where our patients live, work and play. It's these conversations that allow us to diagnose and treat the real
causes of our patients' ills.</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"> </span></span></div>
<div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.npr.org/blogs/health/2014/02/15/277027231/when-a-prescription-for-pain-pills-becomes-a-gateway-to-addiction" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.poynter.org/wp-content/uploads/2013/11/npr_logo_rgb.jpg" height="101" width="320" /></a></span></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.npr.org/blogs/health/2014/11/29/365503118/why-the-er-doctor-asks-patients-whats-happening-at-home" target="_blank">Why the ER Doctor Asks Patients What's Happening At Home</a></span></span></td></tr>
</tbody></table>
</div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Thanks to everyone for reading, and in particular to the many
people who pointed out the critical necessity of teamwork--with nurses,
physician assistants, technicians, nurse practictioners, case managers,
students, social workers, and many more. </span></span></div>
<div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"> </span></span></div>
<div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Indeed, it takes an entire team
to provide true care. As people have commented on <a href="https://www.facebook.com/NPR/posts/10153018477846756" target="_blank">NPR's Facebook site</a>, we in the ER rely on social workers--many of whom are overworked
yet try so hard to help our patients. Whenever we as docs and nurses
refer patients to social workers, they are always fantastic about
helping us. It's critical for us frontline providers who see
patients first to ask the tough questions and look beyond the "chief
complaint" in order to know to involve the
other members of our team.</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"> </span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I have been fortunate over the course of my training and career to
learn from and work with many incredibly caring, highly compassionate,
and superbly competent providers. It's also the community leaders and neighborhood organizations who provide
care outside the walls of our institution, who are critical to the
health of people. </span></span></div>
<div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"> </span></span></div>
<div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">On this Thanksgiving weekend, I give them, and all of
you, my unending gratitude and deep respect. Thank you.</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com39tag:blogger.com,1999:blog-2206076157248089688.post-18288068617338709642014-11-17T19:36:00.002-05:002014-11-17T19:36:36.324-05:00Who’s My Doctor on TED.com!
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I am thrilled that TED has
picked up on <a href="http://www.whosmydoctor.com/">Who’s My Doctor</a> and our
efforts to improve transparency in medicine. </span></span><br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLoi5q-U_aJlXzNW1KxvKZFZbRhn3mrAebnfOuWgSGRAW-Kt9qLsIf7WbtelXx3kRlCC21tg4DZf8-2UWMdvDvGarO1A82Pz_-TUmdtzZ4Nb18eZUVBBEdbf2Cu2dKXpVReIFxdMaSKis/s1600/TEDMED+small.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhLoi5q-U_aJlXzNW1KxvKZFZbRhn3mrAebnfOuWgSGRAW-Kt9qLsIf7WbtelXx3kRlCC21tg4DZf8-2UWMdvDvGarO1A82Pz_-TUmdtzZ4Nb18eZUVBBEdbf2Cu2dKXpVReIFxdMaSKis/s1600/TEDMED+small.jpg" height="213" width="320" /></a></span></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><br /><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.ted.com/talks/leana_wen_what_your_doctor_won_t_disclose" target="_blank"><i>Click here for link to TED talk </i></a></span></span></td></tr>
</tbody></table>
<div style="text-align: center;">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"></span></span>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">TED prohibits “selling from
the stage” and apparently my call to action at the end was too much of a “sell”.
Here is the intended conclusion of my original TEDMED talk.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>"Radical
transparency won’t be easy. There will be many critics, some who have ulterior
motives and have something to hide, and others who are just scared of changing
the status quo. But if it’s anywhere we can unlock our imaginations, any place
where we dare to speak up, with anyone who can make the impossible a reality,
it’s here at TEDMED, with all of you. </i></span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>
</i></span></span><div class="MsoNormal">
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>I
call upon everyone here—anyone who will ever be a patient or family member of a
patient—to sign the <a href="http://www.ipetitions.com/petition/total-transparency-manifesto">total
transparency manifesto</a>. I call upon doctors, nurses, physical therapists,
nutritionists, and all healthcare providers to take off our white coats and show
our patients who we are. </i></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>I’m taking the leap. This, today, is my pledge<span>.</span> Will you join me?"</i></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">The talk is <a href="http://www.ted.com/talks/leana_wen_what_your_doctor_won_t_disclose" target="_blank">here</a>. I'd love to hear what you think.</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com52tag:blogger.com,1999:blog-2206076157248089688.post-16154356914325462332014-11-08T17:20:00.002-05:002014-11-08T17:20:54.254-05:00On Caring for the Neglected 20%: People With Disabilities<style>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">In last month’s <i>Health Affairs</i>, I wrote a <a href="http://content.healthaffairs.org/content/33/10/1868.full">personal
perspective</a> about unequal treatment for patients with disabilities. Nearly
20% of the population in the U.S. have a disability; yet, teaching about care
for people with disabilities is not a mandated part of the medical curriculum.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">This is a deeply personal issue to me. As someone <a href="https://www.youtube.com/watch?v=W6z18y2IP6k">who grew up with a speech
impediment</a>, I am acutely aware of the prejudices and disparities that
result from lack of knowledge. </span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEqqUw3fUaAY4jI7jA00si-tuJuD78MN-BH9C6ec3IqBSJc3HGKozg7qkVC1k2VGFBenmYtpRy7mfc1Om-T4wNdC0glab1mECy3l9QvVF0qu2dntOdIp-vik_u4lL4GtncQ9Osj8djtoQ/s1600/10346538_10100483724733582_906815484251785753_n.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhEqqUw3fUaAY4jI7jA00si-tuJuD78MN-BH9C6ec3IqBSJc3HGKozg7qkVC1k2VGFBenmYtpRy7mfc1Om-T4wNdC0glab1mECy3l9QvVF0qu2dntOdIp-vik_u4lL4GtncQ9Osj8djtoQ/s1600/10346538_10100483724733582_906815484251785753_n.jpg" height="200" width="150" /></a>I’m grateful to <i>Health Affairs</i> for publishing <a href="http://content.healthaffairs.org/content/33/10/1868.full">this article</a>
and producing the <a href="http://www.healthaffairs.org/podcasts/a-simple-case-of-chest-pain-sensitizing-doctors-to-patients-with-disabilities/?homepage">associated
podcast</a>. This has been nearly10 years in the making—thanks to my mentors
and colleagues Dr. Fitzhugh Mullan and Dr. Audrey Young, among others, for
encouraging me to write about my experiences. </span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">And I will be forever indebted to
Professor Vivian Sisskin: a friend, mentor, supporter, cheerleader, and best
speech therapist ever. This essay is dedicated to all those who are fighting to
ensure equitable and accessible healthcare.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Link to <a href="http://content.healthaffairs.org/content/33/10/1868.full" target="_blank"><i>Health Affairs</i> article:</a></span></span></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://content.healthaffairs.org/content/33/10/1868.full" target="_blank"><img alt="http://content.healthaffairs.org/content/33/10/1868.full" border="0" src="http://content.healthaffairs.org/icons/logo.gif" /></a></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.washingtonpost.com/national/health-science/for-people-with-disabilities-doctors-are-not-always-healers/2014/10/24/afb632e6-45a0-11e4-b437-1a7368204804_story.html" target="_blank">Condensed version in the <i>Washington Post</i></a>: </span></span></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://upload.wikimedia.org/wikipedia/commons/9/93/The_Logo_of_The_Washington_Post_Newspaper.svg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://upload.wikimedia.org/wikipedia/commons/9/93/The_Logo_of_The_Washington_Post_Newspaper.svg" height="49" width="320" /></a></span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com29tag:blogger.com,1999:blog-2206076157248089688.post-22887747759233437802014-11-04T21:54:00.001-05:002014-11-04T21:54:14.598-05:00A Month of Conferences & Inspiration
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">My blog entries have been light over the last month in large
part because of significant travel. In between clinical shifts in the ED and
co-leading a fantastic cohort of GWU’s Residency Fellowship in Health Policy, I
was fortunate to be invited to speak at several conferences in October. Here
are some highlights:
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">In early October, I was honored to keynote the <a href="http://www.newsadvance.com/news/local/work-of-mammogram-advocacy-group-lauded-at-luncheon/article_63e46ed0-50d3-11e4-959c-001a4bcf6878.html">Centra
Health Foundation annual gala</a> in Lynchburg, VA to celebrate the work of
several hundred volunteers, all of whom were either breast cancer survivors or
family members of survivors. The event was moving and powerful; I thought of
how proud my mother would be to hear me share her story with so many courageous
and inspiring women.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Next was the <a href="http://www.ucdprehealth.org/">12<sup>th</sup>
Annual UC Davis Pre-Health Professions Conference</a> in Davis, CA. Ten years ago,
when I was the national president of the American Medical Student Association,
I was approached by a student from a community college named Joubin Afshar who
told me that he had started a conference for community college students who
wanted information about the health professions. I attended the conference
then, and was blown away by the drive and passion of these students. Nearly all
were first generation college students, and for many, this was their first and
only exposure to medical professionals. </span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Having been such a student myself, I vowed to return
whenever possible. Last year and this year, I gave a keynote and led four
workshops on leadership in medicine. Nearly 8,000 students attended the
conference—many took overnight buses across California and even from the East
Coast. It’s remarkable to see the work done by a small group of committed
students. I wonder how many health professionals are where they are now because
of the work of Joubin and his colleagues. (I also had the opportunity to see a
friend and colleague, <a href="http://www.davisliumd.com/">Dr. Davis Liu</a>:
an exceptional leader, thinker, and physician.)</span></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2zjzI7qF-dsin48w1y9sRKu-YnZCERUpEyq17klHonFUNYRmSAImlugNNBFBlHQ65lYzjNIiePFhX92IK_LF4JuJSZ-0y04w8M-EpxPIslwgdnHKiuqzWqADTKbozg6FXYk5F_lhAY-s/s1600/ELAHC+2.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi2zjzI7qF-dsin48w1y9sRKu-YnZCERUpEyq17klHonFUNYRmSAImlugNNBFBlHQ65lYzjNIiePFhX92IK_LF4JuJSZ-0y04w8M-EpxPIslwgdnHKiuqzWqADTKbozg6FXYk5F_lhAY-s/s1600/ELAHC+2.jpg" height="240" width="320" /></a></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">My former Rhodes colleague who is now Chief Resident at
Einstein Hospital in Philadelphia, Dr. Gary Huang, invited me to give Grand
Rounds to the Departments of Internal Medicine and Emergency Medicine (pictured
here with fellow Chief Resident and very kind physician Dr. Carlos Davila). I
received many questions on what physician trainees can do to avoid burnout and
deliver true patient-centered care. </span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">No answer I gave could have been as telling
as the actions of Dr. Huang. As we were coming down the elevator, a woman in
her fifties stopped us to ask directions to a particular surgeon’s office. I
watched as Gary helped her figure out the name of the surgeon, led her to
identify his location, then navigate her there. So many other people would have
simply said, “I don’t know” and implied that it’s not their job to know, but not
Gary. He took the time to help this woman in need, going far out of his way to
do so. He didn’t do it to impress her or me (and I suspect he and his equally
humble and caring wife Sherry would both be embarrassed by this blog post), but
because it was the right thing to do. This action speaks volumes about the type
of doctor he is, and answers the question that the residents asked: there may
be many factors that make us disconnected from our patients, but it is within
our abilities to treat patients as people, to value each person’s humanity, and
to exemplify basic dignity and respect. </span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">At the <a href="http://www.acep.org/saContent.aspx?id=86186">Urgent
Matters Conference</a> during the American College of Emergency Physicians
meeting in Chicago, Dr. Jesse Pines expanded upon these themes. The other
presenters (including my former attending at Brigham and now MGH Vice Chair,
Dr. Ali Raja) and I spoke about how patient-centeredness and better
communication can reduce overtreatment, improve patient safety, and transform care.
