by CathyG | Apr 15, 2014 | medical care, single life
Single people die younger. According to this article, the difference might be due to a spouse who nags you to eat better or see a doctor. I think it’s also likely that you’ll get better care from doctors when a family member can advocate for you. Read the article here.
And here’s another article about positive effects of marriage on men’s health. Click here.
One thing that gets ignored is the way the health care system views single versus married people. It’s assumed that you’ll have a family member pick you up after outpatient surgery. The Family Medical Leave provides only for care of a parent, spouse or child – not even a brother or niece, let alone a friend. People can’t get off work to drive a friend home from the hospital, especially in the middle of the day with short notice. Additionally, we keep hearing that it’s important to have family members with you if you’re in a hospital; otherwise you’re far more subject to medical errors, neglect and even outright abuse.
Some people genuinely enjoy their own solitude and single status. In terms of aging, that’s a plus, because we’re more independent and less likely to mourn. But getting care becomes a massive invasion of privacy, with limited options for support.
by CathyG | Apr 1, 2014 | Uncategorized
Another WSJ article that makes my blood boil: How Doctors Rate Patients: Patient Activation.
Concepts like “patient activation” are misleading, manipulative and even dangerous. Doctors do not want activated, engaged patients. They want docile patients who will do as they are told without asking probing questions. They do not want patients who ask why published research seems to contradict their recommendations. They do not want to hear that they are reporting statistics inaccurately. They want patients who will follow their instructions (often incomplete and poorly worded) yet they regard their patients as irresponsible children.
For example, this article writes, “They [i.e., those who are not “model patients”] fail to take their medications, skip preventive screenings and end up back in the hospital soon after discharge.”
Taking medications isn’t always straightforward. I am an educated professional who’s given my cats everything from antibiotics to sub-cutaneous fluids to insulin shots. Yet after eye surgery I’m struggling to comply with vague instructions and poorly designed eye drop dispensers.
The term “preventive screenings” is nonsense. By definition, screenings detect disease or treatable conditions. At best, screenings allow early detection and risk reduction. Screenings do not prevent disease or even death. You can get colonoscopies and mammograms as directed and still die from colon or breast cancer. Flashy numbers like “50% reduction” refer to relative rather than absolute difference; the actual impact is usually very small and the cost of false positives very large. The Society for General Internal Medicine has questioned the usefulness of annual physical exams for asymptomatic adults. If doctors really want patients to be engaged, they will interpret statistics accurately and share *all* the research.
Finally, if doctors really want engagement, they need to treat patients like adults. Following eye surgery, I’m entrusted with a complicated regimen of eyedrops and I’m told to fast the night before surgery; my non-compliance will lead to negative outcomes that are expensive to fix. Yet though I live a few minutes away from the hospital, I’m not trusted to make sure I have transportation home. The hospital wants to call my ride the morning of surgery to make sure they’re really coming. I find this call degrading and insulting.
Yes, I know the risks, but I also know how to manage those risks intelligently. I will be alert and ambulatory after surgery and if I feel unable to leave on my own I know how to get help.
“Patient activation” is just another scheme to get more money by blaming patients for mistakes, carelessness and heavy workload. If doctors spent less time on meaningless “prevention” and more time working with people who really need help, many of these issues would go away.
I’m also disgustingly healthy, eat reasonably, have good genes and exercise. I rarely see doctors. Recently, when I asked a handful of questions, a doctor said with a straight face, “Your problem is you don’t have experience with the system. You don’t know how to be a patient.”
by CathyG | Mar 31, 2014 | medical care, single life
Recently I came across this article, allegedly reporting that being married confers health benefits: http://www.medicalnewstoday.com/articles/274828
Here’s my comment:
Being happily single and disgustingly healthy, I had a few concerns about this article.
Bella DePaulo’s book, Singled Out, provides a rigorous discussion of flaws in research comparing single and married people. For instance, often researchers lump together the “never-married,” divorced and widowed, without controlling for recency of divorce or widowhood. Those who never married actually have an advantage as they age because they are used to being alone.
