drowning in a sea of information

The New York Times published an interesting series of articles today called "Decoding Your Health" about the vast amounts of information that sick and healthy consumers face everyday. As we discussed on this blog yesterday, there is more medical information available to consumers than ever before. And it can be difficult for those of us without a medical background to wade through it all. As one of the authors of the series Tara Parker-Pope said. "Are patients swimming in a sea of health information? Or are they drowning in it?" The articles offer a variety of opinions and tips for wading through the information.

You can find one of the articles in the series here "You're Sick. Now What: Knowledge is Power", with links to the others: http://www.nytimes.com/2008/09/30/health/30pati.html?partner=permalink&exprod=permalink

And the discussion of the article is here: http://well.blogs.nytimes.com/2008/09/29/decoding-your-health/

What other tips would you add to wading through all the information available?

Seeking answers from doctors and the Internet

The New York Times had a first-person essay about the perils of seeking health information form the Internet, from physicians, and then from the Internet again. There is a lot of health information out there in all sorts of different forms - written, verbal, in-person, online and more- and it can be extremely difficult to wade through it all, especially if you do not have an established relationship with a health professional you trust.

You can find the article here: http://www.nytimes.com/2008/09/30/health/30seco.html?partner=permalink&exprod=permalink

So how do you wade through all the information? What can patients and physician do to wade through it all?

missed opportunities for empathy

The Washington Post printed an article today about a study published in The Archives of Internal Medicine about missed opportunities for physicians to express empathy for patients. The study was between lung cancer patients and their thoracic surgeons or oncologists. The relationship of a cancer patient and physician is complex, not only because of complex treatment plans, but because patients are also dealing with emotional issues such as the loss of identity and the fear of death. Patients reach out to physicians, but physicians may feel more comfortable talking about biomedical issues rather than emotional issues, which don't have an easy answer.

You can find the article here: http://www.washingtonpost.com/wp-dyn/content/article/2008/09/22/AR2008092201894.html

So what do you think? What steps can physicians take to better prepare for emotional encounters?

therapy by phone

The New York Times Well blog posted an interesting article about a new study on the benefits of therapy by phone, published by Clinical Psychology: Science and Practice. The phone offers a means for physicians to reach out to patients who can't or won't make it in for face-to-face visits.

You can find the article here: http://well.blogs.nytimes.com/2008/09/22/the-benefits-of-therapy-by-phone/.

Let's consider this from a communication perspective. What aspects of communication might be lost in therapy by phone rather than in person? Could there be benefits of phone conversations over in-person conversation?

Advertising medical devices

A Senate committee met today to discuss advertising of medical devices. While advertising for medical devices, such as replacement knees and heart stents, are a relatively small share of consumer medical advertising, some believe that because of the risks, extra precautions should be taken with such advertisements. Medical devices almost all require surgery and become a permanent part of the patient, and as such are riskier than a pill. But some are concerned that device advertisements aren't being clear enough about the risks.

You can see a New York Times article about the hearing here: http://www.nytimes.com/2008/09/17/business/17device.html?ex=1379390400&en=f81f16144c4b1d4a&ei=5124&partner=permalink&exprod=permalink.

In light of the article I posted yesterday, what do you think? Should medical device advertisements be more closely regulated?

Effects of direct-to-consumer prescription drug advertising

The ACRP Wire published an article last week about a recent journal article about the first randomized control trial of the effects of direct-to-consumer prescription drug advertising. The design of the study, published in the British Medical Journal, was an interesting twist. Direct-to-consumer prescription advertising is only legal in United States and New Zealand. The advertisements are ubiquitous in these countries, so how could you find a group who never saw such ads? The answer to finding a control group was Canada. Prescription advertising is illegal in Canada, but media from U.S. routinely spills over into border towns. So you had a group of English-speaking Canadians who see such advertising and a group of French-speaking Canadians who do not see such ads.

Consumer advertising for drugs is unlike other advertising, because it is not just a matter of motivating a person to buy a product. Drug advertising requires motivating a consumer to make an appointment with the doctor, keep the appointment, ask for the drug, get the physician to give a prescription, and then motivate the consumer to actually fill the prescription. That's a lot of steps between advertisement and sale of product. But for pharmaceutical companies, those steps lead to a potential for a lot of sales.