The response was much better than expected, in no little part due to the
amazing tweeting capabilities of one Dr. Seth Trueger (aka @MDAware).</span></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizeU4Dn8547xA3RL0d1xyw9SJA_4tAf-ubuwq_omYSWG-v-zGaeig85j27xXsA2lmjWRi6fw6ZFfpljID-WkB4tZhSb4pA-nNjXtb7Q3NcDB3psdveuoW7wJ2_tmX5s26L6NrFxaYcKUA/s1600/ELAHC+3.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEizeU4Dn8547xA3RL0d1xyw9SJA_4tAf-ubuwq_omYSWG-v-zGaeig85j27xXsA2lmjWRi6fw6ZFfpljID-WkB4tZhSb4pA-nNjXtb7Q3NcDB3psdveuoW7wJ2_tmX5s26L6NrFxaYcKUA/s1600/ELAHC+3.jpg" height="200" width="150" /></a></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Then it was on to Nijmegen, the Netherlands, where Corine
Jansen (pictured), Jennie Grau, and their team organized the <a href="http://www.elahc.com/">first-ever listening conference in healthcare</a>.
Initially, when my husband heard that I was speaking at listening conference,
he laughed—isn’t it an oxymoron? And I have to say that I didn’t initially
understand what a listening conference was really about (though the <a href="http://www.listen.org/">International Listening Association</a> has a
long history of hosting these conferences, and cosponsored this one). </span></span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrxP2KwfRFsOkwkjPolGI5bj0R_igT_SFvWVPdN2aSEGQGALEO3truPb7bpJP_LTPb1V-Dr3LVYy4WnOcqK9LZ1RSug2_32FfWzJSiZFTJI9eO06HJeBk6DDjCF70Ry2_gDcvPbQn-Ve0/s1600/ELAHC+1.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrxP2KwfRFsOkwkjPolGI5bj0R_igT_SFvWVPdN2aSEGQGALEO3truPb7bpJP_LTPb1V-Dr3LVYy4WnOcqK9LZ1RSug2_32FfWzJSiZFTJI9eO06HJeBk6DDjCF70Ry2_gDcvPbQn-Ve0/s1600/ELAHC+1.jpg" height="320" width="240" /></a><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">The moment I showed up, though, I got it. Patients, family
members, doctors, nurses—they shared their stories. They were powerful and
unforgettable; indeed, as one participant commented, “the shortest distance
between people is a story.” I heard a doctor speak about how he and his fellow
neurologists assumed that their patients with Parkinson’s disease cared most
about memory and managing their tremors. But when they listened—really
listened—to their patients, they heard that what mattered most to them was
sleep and sex. So they changed the entire medical encounter so that it wasn’t
just about medication management, but also hired a sex and sleep therapist. Corine,
Jennie, your team at REShape (where I took the photo with the best message
ever): hats off to you for a fantastic conference and to the tremendous
individuals I had the pleasure of meeting there.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">This week, it is off to Grantmakers in Health Conference in
DC then American Cancer Society in San Jose, CA. I hope to contribute more
substantive blog posts soon; please write if there are particular topics you
would like to see.</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com47tag:blogger.com,1999:blog-2206076157248089688.post-87921935999365894322014-10-27T12:01:00.003-04:002014-10-27T12:01:38.595-04:00More on OpenNotes & Surprising Results of What Doctors Think
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Recently,
I wrote on <a href="http://www.npr.org/blogs/health/2014/08/14/340351393/when-patients-read-what-their-doctors-write">NPR’s
Shots Blog</a> about the movement towards open medical records and the
pioneering work of OpenNotes by Dr. Tom Delbanco and Jan Walker. Here’s an
excellent <a href="http://www.rwjf.org/en/blogs/pioneering-ideas/2014/10/podcast_episode_6.html?cid=xsp_aggout_piopod6">RWJF
podcast</a> about<span style="border: 1pt none windowtext; padding: 0in;"> why they decided getting
health care providers to share their notes with patients, and where their work
is headed next. </span></span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="border: 1pt none windowtext; padding: 0in;">Here’s a hint: what if the 3 million patients who </span>now
have access<span style="border: 1pt none windowtext; padding: 0in;"> to their clinician’s notes could
co-write notes with their providers?</span></span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="border: 1pt none windowtext; padding: 0in;">I'll add another thought: what if we go beyond written medical records, and patients wish to have audio- or video-tapes of their doctors' visits? </span></span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="border: 1pt none windowtext; padding: 0in;">Patient advocates have responded very positively to the OpenNotes concept. I was curious about what doctors think of it and other movements to transparency. Emily Peters from Doximity was kind enough to help me with an informal poll of Doximity users (doctors who register to be on their site). We asked 3 questions and asked doctors to use a 1-5 scale, 1 being not at all likely to 5 being very likely. We received 113 responses:</span></span></span></div>
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<span style="color: black;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS0bqxdi52o0_UvOALphncwlbA1HRJ10aPIeTnXB7958q_A74-0D3QAozydqCJlK_Fy-OvQLFAHhcxIZ0dvZa0oU0SyWNaTdzDH5PIZ8Xb4UWT9-b5tNpBwHjIdIGTDZZhNU1fIuNUNiw/s1600/Screen+Shot+2014-10-27+at+10.56.24+AM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiS0bqxdi52o0_UvOALphncwlbA1HRJ10aPIeTnXB7958q_A74-0D3QAozydqCJlK_Fy-OvQLFAHhcxIZ0dvZa0oU0SyWNaTdzDH5PIZ8Xb4UWT9-b5tNpBwHjIdIGTDZZhNU1fIuNUNiw/s1600/Screen+Shot+2014-10-27+at+10.56.24+AM.png" height="350" width="400" /></a></span></div>
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<span style="color: black;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBe-IzInluDAvRSo-VS0CHZTvicNa4XbGJx1Sy5pJush1MLfgPTKcwrOxskbgH3Qlv71gYFL6X-tM6cqIPzDm9fyNewXWrw2vGWJM3pbwfAUgK1c5-xNJ4emqU7jgQeaYUb5GKmOgW4N0/s1600/Screen+Shot+2014-10-27+at+10.56.43+AM.png" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBe-IzInluDAvRSo-VS0CHZTvicNa4XbGJx1Sy5pJush1MLfgPTKcwrOxskbgH3Qlv71gYFL6X-tM6cqIPzDm9fyNewXWrw2vGWJM3pbwfAUgK1c5-xNJ4emqU7jgQeaYUb5GKmOgW4N0/s1600/Screen+Shot+2014-10-27+at+10.56.43+AM.png" height="171" width="400" /></a></span></div>
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<span style="font-size: x-small;"><i><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">(Please note that I have no financial with Doximity, and this poll is not meant to be a scientific study.)</span></i></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I’d
love to know what you think about this. Do the data surprise you? What do you think about open medical records, and patient-initiated requests to audiotape/videotape their medical encounters?</span></span></div>
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Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com15tag:blogger.com,1999:blog-2206076157248089688.post-22400250469973426072014-09-19T13:49:00.001-04:002014-09-19T13:49:39.776-04:00Innovations in “Upstream” Care
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My <a href="http://whendoctorsdontlisten.blogspot.com/2014/08/going-beyond-band-aid-care.html" target="_blank">last blog</a> was on how today’s medical system fails by not addressing the real
needs of our patients and their communities. Here, I highlight three projects
that take such an “upstream” approach to healthcare:</div>
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Doctors can give prescriptions for medications, but why not
a prescription for healthy foods and safer housing? <a href="https://healthleadsusa.org/">Health Leads</a> employs young people
(usually college graduates interested in careers in health) to be advocates who
assist doctors in clinics and ERs in connecting patients with community
resources. They help with everything from food assistance to job training to
legal counseling. They help to “fill” the other prescriptions that people need
to achieve better health.</div>
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<a href="http://cdn.lightgalleries.net/4bd5ec0f29823/images/chicago20110908_0019-1.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://cdn.lightgalleries.net/4bd5ec0f29823/images/chicago20110908_0019-1.jpg" height="320" width="320" /></a></div>
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Recognizing that black males have significant health
disparities and that outreach and education must start in the community, <a href="http://projectbrotherhood.net/">Project Brotherhood</a> was conceived
from a simple idea: give patients free haircuts, and use barber shops as a
place to screen and counsel on illnesses such as high blood pressure and STI
prevention. Its model of multidisciplinary, culturally competent care
incorporates other aspects of social support, including on fatherhood and job
support.</div>
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<i style="mso-bidi-font-style: normal;"><span style="mso-spacerun: yes;"> </span>The New York Times</i> just published a story
about an <a href="http://opinionator.blogs.nytimes.com/2014/09/18/a-chance-to-go-from-hard-lives-to-healing/?ref=opinion">“EMS
Corps”</a> in East Oakland that specifically recruits at-risk youth and train
them to be emergency medical technicians. They provide mentorship for young men
who come from backgrounds of poverty and violence, and train them to become
professionals who will serve their communities. As the story cites, these men
are taught that they aren’t the problem—they are the solution. </div>
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These are only some of the some of the many innovations
occurring around the country. We need far more interventions that <a href="http://www.huffingtonpost.com/leana-wen-md/going-beyond-band-aid-car_b_5648649.html">go
beyond “band aid” care</a>. In the words of public health doctor Rishi
Manchanda (whose recent <a href="http://www.ted.com/talks/rishi_manchanda_what_makes_us_get_sick_look_upstream" target="_blank">TED talk</a> I highly recommend), we must change our entire approach to healthcare,
away from simply treating the effects of illnesses to targeting interventions
to where people live, work, and play—where health really begins.</div>
Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com8tag:blogger.com,1999:blog-2206076157248089688.post-54747241657400262712014-09-15T11:21:00.000-04:002014-09-20T02:09:06.102-04:00Guest: Narrative Medicine & Inside Stories<style>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>I am
delighted to host a guest blog by writer and narrative medicine specialist Annie Robinson, who describes
her journey with storytelling.</i> </span></span></div>