As for cancer patients living longer, I’d want to know, “Are these people holding on longer, even living in pain, because they’re waiting to see a grandchild get married or graduate from college? Are their spouses and children reluctant to turn off life support, as compared to the more distantly related proxies of single people?”
Rather than emphasize the health benefits of marriage (which aren’t entirely clear), I’d like to see some focus on how the medical community treats married vs single people. Many singles find that getting an “approved” ride home from out-patient surgery has been so stressful, I will avoid having elective procedures that require a ride from a responsible adult. A woman with a tall husband or son at her side will be treated far more courteously than a single woman who shows up alone. There’s nothing wrong with solitary life (see Anthony Storr’s classic book, Solitude), yet the system discriminates against them. I’m pretty social, but if I choose to be a curmudgeonly hermit, why should I be denied access to quality health care? That’s the *real* question.
by CathyG | Mar 23, 2014 | medical care
In an article, “Patient satisfaction: Hospitals are not like car dealerships” (March 22, 2014) David Mokotoff
DAVID MOKOTOFF, MD | PHYSICIAN | MARCH 22, 2014
The article is here.
Mokotoff writes, “Here’s what I would like to ask the patients:
Did the condition for which you entered the hospital improve or go away?
Was the hospital bill clear and accurate and easy to understand?
Did a doctor explain procedures to you fully and in enough detail?
Was the food hot and edible?
Here’s how I commented:
Up to a point you are right. However, I am a super-healthy person who avoids doctors and declines tests. Recently I had cataract surgery as an outpatient in a top hospital. The surgery went well. My surgeon and anesthesiologist were superb once we got to the OR. To them, my case was boring because I’m so healthy.
For me, the whole experience was so stressful I developed physical symptoms. I was horrified by what I experienced: incorrect data entered in my records, repeated queries about irrelevant personal information; failure to note allergies on my chart till we got to the moment of entering the OR; required pre-op tests that are dismissed as useless in research published in leading medical journals (along with a scary high probability of false positives); inflexible requirements for finding a ride home when operations are scheduled at the last minute (hello – friends and even some relatives can’t get off from work); pre-op and post-op instructions presented in a disorganized, incomprehensible fashion (I have a Ph.D. and professional writing experience); stressful noisy waiting rooms with blaring TVs; rude nurses and technicians; and a lot more.
You may think it’s no big deal, but my relationship with the medical profession is more hostile than ever and it was pretty bad before. I was so traumatized that I’m refusing all future tests for cancer, heart disease or other illnesses. There’s no way I could handle the stresses of a major episode. I’m putting an advance directive in place and becoming an advocate for assisted dying, which I think should be made even easier.
After all, spy pilots used to get cyanide pills to avoid getting shot down in POW camps. Modern hospitals aren’t much different. You underestimate the impact of stress on otherwise healthy people.
by CathyG | Mar 14, 2014 | Uncategorized
Headline: CDC: Flu vaccine 61% effective, but too few adults get it
Robert Roos | News Editor | CIDRAP News | Feb 20, 2014
2319 children and adults were involved in the study. 784 tested positive for flu.
29% of those who had been vaccinated tested positive, vs. 50% of those who tested negative.
This sounds good but it’s not a 61% effectiveness rate; the difference is 21%. They get 61% by dividing 29/50, which just doesn’t make sense. You decrease your risk from 50% to 29% … roughly from a half to just under a third.
Further, of those who had not been vaccinated, there’s only a 50-50 chance of getting the flu.
A stock photo with the article shows a youngish man in a hospital bed with an IV and breathing tube. There’s no claim that this man suffers from flu.
But the truth is, your risk drops from 50% (not vaccinated) to 29% (if vaccinated). That’s roughly from a half to just under a third. Not at all the same thing. And it’s not known how these findings translate to larger populations. In fact, from everything I can tell, this population is self-selected; there may be a self-selection difference between those who chose to get vaccinated and those who didn’t.