But does the advertising work? This study showed for some of the drugs there was little effect in prescription rates from the exposure to advertising and with others there was an initial spike in prescriptions that evened out over time. It is an interesting study that should contribute to the conversation in this country about whether such advertisements help or harm health consumers.

You can find additional information about the study procedures and results here: http://newsmanager.commpartners.com/acrpwire/issues/2008-09-11/5.html

Healing the gap between patient and physician

The New York Times is starting a new series of columns to be featured each Thursday dedicated to exploring the gap between patients and physicians. Dr. Pauline Chen will facilitate the conversation, as patients and physicians explore this complex relationship, which is increasingly marked by distrust. I am looking forward to the conversation that emerges.

You can find the first column here: http://www.nytimes.com/2008/09/11/health/chen9-11.html?ex=1378872000&en=0c9fe0a40d188c53&ei=5124&partner=permalink&exprod=permalink

You can find the discussion and comments here: http://well.blogs.nytimes.com/2008/09/11/doctors-and-patients-start-talking/

A nurse's perspective

I have had a soft spot for nurses since I did my Master's thesis on nurse communication behaviors. They provide a tremendous amount of clinical and emotional care in what can be very intense and stressful settings. And they are often overlooked.

The New York Times Cases section offered a rare nurse's perspective. Theresa Brown, an RN from Pennsylvania, who also happens to have a literary background, offers a moving reflection on witnessing death and the lessons for life.

You can find the article here: http://www.nytimes.com/2008/09/09/health/09case.html?ex=1378699200&en=05f3b38d7b5ff8f8&ei=5124&partner=permalink&exprod=permalink

A doctor's attire

The New York Times Health blog reported today about a new British National Health Service directive for physicians to wear clothing that allows for bare arms below the elbows and no longer wear neckties. The intention is to prevent infection transferred through the hems of loose or long clothing. The evidence of this practice is still emerging, and the U.S. has yet to institute such a policy.

Physicians across this country are encouraged to dress professionally, often including a long white coat. But clothing policies raise the questions of how clothes effect patients perceptions of a physician. Would you perceive your doctor differently if he or she was in short sleeves, without tie or white coat?

You can find the article here: http://well.blogs.nytimes.com/2008/09/08/do-you-really-want-to-see-your-doctors-elbows/

Insisting on a test a patient insists she doesn't need

This discussion is from last week's New York Times Well blog but I still think it is worth bringing up. The heated discussion was about physician's who consider women of child-bearing age to be "pre-pregnant," and as such insist on pregnancy tests before certain procedures, even when a woman insists there is no way she could be pregnant.

Of course, it is pertinent for a physician to know if a female patient is pregnant, as certain medications and x-rays are dangerous to an unborn child. And women do not always know when they are pregnant and some may lie about their sexual history and likelihood of being pregnant. But the frustration expressed by many women in the blog discussion shows that some physicians are not approaching this delicate discussion in the most constructive way.

You can find the discussion here:http://well.blogs.nytimes.com/2008/08/28/do-doctors-view-women-as-pre-pregnant/

So how could physicians and patients both approach this conversation in a more positive way?

pharmaceutical hype

My apologies for the prolonged absence. I have been busy preparing for the Association of Clinical Research Professionals clinical research coordinator certification exam coming up this Saturday(http://www.acrpnet.org/MainMenuCategory/Certification/GetCertified/CRCCertification.aspx).

I did want to take a minute to point out an interesting discussion of The New York Times Well blog about the media's role in promoting a new drug. It is a discussion about the HPV vaccine Gardasil, and the large media buzz that in effect promoted the drug when it was first made available to the public. Long-term efficacy data is still emerging about the vaccine causing some to wonder if the maker over-hyped its benefits. But a watchdog group is saying that media coverage when the vaccine was released contributed to the hype.

The report raises interesting questions about the role of media in reporting medical research. Are the media there to repeat what the pharmaceutical companies say about the product or should reporters and editors be doing more to present the meat of the research rather than the promised results?

You can find the Well blog here: http://well.blogs.nytimes.com/2008/08/29/blaming-the-media-for-gardasil-hype/