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<br /></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgt7BNWGiYlY2KdpMSYNPup_fDuErUa4olSCPGN3ox8y3yKmbIZY7Kn3HwS7Khd88-rSS4uc8HprxLlMyen6hiOFSLIYYudJ-Dj5k8Lk6geMqKfHdbdsz_QvpE5z5Ktzk5kgk68lQlAwkg/s1600/photo.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgt7BNWGiYlY2KdpMSYNPup_fDuErUa4olSCPGN3ox8y3yKmbIZY7Kn3HwS7Khd88-rSS4uc8HprxLlMyen6hiOFSLIYYudJ-Dj5k8Lk6geMqKfHdbdsz_QvpE5z5Ktzk5kgk68lQlAwkg/s1600/photo.JPG" height="200" width="200" /></a></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">On a warm June afternoon, clustered around picnic
tables, cradled in the mountains of the Berkshires in western Massachusetts,
eight medical students from around the world began telling one another their
stories. They were among approximately 40 students invited to participate in a
weeklong intensive program run by AMSA for medical students interested in
integrative medicine called LEAPS. As a graduate student <a href="http://ce.columbia.edu/Narrative-Medicine">of Narrative Medicine at
Columbia University</a>, I was asked to help facilitate the program.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Over iced tea and dark chocolate, they spoke of
heartbreak and grief and divorce, of exam-stress and isolation and fear. They
also shared brilliant visions of innovative approaches to medical care, and
their aspirations to foster intimate relationships with their fellow medical students,
their families and friends, and their patients. I listened with rapt attention
as they described how, from personal struggles, conviction and vision were born
for their careers as caregivers. I shivered, on that muggy summer day, knowing
I was in the presence of my tribe.</span></span><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"> </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I was raised to revere the power of storytelling,
which has been a critical component in how I have navigated my way through the
world. It proved particularly useful when I entered the healthcare system in my
early adolescence. I have spent over half of my life now as a patient,
grappling with illnesses and issues of embodiment. In large part, it has been
by speaking my struggles aloud that I have been able to heal. Telling my
stories has allowed me to harness the power of the dark times to create
connections and attain insight.</span></span><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"> </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">As I sat there at LEAPS, witnessing medical students
experiencing what I myself had experienced time and again–that relationships
and wisdom come from baring one’s soul – I began to envision a way to enable
more students to engage in this powerful narrative process. The seeds for my
oral narratives podcast project <i><a href="http://in-training.org/inside-stories">Inside Stories: Medical Student
Experiences</a></i> were planted. I wanted to hear more student stories
about the path to medicine, about struggles and triumphs, roadblocks and
dreams. Through sharing over the course of that week, the students gained
clarity and catharsis, and many remain in touch to this day.</span></span><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i> </i></span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>Inside Stories</i> emerged from those conversations with LEAPS students. The idea was
to develop a podcast platform that would enable medical students anywhere to
both voice and listen to stories about medical student experience. <i>Inside
Stories’</i> mission is “to provide a means of personal healing,
self-realization and empowerment through the sharing and receiving of personal
stories, as well as to cultivate community among students in the often
isolating medical school environment.” The interview process involves
recording stories from current medical students, remotely or in-person.
Recruitment has been done via word-of-mouth, social media platforms, and at
medical humanities conferences. Student participants comprise a diverse
demographic of men and women from all four years of medical school, of various
races and nationalities, interested in medical fields ranging from OB/GYN to
pediatrics to gastroenterology and many more.</span></span><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"> </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">The topics addressed are vast. Hannah spoke about the
challenges of navigating in medical school while being a mother. Petra
reflected on how her spiritual path informs the challenges being a medical
student. Katie discussed the encouragement she gained from finding her mentor.
Leah shared how writing poetry aided her personal healing. Samar described how
self-care practices helped her get through school. Angie talked about how her
Syrian heritage drove her motivation to become a physician. Hieu shared his
experiences as a community health worker in Uganda propelled his motivation to
combat structural violence. Carlton described his motivation to pursue medicine
in the South, to offer the African-American community a provider with
whom they can identify.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">To date, over 40 students have participated
in the project. One participant reflected: “At first I was intimidated at
the prospect of sharing my deepest feelings to a public audience, especially
because I had never verbalized these feelings and in general I am a very
private person. Ultimately, I'm glad I committed myself to this project and am
proud to have my message out in the open.” Another described how sharing
felt validating: “It made it seem real - everything that I had been through.”</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I hope that by listening to the accounts of the
courageous, insightful students whose stories constitute this project, others
will follow suit and be inspired to share the personal stories at the
heart of their journeys through the world of medicine<i>.</i></span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>If you or
someone you know might be interested in telling their story about their
experience in medical school, or if you have further questions about Inside Stories, please contact Annie and
visit this <a href="http://in-training.org/inside-stories">website</a> and on
Twitter @Inside_Stories.</i></span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com10tag:blogger.com,1999:blog-2206076157248089688.post-61263420993312791842014-08-19T18:35:00.000-04:002014-08-19T18:35:35.563-04:00Should Patients Have Total Access to Their Medical Records?
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">The law says yes. Prior to 1996, patients had to sue to see
their own records. Since HIPAA—the Health Insurance Portability and
Accountability Act—patients are guaranteed by law to have access to their
records. However, the process for getting medical records is often so
cumbersome that people don’t look at them, and usually not well after their
medical visit.</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div class="MsoNormal">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">In my medical training, I learned that the medical record is
a tool for doctors to communicate with each other. But could it be harnessed as
a collaborative tool for patients?</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div class="MsoNormal">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.npr.org/blogs/health/2014/02/15/277027231/when-a-prescription-for-pain-pills-becomes-a-gateway-to-addiction" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.poynter.org/wp-content/uploads/2013/11/npr_logo_rgb.jpg" height="101" width="320" /></a></span></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.npr.org/blogs/health/2014/08/14/340351393/when-patients-read-what-their-doctors-write" target="_blank">When Patients Read What Their Doctors Write</a></span></span></td></tr>
</tbody></table>
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<br /></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div class="MsoNormal">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZgm10sd1e3p2E7cTH77AwU8S8tvG036aaBV456D87FUN3tkYW4jQzeMjxPnS3s9an7RWjMVxlA4fuLZqEIhKrfjY5CGdcM06HUFnKp3IQXyGDgHG2A6dlfQ91tylm_HlsDPod5I8h6_U/s1600/NPR+photo.JPG" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZgm10sd1e3p2E7cTH77AwU8S8tvG036aaBV456D87FUN3tkYW4jQzeMjxPnS3s9an7RWjMVxlA4fuLZqEIhKrfjY5CGdcM06HUFnKp3IQXyGDgHG2A6dlfQ91tylm_HlsDPod5I8h6_U/s1600/NPR+photo.JPG" height="320" width="240" /></a><a href="http://www.npr.org/blogs/health/2014/08/14/340351393/when-patients-read-what-their-doctors-write">My
latest NPR article</a> discusses ongoing national experiments to provide open
access to patients not only of their test results, but also their doctor’s
notes. Participating doctors were initially opposed to the concept, but the
results from the experiment have been striking:</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div class="MsoListParagraphCxSpFirst" style="text-indent: -0.25in;">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span>·<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span>80%
of patients who saw their records reported better understanding of their
medical condition and said they were in better control of their health;</span></span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div class="MsoListParagraphCxSpMiddle" style="text-indent: -0.25in;">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span>·<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span>Two-thirds
reported that they were better at sticking with their prescriptions;</span></span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div class="MsoListParagraphCxSpLast" style="text-indent: -0.25in;">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span>·<span style="-moz-font-feature-settings: normal; -moz-font-language-override: normal; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;">
</span></span><span>99%
percent of the patients wanted OpenNotes to continue</span></span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><div class="MsoNormal">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span>When
patients see their records, there's more trust and more accuracy. But that
doesn’t mean that OpenNotes is a panacea. There are new controversies that are
arising. I address them in this article, and also on Weekend Edition. <a href="http://www.npr.org/blogs/health/2014/08/14/340351393/when-patients-read-what-their-doctors-write">Listen
here</a> for the interview with legendary journalist Linda Wertheimer.</span></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">What do you think? Should patients have full access to what
their doctors write about them?</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com7tag:blogger.com,1999:blog-2206076157248089688.post-64578912865811129782014-08-16T13:45:00.000-04:002014-08-16T13:45:05.813-04:00Open Payments: Will Transparency Hurt Or Help Patients?
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Today, I was interviewed
on <a href="http://www.cbsnews.com/videos/troubles-hit-site-that-discloses-payments-given-to-doctors/">CBS This Morning</a> about whether the government’s Open Payments website should be delayed.
This is part of the Physician Payment Sunshine Act that will provide public
access to payments made to physicians by pharmaceutical and medical device
companies.
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPMDclP36OlW_2WITKyHiLS0tslMuzSER72IPmAF0FydU1KF0b68KczeCmgJPm486Od8r9jAVVeLM_TjoE0JI-biN-DzDlHz9yxStx-xj8dqR-oC7xC7ltHQD9124EAHOTXZ9Bd7X37_0/s1600/Screen+Shot+2014-08-16+at+1.10.15+PM.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiPMDclP36OlW_2WITKyHiLS0tslMuzSER72IPmAF0FydU1KF0b68KczeCmgJPm486Od8r9jAVVeLM_TjoE0JI-biN-DzDlHz9yxStx-xj8dqR-oC7xC7ltHQD9124EAHOTXZ9Bd7X37_0/s1600/Screen+Shot+2014-08-16+at+1.10.15+PM.png" height="224" width="400" /></a>Over the years, I have become
<a href="http://www.npr.org/blogs/health/2013/12/14/250714833/before-the-prescription-ask-about-your-doctors-finances">increasingly concerned</a> about the harmful effects of financial conflicts of
interest on patient care. <a href="http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.0040150">Dozens of studies</a> have shown that financial relationships between doctors and
drug/medical device companies influence physician prescription practices. </span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">My research on patient-centered
care also shows that patients are concerned about these potential conflicts of
interest and how they may affect their care. Our patients deserve to know how
their doctors are paid and whether this may affect them. The Sunshine Act will
provide much-needed, critical tools for increasing transparency and accountability,
and will help exert pressure to prevent inappropriate financial relationships
between doctors and industry in the future.</span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">The Open Payments website
that will display the payments to doctors has already been delayed by more than
a year. Now, in light of some technical problems, physician groups including
the American Medical Association are arguing that there should be another
six-month waiting period. While it is important to provide doctors an
opportunity to review and dispute payments to them, this should not delay
timely release of physician payments data to the public. </span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><a href="http://www.ama-assn.org/ama/pub/news/news/2014/2014-08-15-ama-requests-delay-sunshine-act-publication.page">The American Medical Association argues</a> that inaccurate information could undermine trust. If
physicians want to improve trust, they can take a proactive approach and begin
conversations with patients. They can send out an email or letter clarifying their
affiliations with drug companies. They can participate in <a href="http://www.whosmydoctor.com/">Who’s My
Doctor</a> and explain their philosophy
publicly, online. They can have one-on-one conversations with those who have
questions. Such openness will only improve the doctor-patient relationship,
improve trust, and increase accountability.</span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">For those doctors who truly
are ashamed of their payment history, perhaps they can reevaluate their
financial relationships. As former Supreme Court Justice William O. Douglas
said, “Sunlight is the best disinfectant.” The sunlight is available now.
Physicians and patients alike should <a href="http://www.ipetitions.com/petition/total-transparency-manifesto">embrace it</a>,
now.</span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><i>Parts of this post were part of an open letter I sent to Ms. Marilyn
Tavenner, CMS administrator, on May 27<sup>th</sup> 2014 with the subject of “</i><i>Revision of a currently approved collection; <span>Title of Information Collection</span>: Registration, Attestation,
Dispute & Resolution, Assumptions Document and Data Retention Requirements
for Open Payments (CMS-10495).”</i></span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com6tag:blogger.com,1999:blog-2206076157248089688.post-61338470688625881042014-08-04T15:17:00.001-04:002014-08-05T15:35:51.298-04:00Going Beyond “Band Aid” Care<style>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">When I was a medical student, I worked with an NGO in Rwanda
to provide medical care to women with HIV. Nearly all had witnessed their
family members murdered during the genocide, and many became afflicted with HIV
as a result of rape. Our initial focus was on getting antiretroviral therapy to
these women, but we quickly realized that while it was important for them to
have access to medications, they couldn’t be healthy unless they also had
enough food to eat. They couldn’t stay safe unless they had shelter. They
couldn’t be well unless we addressed their psychological trauma.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">As an emergency physician working in inner city ERs in St.
Louis, Boston, and D.C., I see this same problem every day. My 8-year old patient, Kami, comes in wheezing and
short of breath. She has asthma, and two years ago, she lost her inhaler. She and
two brothers are staying with her mother’s cousin; lots of people smoke in the
house; and she’s missed several days of school. I can give her a breathing
treatment and prescribe an inhaler, but how do I help her achieve good health?</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Over the last year, I’ve seen
19-year old Byron in the ER three times. The first time, he was stabbed on the
arm. It was a superficial cut; he received some stitches. The second time, he got
in a fight and broke his hand. I gave him a splint and sent him home. The third
time, he was shot twice in the abdomen. I stabilized him and sent him to the
operating room. I wonder when he will be back for another violent injury. Is
there a better way to help him than to patch him up, piece by piece?</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Then there’s Josephine, a
38-year old single mother of four. She was told four years ago that she has
cervical cancer. Between her three part-time jobs and taking care of her children,
she had no time to see a doctor. Her boss threatened to fire her if she left in
the middle of the day. She tried to call a specialist, but they wouldn't take
her insurance. By the time she comes to the ER, her cancer had spread to her
intestines and her lung. We set her up for treatment, but what does it say
about our society that her disease had to progress this far?</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Our healthcare system is good at providing short-term fixes
for problems. We pride ourselves in having the most advanced technologies in
the world. We can provide this excellent care for the few hours the patient is
with us in the ER, hospital, or clinic—but then the patient is on her own and
back to the same problems, 24 hours a day, 365 days a year. Numerous studies
have shown that it’s where
we live, learn, work, and play that have a far greater impact on our well-being
than the treatment delivered in a hospital.</span></span><br />
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://upload.wikimedia.org/wikipedia/commons/0/08/Band-Aid_close-up.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://upload.wikimedia.org/wikipedia/commons/0/08/Band-Aid_close-up.jpg" height="100" width="200" /></a> I chose to be an emergency physician because I want to
provide excellent care to everyone, regardless of ability to pay. We in the ER
provide a necessary service, but it’s far from being sufficient. We need
comprehensive strategies that promote health and target problems “upstream”. We
need to recognize that health does not exist in a vacuum, that it is intimately
tied to issues such as literacy, employment, transportation, crime, and poverty.
An MRI here, a prescription there—these are Band-Aids, not lasting solutions. Our
communities need innovative approaches to
pressing issues like homelessness, drug addiction, obesity, and lack of mental
health services.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">The sage Dr. Patch Adams said that if we treat the disease, we
lose; if we treat the patient, we win. To help the patient, we must also
address the health of the community.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Over the next several blogs, I will be exploring interventions
that show promise in addressing the needs of the patient and their community. I
welcome your ideas and suggestions.</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com14tag:blogger.com,1999:blog-2206076157248089688.post-80982303681580401892014-08-03T14:02:00.001-04:002014-08-03T14:02:20.589-04:00TEDMED!<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">This week, TEDMED announced its <a href="http://blog.tedmed.com/?p=5483" target="_blank">final speakers</a> for the dual San Francisco-Washington, D.C. event. </span></span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><a href="http://www.tedmed.com/resources/displaypicture?id=36591" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://www.tedmed.com/resources/displaypicture?id=36591" height="80" width="320" /> </a></span></span></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><a href="http://www.tedmed.com/event/stage2014" target="_blank">TEDMED 2014</a></span></span></div>
<br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I am excited and honored to be part of this list, along with a phenomenal group of healthcare leaders & entrepreneurs including Abraham Verghese, Thomas Goetz, Danielle Ofri, Betsy Nabel, and many more.</span></span><br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">My talk will be on radical transparency in medicine. More to come soon--and please join us at the Kennedy Center in September!</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com3tag:blogger.com,1999:blog-2206076157248089688.post-45813201949801710052014-07-26T02:09:00.001-04:002014-07-26T02:09:21.589-04:00Guest Post: In a Patient’s Death, My Life Found New Purpose
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<i><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="color: #141414;">I am delighted to host this guest blog from Dr. Eric Bing, physician and professor of global health. We share a passion for fighting disparities in health, a passion is deeply rooted in personal experience, and that comes through in this poignant essay.</span></span></span></i></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="color: #141414;">I was a Harvard-educated physician yet I couldn’t save a patient
from an easily preventable disease.<span> </span>In
her death, my life found new purpose.</span></span></span></div>
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</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="color: #141414;">Her name was Lorraine.<span> </span>She
was abandoned when she was just six weeks old—left alone in a dark building on
a cold winter’s morning. Wrapped in only a soiled blanket, she had nothing to
soothe her cries. She might have died if not for those cries, for someone heard
her and carried the tiny body </span>to the infant’s grandmother. In Philadelphia in the
1930s, neighbors knew everything about each other, and the existence of this
child was not a secret. Her grandmother took her in. She had already raised
15 children of her own, so what was one more? </span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">As
a little girl, Lorraine grew up fast. Even with her sharp mind, like many black
girls at that time, she had little money and even fewer opportunities. She
slept in the crawl space under her grandmother’s stairs. When she was 12,
Lorraine began working as a domestic servant, cleaning houses and caring for
children not much younger than herself. She later dropped out of school,
and while still a teenager began having babies of her own.<span> </span></span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">She
was so busy taking care of others that when she began having light, occasional
vaginal bleeding, she ignored it.<span> </span>She
had already gone through menopause so this was nothing to worry about.
But over time the light bleeding became heavy and the occasional occurrence
became alarmingly frequent. After an anxious trip to the doctor, tests
confirmed that she had cervical cancer, caused by the human papilloma virus she
had acquired years earlier.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Lorraine’s
life was once again in danger, but this time from an easily preventable disease.
</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Cervical
cancer can be diagnosed in its earliest stages by a simple Pap smear. In
developing countries where Pap smears are too expensive, it is being diagnosed
using a few drops of vinegar or prevented in girls with a simple vaccination.
And it can be treated at an early stage by freezing lesions off, like a
wart. <span></span>But in order for early care
and treatment to work, you must not only have access to care, you must use
it. And like many women, she did not do that; the needs of others always
came first.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">By
the time her cancer was diagnosed, it had already spread throughout her
pelvis. From there it would move to her liver, bones, and lungs before
spreading to her brain and taking her life. </span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I
cared for Lorraine until the day she died, however she had cared for me from
the day I was born. </span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Lorraine
was my mother.<span> </span>And her death from an
easily preventable disease changed my life. </span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdPYwL1cuFqJiUM9lKQFOAqhFNTa82y8mN5tOcJ_C2niIxO6X8gWRiQuZMDNaJH5ILr60Q2t9-Z9PlzKkIBXDuC1qPrUf0lGtdJ2KLJUz3FzLtnNheA_2a1L51aQYIPcOwzifZ4oYAJ74/s1600/Eric+Bing+and+Mom.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdPYwL1cuFqJiUM9lKQFOAqhFNTa82y8mN5tOcJ_C2niIxO6X8gWRiQuZMDNaJH5ILr60Q2t9-Z9PlzKkIBXDuC1qPrUf0lGtdJ2KLJUz3FzLtnNheA_2a1L51aQYIPcOwzifZ4oYAJ74/s1600/Eric+Bing+and+Mom.jpg" height="282" width="320" /></a></div>
<div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I
was a psychiatrist in Los Angeles when my mother died in 1999.<span> </span>Today I am the senior fellow and founding
director of global health at the George W. Bush Institute in Dallas and the
founding director of the Center for Global Health Impact at Southern Methodist
University. </span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal" style="margin-bottom: 15pt;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">At
the Bush Institute, I helped launch, <a href="http://www.bushcenter.org/global-health/pink-ribbon-red-ribbon">Pink
Ribbon Red Ribbon</a>, an innovative public private partnership to combat
cervical and breast cancer in Africa and Latin America by increasing access to
cancer prevention and treatment.<span> </span>In developing
countries, where Pap smears are too expensive, cervical cancer can be diagnosed
by putting a few drops of vinegar on the cervix, which is then examined under a
lamp. Lesions appear white and can be treated at an early stage by freezing
them off.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal" style="margin-bottom: 15pt;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">A
recent study from India showed that this simple vinegar test that costs less
than $1 can reduce deaths by nearly one-third. There are also inexpensive
vaccines that can prevent the viral infection entirely. We can defeat cervical
cancer now in simple, cost-effective ways.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal" style="margin-bottom: 15pt;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">The
challenge is access.<span> </span>In <a href="http://www.amazon.com/Pharmacy-Bicycle-Innovative-Solutions-Poverty/dp/1609947894">Pharmacy
on a Bicycle:<span> </span>Innovative Solutions for
Global Health and Poverty</a>, Rice University business professor Marc J.
Epstein and I show how even access to care barriers can lowered in developing
countries for many diseases, by shifting care to lower-cost providers, focusing
on efficiencies, strengthening existing systems and by stimulating partnerships
among governments, businesses, nonprofits, entrepreneurs and women of all ages.
And, as my mother's death taught me, we must mobilize women to recognize their
risk and realize that by protecting their health, they can live to protect the
ones they love.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal" style="margin-bottom: 15pt;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">As
my mother lay dying in her home in North Carolina, her house was once
again full— with people who had been helped and touched by her over the
decades. My mother had scoffed at the notion of filling a funeral home with
flowers for the dead. "Give me my roses while I can smell them," she
had said. So people obeyed, coming to bid farewell while she could still
hear them.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal" style="margin-bottom: 15pt;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">Despite
the steady stream of people at her bedside, she fretted in her final days about
what she saw as her lack of accomplishment and lasting impact: She was
intelligent but uneducated. She was courageous yet lived in fear. She had done
nothing with her life, she felt. She had not fulfilled her life's mission.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal" style="margin-bottom: 15pt;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">When
she was finished reliving what she thought was a string of disappointments, I
began to re-tell her life story—not as she understood it—but as I saw and
experienced it as her youngest son.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal" style="margin-bottom: 15pt;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I
told her that I believed that her life's mission was to unleash passion and
purpose in the lives of those she touched. Not only had she raised five
children who went on to careers in business, education and medicine; she had
applied her quick mind, hearty laugh and steel backbone to helping anyone she
came across who was in need. </span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal" style="margin-bottom: 15pt;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">She
taught us that love is what creates a family. She helped us see that
a good heart must be coupled with hard work in order to succeed. Those
that she had helped were now helping others, and they would in turn help
others, and they, still others. Through others, her spirit would live on,
continuing to change the world. </span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">As
we spoke, I could see a shift occurring within her as she sat there
quietly. Softly, a warm smile filled her face, as though she was looking
in the mirror and for the first time loved the woman she saw. </span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">My
mother died in my arms, leaving the world far more peacefully than she entered
it.<span> </span><span style="color: #141414;">In her
death, my life found new purpose.</span></span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><i>Eric
G. Bing is the co-author of "<a href="http://www.amazon.com/Pharmacy-Bicycle-Innovative-Solutions-Poverty/dp/1609947894">Pharmacy
on a Bicycle: Innovative Solutions for Global Health and Poverty"</a></i><i> and senior fellow of global health at
the <a href="http://www.bushcenter.org/george-w-bush-institute">George
W. Bush Institute</a></i><i>. He
is also a professor global health at Southern Methodist University and founding
director of the <a href="http://www.smu.edu/GlobalHealthImpact">Center
for Global Health Impact</a></i><i>.</i></span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><i>A
version of this article originally appeared in the LA Times, June 23, 2013, as <a href="http://articles.latimes.com/2013/jun/23/opinion/la-oe-bing-cervical-cancer-20130623">A
cancer that need not kill</a></i><i>, by
Eric G. Bing.<span> </span>It is reprinted here with
permission of the publisher.</i></span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com9tag:blogger.com,1999:blog-2206076157248089688.post-5439072867104187812014-07-02T22:35:00.000-04:002014-07-02T22:35:49.631-04:00From NYC and the Leonard Lopate Show<div class="MsoNormal">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">This week, I had the honor of speaking with <a href="http://www.wnyc.org/story/how-get-better-health-care-your-doctor/" target="_blank">Leonard Lopate</a>, the award-winning host of National Public Radio's WYNC show.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Among the topics, we spoke about:</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">* What is cookbook medicine and why aren't checklists always good?</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">* What happens when doctors don't listen? </span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">* Why is getting a diagnosis so important?</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">* How can patients help doctors help them? </span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">* Is malpractice a big problem?</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">* How will the Accountable Care Act shape the future of medicine?</span></span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXDDabBRxEfnGkJqa7kqVuxbpHVAUCnj02QXrbTCtwh076O4cZkGwPUceCesoEdPEGoX2-TG6pucCwXnR1-vzW-V6wXHGiYaQXp45ow1p40LyjaVbhsXh1-ypJAOkBqGbdQstE_gHNNP0/s1600/Leonard+Lopate+-+Version+2.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXDDabBRxEfnGkJqa7kqVuxbpHVAUCnj02QXrbTCtwh076O4cZkGwPUceCesoEdPEGoX2-TG6pucCwXnR1-vzW-V6wXHGiYaQXp45ow1p40LyjaVbhsXh1-ypJAOkBqGbdQstE_gHNNP0/s1600/Leonard+Lopate+-+Version+2.jpg" height="271" width="320" /></a></div>
</div>
<div class="MsoNormal">
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.npr.org/blogs/health/2014/02/15/277027231/when-a-prescription-for-pain-pills-becomes-a-gateway-to-addiction" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.poynter.org/wp-content/uploads/2013/11/npr_logo_rgb.jpg" height="101" width="320" /></a></span></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><br /></td></tr>
</tbody></table>
<h4 style="text-align: center;">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b><a href="http://www.wnyc.org/story/how-get-better-health-care-your-doctor/" target="_blank">How to Get Better Health Care From Your Doctor</a></b></span></span></h4>
</div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">We received many <a href="http://www.wnyc.org/story/how-get-better-health-care-your-doctor/" target="_blank">comments from listeners</a>. Among those posted is one from Ellen from Upper Manhattan:</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">"</span></span><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I have no problem helping a doctor be as good as she/he can be with me.
The anger we feel at doctors comes directly from our fear of
helplessness in a vital aspect of our lives.... For me, the antidote
is empowering and caring about myself."</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">What do you think? I'd love to hear your thoughts! </span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com8tag:blogger.com,1999:blog-2206076157248089688.post-73915053384734601672014-06-27T09:50:00.000-04:002014-06-27T09:50:50.848-04:00One ER Visit; Two Contrasting Stories<style>
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<div class="MsoNormal">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">My <a href="http://www.npr.org/blogs/health/2014/06/25/324005981/heart-of-the-matter-treating-the-disease-instead-of-the-person">latest
NPR article</a> was about conflicting accounts of the same ER visit. I
presented the case of a man who came in with chest pain. He was deeply upset
about his care, but the providers had a very different perspective.</span></span></div>
<div class="MsoNormal">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.npr.org/blogs/health/2014/02/15/277027231/when-a-prescription-for-pain-pills-becomes-a-gateway-to-addiction" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.poynter.org/wp-content/uploads/2013/11/npr_logo_rgb.jpg" height="101" width="320" /></a></span></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><a href="http://www.npr.org/blogs/health/2014/02/15/277027231/when-a-prescription-for-pain-pills-becomes-a-gateway-to-addiction"><br /></a></span></span></td></tr>
</tbody></table>
<h4 style="text-align: center;">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b><a href="http://www.npr.org/blogs/health/2014/06/25/324005981/heart-of-the-matter-treating-the-disease-instead-of-the-person" target="_blank">Heart of the Matter: Treating the Disease Instead of the Person</a></b></span></span></h4>
</div>
<div class="MsoNormal">
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I had no idea that that this article would draw so many
comments (nearly 300,000 at last check). Scott Hensley, NPR’s Shots editor,
posted a <a href="http://www.npr.org/blogs/health/2014/06/26/325823858/clashing-accounts-of-heart-attack-case-spark-reader-debate">compilation
of the comments</a>, along with my remark:</span></span><br />
</div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">"While I'm gratified that so many
readers appreciate the time pressures of working in a busy ER, I am saddened by
how many respondents accept that efficiency must come at the expense of
humanity. Our health-care system needs to change to bridge the disconnect
between what patients need and what hospitals do. All of us — as providers and
patients —need to speak up, and demand a system that values both competence and
compassion, and enables doctors to practice true patient-centered care."</span></span><br />
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<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I’d love to hear your thoughts. What can be done to improve
our healthcare system?</span></span></div>
Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com3tag:blogger.com,1999:blog-2206076157248089688.post-72102401652170280352014-06-19T15:15:00.000-04:002014-06-19T15:15:00.814-04:00The Effects of Obamacare
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">One of the most popular provisions in the Affordable Care
Act (ACA) is that of allowing young adults to obtain healthcare through their parent’s
policy until they are 26.
</span></span><div class="MsoNormal">
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="separator" style="clear: both; text-align: center;">
<a href="http://newsatjama.files.wordpress.com/2014/06/6-17-15-kao-ping-chua-headshot.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="http://newsatjama.files.wordpress.com/2014/06/6-17-15-kao-ping-chua-headshot.jpg" height="213" width="320" /></a></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">This week, my friend and colleague <a href="http://whosmydoctor.com/styled-3/styled-16/styled-22/Chua.html" target="_blank">Dr. Kao-Ping Chua</a>, a
pediatrician and health policy researcher at Boston Children’s Hospital,
published a <a href="http://jama.jamanetwork.com/article.aspx?articleid=1881299">research
article</a> in the <i>Journal of the
American Medical Association</i> that shows young adults report improved health
and lower out-of-pocket costs after implementation of Obamacare.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><div class="MsoNormal">
<br /></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">"</span></span><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I decided to do the study because young adults have had the highest rate
of uninsurance in the United States, leading to poorer health and a
higher risk of catastrophic health costs," Dr. Chua said in an interview.</span></span></div>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">As an emergency physician, I am delighted to see young
people take advantage of this aspect of the ACA. I also look forward to more
research findings on the impact of Obamacare on health costs and outcomes. </span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com4tag:blogger.com,1999:blog-2206076157248089688.post-16729927434811484202014-06-05T11:10:00.002-04:002014-06-05T22:49:06.067-04:00A Simple Act of Kindness<style>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">As an emergency physician used to working in busy, urban
ERs, I like to think that I’m not easily surprised. The other day, someone did
something that really amazed me.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Our patient was a young woman who had a headache and
requested medications to take it away. On an average ER shift, we see dozens of
patients with similar complaints to hers. On busy days, the evaluation and
treatment become rote: take a history, do a physical exam, administer
treatment, fill out paperwork, and so on and so forth.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I had finished the evaluation and was typing my note when
our ER tech, Emily, came up to me. She held a baby in her arms who was gurgling
and sucking his thumb.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">“Do you remember this one?” she asked me.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I vaguely recalled that there was a crying baby in the room
with my patient. Emily confirmed, “It’s hers. I just took the baby to give her
a little break.”</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Emily figured out something that I didn’t. Over the next
hour, she entertained the baby while its mom slept, all the while carrying on
with her other busy duties. When my patient woke up, her headache was much
better.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">In today’s medical world, it’s so easy to forget the <a href="mailto:http://whendoctorsdontlisten.blogspot.com/2013/03/preserving-humanity-of-patients-and.html">human
aspect of care</a> and to neglect the <a href="mailto:https://www.youtube.com/watch%3Fv=GqXfpOu8bNY">low-tech solutions</a>
that are so important. As my hero, Dr. Bernard Lown says, you should always
feel better after having gone to see the doctor. We are so used to making
people feel better through medications; we must not forget the other simpler,
and even more critical treatments.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">When I complimented Emily on her excellent care, she
blushed. “It was nothing,” she said. (She was so hesitant to accept credit that
she didn’t want her real name to be in this article.)</span></span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkaNO50TIpNm-QYDIBjrnLtIsWkj2hXDNetbUdsSUo474VAhf2dkMgzoqlKdxJOWbgX5W6ZEYpb4SnxUyIiBTNCh_i9XDIzG3xXKNUyv43kwPh8NH5Vs0LxXAHuZ6uiEOIWTv5KzSDcqrG/s1600/No+act+of+kindness%252C+no+matter+how+small%252C+is+ever+wasted%252C+Aesop.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkaNO50TIpNm-QYDIBjrnLtIsWkj2hXDNetbUdsSUo474VAhf2dkMgzoqlKdxJOWbgX5W6ZEYpb4SnxUyIiBTNCh_i9XDIzG3xXKNUyv43kwPh8NH5Vs0LxXAHuZ6uiEOIWTv5KzSDcqrG/s1600/No+act+of+kindness%252C+no+matter+how+small%252C+is+ever+wasted%252C+Aesop.jpg" height="200" width="320" /></a></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">But it’s not nothing. It’s a bright spot, a simple act of
kindness, something that can and did make a difference in someone else’s life.
She didn’t do it because she wanted recognition or praise for it; she did
because it was the right thing to do.</span></span></div>
<div class="MsoNormal">
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">All of us have the opportunity to inject a little bit of
brightness into someone else’s day. </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">What will your act of kindness be?<span style="font-size: x-small;"><i> </i></span></span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: x-small;"><i>(Addendum: After I posted this article, the wonderful provider who was the source of inspiration for this article told me she was fine with having her first name here. Emily's real name is Dana.)</i></span> </span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com16tag:blogger.com,1999:blog-2206076157248089688.post-53561848919430220042014-05-19T11:48:00.000-04:002014-05-20T22:24:16.152-04:00Care for the Neglected 20%<style>
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<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">In this week’s “Shots” on NPR, I wrote about the <a href="mailto:http://www.npr.org/blogs/health/2014/05/17/313015089/doctors-ignorance-stands-in-the-way-of-care-for-the-disabled%3Futm_source=facebook.com%26utm_medium=social%26utm_campaign=npr%26utm_term=nprnews%26utm_content=20140517">barriers
to care faced by patients with disabilities</a>. Some of these barriers can be
directly attributed to the lack of education healthcare providers receive about
caring for people with disabilities.</span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoNormal">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><a href="http://www.npr.org/blogs/health/2014/05/17/313015089/doctors-ignorance-stands-in-the-way-of-care-for-the-disabled?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20140517" target="_blank"></a><a href="https://www.blogger.com/null" style="margin-left: auto; margin-right: auto;"><img border="0" src="http://www.poynter.org/wp-content/uploads/2013/11/npr_logo_rgb.jpg" height="101" width="320" /></a></span></span></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><a href="http://www.npr.org/blogs/health/2014/05/17/313015089/doctors-ignorance-stands-in-the-way-of-care-for-the-disabled?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20140517" target="_blank"><br /></a></span></span></td></tr>
</tbody></table>
<h4 style="text-align: center;">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><b><a href="http://www.npr.org/blogs/health/2014/05/17/313015089/doctors-ignorance-stands-in-the-way-of-care-for-the-disabled?utm_source=facebook.com&utm_medium=social&utm_campaign=npr&utm_term=nprnews&utm_content=20140517" target="_blank">Doctors' Ignorance Stands In the Way of Care For the Disabled</a></b></span></span></h4>
<div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I was shocked to learn that though <a href="http://www.census.gov/prod/2012pubs/p70-131.pdf">nearly 20% of the
American population</a> have a physical or mental disability that causes
significant life impairment, studies show that <a href="http://resources.specialolympics.org/Topics/Research/Program_Research_Toolkit/Training_of_Health_Professionals.aspx">less
than 20%</a> of medical schools have curriculum that discuss the needs of
patients with disabilities. <a href="http://resources.specialolympics.org/Topics/Research/Program_Research_Toolkit/Training_of_Health_Professionals.aspx">More
than half of medical school deans</a> report that their students are not
competent to treat people with disabilities.</span></span><br />
</div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdLwBVISVPO__PZFYGK3bG4w3OMWXNu8KeFHHqeC1ra3iOdqkV_0iK6OI3ADSN-nFGzysa2OR-VlRSc4ZkvzrNF0aLqVpgbLIvixGAkUlbjMX9cUsGo67j5sq5Uojxa05dTuwG8CbpXAM/s1600/TEDxFoggyBottom+square.jpg.png" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgdLwBVISVPO__PZFYGK3bG4w3OMWXNu8KeFHHqeC1ra3iOdqkV_0iK6OI3ADSN-nFGzysa2OR-VlRSc4ZkvzrNF0aLqVpgbLIvixGAkUlbjMX9cUsGo67j5sq5Uojxa05dTuwG8CbpXAM/s1600/TEDxFoggyBottom+square.jpg.png" height="200" width="200" /></a></div>
<div class="MsoNormal">
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">As someone who grew up with a severe and often
debilitating stutter (see <a href="https://www.youtube.com/watch?v=W6z18y2IP6k" target="_blank">TEDxFoggyBottom talk </a>where I discussed this in depth), caring for people with disabilities is a topic very
personal to me. As a child, I had to visit the doctor several times a month for
asthma attacks. When I had trouble getting out my words, doctors would ask my
parents if I were mentally retarded. Sometimes, they initiated far more
aggressive treatment because they thought my stutter was from difficulty
breathing.</span></span><br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">When I was a medical student, I recall an attending
physician ordering a head CT on a patient who had a severe stutter just to make
sure he wasn’t having a stroke. Had he listened to the patient for a few more
minutes, he would have found out that this was how the patient always spoke,
and that he was there for a completely unrelated issue. This is just one of
many examples of how lack of understanding and training present a significant
barrier to care.</span></span><br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">In response to the NPR article, <a href="mailto:http://www.npr.org/blogs/health/2014/05/17/313015089/doctors-ignorance-stands-in-the-way-of-care-for-the-disabled%3Futm_source=facebook.com%26utm_medium=social%26utm_campaign=npr%26utm_term=nprnews%26utm_content=20140517">some
readers</a> have written about the burgeoning field of Physical Medicine and
Rehabilitation. This is a much-needed specialty in medicine—but all doctors,
nurses, and other healthcare providers need to be educated about how to take
care of 20% of our patients.</span></span><br />
<br />
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">I’d love to hear from you. What can we do to better educate
healthcare professionals? Are there other areas that are neglected in medical
training? </span></span></div>
<span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com15tag:blogger.com,1999:blog-2206076157248089688.post-27007489778247815942014-05-12T09:00:00.000-04:002014-05-12T09:00:07.500-04:00Are Medical Checklists Bad for Your Health?
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Using checklists in medical care sounds like common sense.
We’ve all heard the stories of the man who had the wrong leg operated on, and
the woman who had a sponge left in her belly. Checklists are routine in other
professions to standardize management, and we know they can <a href="http://atulgawande.com/book/the-checklist-manifesto/">prevent hospital
infections and surgical error</a>.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">But can there be a downside to checklist medical care?
Consider these two examples:</span></span></div>
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<i><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>Scenario 1</b> </span></span></i></div>
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<i><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">You come into the ER after you dove to catch a softball. You’re
pretty sure you have a bruised rib, but because you said the magic words of
“chest pain”, you get whisked away to get blood drawn and then to get an EKG
and a chest x-ray. You’re told this is all part of the “chest pain protocol”.
But did you really need all of these tests done? </span></span></i></div>
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<i><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>Scenario 2</b> </span></span></i></div>
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<i><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">You tell your doctor you’re tired and feeling run down. Your
doctor does “routine blood work”, again following a checklist of things to look
through: anemia, thyroid problems, and so forth. Everything is “normal”. The
checklist is complete, so your doctor assures you that you’re OK—even though
you know you’re not.</span></span></i></div>
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</span></span><div class="separator" style="clear: both; text-align: center;">
<a href="http://alexazzi.com/wp-content/uploads/2012/02/0207_docs_04.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" src="http://alexazzi.com/wp-content/uploads/2012/02/0207_docs_04.jpg" height="200" width="178" /></a></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">In my work as an emergency physician, I know that checklists
can be helpful. They ensure complex procedures are done thoroughly and provide
an extra assurance for safety. However, before undergoing the procedure or any
treatment, you must first have a <a href="http://www.huffingtonpost.com/leana-wen-md/medical-diagnosis_b_2396642.html">diagnosis</a>.
This diagnosis, and the subsequent treatment, needs to be personalized to you.
A “cookbook” approach where you get the same recipe of tests and medications as
anyone else will result in expensive, <a href="http://www.womenshealthmag.com/health/too-much-medical-care">unnecessary care</a>,
and even misdiagnoses and harm.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Here are five tips to make sure you get the best, personalized
care for you:</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>#1. Insist on telling
your story.</b> Studies have shown that <a href="http://www.cnn.com/2013/01/16/health/doctors-listen/">80% of all
diagnoses</a> can be made based just based on the story of your illness.
Doctors have limited time to listen to your story, so you must make sure your
doctor understands why you’re there. Don’t just say that you have “chest pain”;
explain when it started, what you were doing, and how it felt. Write down key
elements. Practice until you can tell it in 30 seconds or less. Then tell it to
your doctor the moment you see her to make sure the doctor focuses on your individualized
story.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>#2. Give open-ended
responses to close-ended questions.</b> If you suspect that the doctor is going
through a checklist of yes/no questions, try to get her to focus on you by
adding personal elements to your answers. If you’re asked, “when did you start
feeling so tired?”, don’t just say “two weeks ago.” Add that you’re normally
very energetic and run 5 miles a day, but for the last two weeks, you can
barely get out of bed to work. These answers help provide context to who you
are.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>#3. Ask about your
diagnosis before you consent to tests.</b> If you’re told you need to get blood
drawn, ask why. Sometimes, that’s enough to stop the “cookbook” from taking
over. Every test should be done for a specific reason, not just because it’s
what’s done in this protocol, but because it helps focus the diagnosis. Also
ask about what to do if the tests are negative. Just because they’re negative
doesn't mean there isn’t anything wrong, so what should be next steps? </span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>#4. Inquire about treatment
options.</b> In very few situations is there only one test that could work or one
protocol that must be followed. If your doctor says you need to do this one set
of tests, ask what your other options are. Often, <a href="http://whendoctorsdontlisten.blogspot.com/2013/08/dont-just-do-something-stand-there.html">watchful
waiting</a> is a perfectly acceptable alternative. Discussing options helps to
remind your doctor to tailor the treatment to you.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>#5. Let your doctor know
that you want to be a partner in your decision-making.</b> If you still think
that your doctor is following a recipe rather than individualizing care, ask
her to explain her thought process to you. Say that you respect her expertise,
and you want to learn what it is that she is thinking. Your doctor may be so
busy or so used to checklists that your request can help her to refocus on you
and your individual needs.</span></span></div>
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</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>This article was previously published in <a href="http://www.womenshealthmag.com/health/female-physicians">Women's Health
Magazine</a> (posted here with their permission).</i> </span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com343tag:blogger.com,1999:blog-2206076157248089688.post-90654854227139048952014-05-05T19:28:00.000-04:002014-05-05T19:28:40.134-04:00My "Coming Out" Story at TEDxFoggyBottom
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Have you ever had a shameful
secret, something you hid from the world, something you wished more than
anything that you could get rid of?</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I did. Growing up, <a href="https://www.youtube.com/watch?v=W6z18y2IP6k">I had a severe stutter</a>
that was often so bad I couldn’t get out any words at all. One of my earliest
memories is hiding in the janitor’s closet during recess so I didn’t have to
talk to anyone. In second grade, I stabbed myself with a pencil so I could get
out of answering in class. That piece of pencil lead is still in my leg as
testament to my shame.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">If only I could get over my deepest
shame, my terrible fear! Surely fear is something bad, something that prevents
us from reaching our goals. Yet, books and movies are filled with stories of
success that only come after overcoming fear and facing adversity. So how do
you select for the good parts of fear that build character rather than destroy
confidence? </span></span></div>
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<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgCZWs45ebvY096BbNyj3RWnlT7IaJxa_1Z-yoXeHgfr1VR3cZYHKjE94eN2OnT3niT3BjlZi-U5iECf4FBW3ZmROk4eaRQ3TaKgJULxYQb__l2qoGQCB8ajLL1qUur9SdGq4BRiqZvASI/s1600/TEDxFoggyBottom+2.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgCZWs45ebvY096BbNyj3RWnlT7IaJxa_1Z-yoXeHgfr1VR3cZYHKjE94eN2OnT3niT3BjlZi-U5iECf4FBW3ZmROk4eaRQ3TaKgJULxYQb__l2qoGQCB8ajLL1qUur9SdGq4BRiqZvASI/s1600/TEDxFoggyBottom+2.jpg" height="213" width="320" /></a></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">In February, after more than
30 years of hiding, I finally “came out” and talked about my stuttering <a href="https://www.youtube.com/watch?v=W6z18y2IP6k">in this TED talk</a>.
Becoming open about your deepest, darkest secret—it’s not easy. Actually, it’s
downright scary to open that closet door when you spent your whole life keeping
it shut. A part of me still cringes when I think of the little girl hiding in the closet with the pencil lead in her thigh. A part of me wishes I were never that little girl. Yet, I also recognize that being a person who stutters is part of my identity, like being a woman, a sister, a wife, a doctor, an Asian-American.</span></span></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"> </span></span> </span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">In the talk, I discuss three lessons that have helped me the most:</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>#1. Separate fear from shame, and take shame head on.</b> It took me many years to learn that fear different
from fear. Fear is when you are afraid of something, afraid of doing or trying
something. Shame is when what you are afraid of is yourself. Hiding feeds
shame, and openness is its antidote. To overcome fear, we have to first
overcome shame.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>#2. Tackle your “what if?” with “so what”.</b> There are four words that plague us and feed shame
and fear: what if I fail? Instead of avoid them, answer with two more: “so what?”.
If there’s something you want to do, what’s the worst that will happen if you
go for it? We know the answer, right? We’ve all been there. Nobody will laugh.
You won’t die. As Tina Fey says, <span class="st">you can't be that kid standing
at the top of the waterslide<i>,</i>
overthinking it. You have to go down the chute. </span></span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>#3. Ask yourself, what’s the worst that could happen
if I DON’T do it?</b> Who will it hurt? If
you want to be a doctor and don’t become one because you’re too afraid, who
will serve your community? If you’re afraid of speaking up to help someone in
need because you’re afraid of stuttering, who will do it instead? All of us are
here today because other people made sacrifices, because they faced fear head
on for us. Now it’s our turn, for those who follow.</span></span></div>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Please share your stories: have you brought something you're ashamed about into the open? How have you turned your fear inside out?</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"></span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com5tag:blogger.com,1999:blog-2206076157248089688.post-78250418418686159002014-04-15T13:52:00.000-04:002014-04-15T13:54:03.972-04:00One Year After: A Tribute to Our Patients and Our City<style>
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<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right; margin-left: 1em; text-align: right;"><tbody>
<tr><td style="text-align: center;"><a href="http://media.npr.org/assets/img/2013/04/25/mass-general1_custom-06bca33450849702e901101fc5fdc3efe03e0568.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" src="http://media.npr.org/assets/img/2013/04/25/mass-general1_custom-06bca33450849702e901101fc5fdc3efe03e0568.jpg" height="201" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Courtesy of NPR from npr.org</td></tr>
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<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">On April 15<sup>th</sup>, 2013, I woke up at 5:30am and
walked to Mass General Hospital to begin my ER shift. It was the day of Boston
marathon, and we were prepared for the usual influx of people with heatstroke
and dehydration. That day, as other days, we also treated dozens of critically
ill patients with heart attacks, strokes, and severe infections.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Just before 3pm, we received the call that nobody could have
predicted. Bombs had detonated at the Boston marathon. Many people were gravely
injured.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Minutes later, they arrived in our ER. Some were not
breathing. Others were missing limbs. All were covered with blood and soot.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">As an emergency physician, I am trained to treat traumatic
injuries. But while I helped direct our trauma teams to triage then resuscitate
these patients, I was terrified. My husband and I lived in Back Bay, next to
the explosions. He had texted me not long before to say that he was headed to
the finish line to watch the marathon. I didn’t know where he was; I feared
that the next patient I took care of could be him.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">I wrote about this fear and guilt in an <a href="http://www.npr.org/blogs/health/2013/04/24/178850615/boston-er-doctor-finds-marathon-memories-hard-to-shake?live=1">NPR
article</a>, and subsequently about <a href="http://articles.philly.com/2013-04-30/entertainment/38905605_1_first-responders-blood-emotions">the
need to care for the many healthcare providers</a> who served on that day.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Now, one year later, I no longer live in Boston, but I will
always remember April 15<sup>th</sup>. I remember the bravery and
resourcefulness of the first responder, bystanders, and volunteers. I remember
the teamwork in our hospital among every service—not just those of us caring
for the victims themselves, but also those oncologists and obstetricians who jumped
in and provided excellent care for other patients in our ER. I remember the
support from our city and indeed our broader community in the U.S. and around
the world. </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Most of all, I remember the courage of the victims and their
families. Their resilience serves as inspiration for all of us.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">As I remember April 15<sup>th</sup>, I am grateful to have
had the opportunity to take care of these brave men, women, and children. I’m
honored to be able to serve and proud to be a physician and emergency care provider.</span></span></div>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com3tag:blogger.com,1999:blog-2206076157248089688.post-23093378397654831092014-04-01T10:59:00.000-04:002014-04-01T10:59:15.122-04:00Are You Getting Too Much Medical Care?<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>Danielle is a 21-year-old woman with a headache. Her doctor tells
her that she needs a CT scan and a spinal tap. Danielle doesn’t want
these tests; she knows that she drank too much last night and feels like
she has a bad hangover, but should she really say </i>no<i> to her doctor?</i></span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><i>Nancy is a 38-year-old woman with vomiting and diarrhea. Her
toddlers have the same symptoms. The doctor says she needs to get a CT
scan of her belly. He says her blood pressure is “borderline high” and
that she should also start taking medication. She’d prefer to avoid
drugs if possible—what should she do?</i></span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">As an emergency physician, I see dilemmas like these every day, yet
they get very little attention. For so long, the rhetoric has been about
the danger of too <i>little</i> medical care. Newspapers are full of
stories about deaths that have resulted from missed diagnoses and lack
of access to care. TV shows glorify the detective-doctor who doesn’t
give up and persists on ordering test after test in order to solve an
esoteric case.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">While many people still lack access to care, there’s mounting evidence that many people also receive <i>too much</i> care. The prestigious Institute of Medicine estimates that <a data-ls-seen="1" href="http://healthcare-economist.com/2008/11/07/us-spends-700-billion-on-unnecessary-medical-tests/" target="_blank">30 percent of all medical tests and treatments are unnecessary</a>. This is not only wasted money—an estimated $700 billion of unnecessary spending per year—but also potentially harmful. <a data-ls-seen="1" href="http://whendoctorsdontlisten.blogspot.com/2012/08/5-medical-truths-your-doctor-wants-you.html" rel="nofollow" target="_blank">Every test has risks and possible side effects.</a> A CT scan has a <a data-ls-seen="1" href="http://www.scientificamerican.com/article.cfm?id=how-much-ct-scans-increase-risk-cancer" rel="nofollow" target="_blank">risk of radiation</a>, for example, that may lead to cancer later in life. And one test often leads to another, even riskier, test.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">There are many causes of overtreatment. Drug companies and technology
manufacturers have their own incentives for wanting people to receive
more, rather than less, care. While doctors generally mean well, they
also have financial incentives for over-testing. A study in the <i>New England Journal of Medicine</i> found that <a data-ls-seen="1" href="http://www.nejm.org/doi/full/10.1056/NEJMsa064508" rel="nofollow" target="_blank">94 percent of doctors have some relationship </a>with a drug company or medical device company, and many <a data-ls-seen="1" href="http://www.npr.org/blogs/health/2013/12/14/250714833/before-the-prescription-ask-about-your-doctors-finances" rel="nofollow" target="_blank">are paid more for conducting more tests</a>. On top of that, fear of malpractice can also drive doctors to do more, just to be sure.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">The problem isn’t just doctors, though. Patients also believe that
more is better. New tests and treatments succeed in part because the
general public tends to idolize technology. </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Unfortunately, this issue is
complicated because medical advances <i>can</i> be helpful and save
lives in certain circumstances. So how do you know when testing is
appropriate—and when it’s simply too much?</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">There isn’t an easy answer to this question, but I recommend that you
ask your doctor five key questions every time he or she recommends you
undergo a test:</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>What Do You Think My Diagnosis Might Be? </b><br />
Your doctor always has some sense of <a data-ls-seen="1" href="http://whendoctorsdontlisten.blogspot.com/2013/01/why-diagnosis-is-key-to-your-healthand.html" rel="nofollow" target="_blank">possible diagnoses</a>
before you get any tests done. You should find out what he or she is
thinking; that way, you know why the tests are being done and how likely
the various possibilities are. If Danielle had asked her doctor this,
for example, he likely would have told her that odds are she just has a
hangover and that it’s far less than a 1 percent chance that she has
brain bleeding.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>What Evidence Exists Suggesting this Test or Treatment is Beneficial? </b><br />
This is particularly important for screening tests like checking for
high blood pressure, cholesterol, and cancer. Ask your doctor what
studies there are to show that a test improves quality of life. If there
is no evidence for the test or if the jury is still out, you should ask
why your doctor thinks you need the test and <a data-ls-seen="1" href="http://www.npr.org/blogs/health/2013/12/14/250714833/before-the-prescription-ask-about-your-doctors-finances" rel="nofollow" target="_blank">keep in mind your doctor’s possible incentives</a> for testing and treatment.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>What are the Potential Side Effects? </b><br />
Every single test, even just getting your blood drawn, has side
effects—and you should know what they are before you consent to any
tests. Without knowing the side effects, you can’t weigh the risks
against the benefits.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>Is Watching and Waiting an Option? </b><br />
Very few situations are so urgent that a test has to be done ASAP; most of the time, it’s perfectly fine to <a data-ls-seen="1" href="http://whendoctorsdontlisten.blogspot.com/2013/08/dont-just-do-something-stand-there.html" rel="nofollow" target="_blank">wait and see</a>
if other symptoms emerge or if you get better. With Nancy, for example,
it would have been appropriate for her to go home and see if she gets
better; she didn’t need to get a CT scan right away.</span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span> <br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><b>What Other Treatment Options Do I Have?</b><br />
Doctors are trained to “fix” problems with treatments. Many of us don’t
have the knowledge or time to counsel patients on other options, like <span class="mandelbrot_refrag"><a class="mandelbrot_refrag" data-ls-seen="1" href="http://www.womenshealthmag.com/tags/lose-weight?lc=int_mb_1001">diet</a></span>
and exercise changes and/or alternative treatments. But these other
treatments may be just as effective and may help you avoid potentially
harmful side effects. Perhaps Nancy’s blood pressure could be controlled
with diet alone, for example. There are always alternatives; ask about
them.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">
</span></span><span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Ultimately, you should have a <a data-ls-seen="1" href="http://www.womenshealthmag.com/health/female-physicians" target="_blank">trusting partnership</a>
with your doctor and feel comfortable asking hard questions. You are
your own best advocate, and you have to speak up to make sure you get
the right medical care—and avoid unnecessary tests and treatments.</span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><i>This article was previously published in <a href="http://www.womenshealthmag.com/health/female-physicians">Women's Health
Magazine</a> (posted here with their permission).</i></span></span> </span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com3tag:blogger.com,1999:blog-2206076157248089688.post-61065877302062012072014-03-21T20:18:00.000-04:002014-03-31T16:08:47.466-04:00Help Your Doctor Help You<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">This week, I wrote an article in Slate with the provocative theme of <a href="http://www.slate.com/articles/health_and_science/medical_examiner/2014/03/ten_types_of_emergency_room_patients_how_to_improve_your_care_by_avoiding.html" target="_blank">"10 Types of ER Patients". </a></span></span><br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><br /></span></span>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">My intention in writing the article is not to stereotype or imply that patients don't have good reasons for coming to the ER. </span></span><br />
<br />
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">Rather, in my work as an emergency physician and separately as a patient advocate, I've met many patients who are frustrated by their care. I've seen the same missed opportunities and miscommunication happen over and over. This is my attempt to provide advice and guidance before they came to the ER.</span></span><br />
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</div>
<h4 style="text-align: center;">
<b><span style="font-size: large;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;"><span style="font-size: small;"><span style="font-family: "Trebuchet MS",sans-serif;"><a href="http://www.slate.com/articles/health_and_science/medical_examiner/2014/03/ten_types_of_emergency_room_patients_how_to_improve_your_care_by_avoiding.html" target="_blank">The 10 Types of Patients I See in My Emergency Room</a></span></span></span></span></b></h4>
<span style="font-size: small;"><span style="font-family: "Helvetica Neue",Arial,Helvetica,sans-serif;">What do you think? Is this advice helpful? I'd love to hear your thoughts.</span></span>Dr. Leana Wenhttp://www.blogger.com/profile/08879099283276712655noreply@blogger.com3