Campaigning for health care reform

In 1992 and 1993 opponents to health care reform ran a series of ads featuring a fictional middle class couple, Harry and Louise, who were worried that health care reform would limit their access to care. Now health care reform is before Congress again and Harry and Louise are reprising their roles. But this time, the grayer Harry and Louise are in favor of health care reform. The New York Times article has links to videos from 1992 and 2009.

In some ways, the change reflects the changing landscape of the costs of health care. The change also reflects the different groups that are coming together for health care reform that did not come together in 1992. But in addition to all of those factors, after watching the clips, I think you'll agree that reviving the Harry and Louise ads is just smart advertising.

When the doctor has a hard time saying no

CNN had an interesting article exploring the reasons why physicians can have a hard time saying no to patient requests, even when those requests could be harmful to the patient. One of the factors is time: it may simply be easier to give a patient what they ask for rather than have a conversation about why it is inappropriate. But sometimes, the requests are difficult to turn down because of the nature of the physician-patient relationship. The physician wants to help their patients by providing them the care they want. And physicians don't want to lose patients by denying requests.

Patients are expected to take an active role in their own health care and are increasingly treated like health care consumers. With increasingly informed patients, physicians need to have real discussions with their patients, even when the topic is uncomfortable. This means taking the time to discuss the real risks and benefits of treatments. And patients need to be willing to listen their physicians, even when the physician declines their request.

Physician lawmakers see the health care debate up close

The 16 physicians who serve in the U.S. Senate and U.S. House of Representatives have all seem the problems with the current health care system - patients who cannot afford prescriptions, patients who cannot get insurance, and working with the limits of managed care. But they don't agree on how the U.S. should address health care reform. An article this week in the New York Times shows the perspective that these physician lawmakers bring to the health care reform debate. They can agree of a few key points - the importance of insurance portability and eliminating pre-existing conditions. But the physicians, like Congress at large, do not agree about whether a public option should be part of the solution or what that would look like.

Though they do not always agree, the physician lawmakers offer a unique voice in the conversation about the future of health care. These physicians have a unique platform to speak up for their patients and to speak up for all the health care workers who would help them. If they make use of that platform, we will all benefit.

Answering the question "Where did I come from?"

The New York Times had an article last weekend about the additional complexities of answering a child's question "Where did I come from?" when a surrogate is involved. No matter what technology was used to conceive a child, parents are encouraged to communicate to children that no matter how they came about, they are with the parents they are supposed to be with. And with more and more surrogate pregnancies, more families are going to consider just how they will communicate their unique story with their children.

Convent offers model for end-of-life care

The New York Times had a compelling article this week about a convent in New York providing comfort, care and support to elderly sisters at the end-of-life. The sisters in the convent communicate with their social network and their physicians about the care they wish to receive, and ultimately the death they want to have. Most of the sisters die at home in the convent, surrounded and comforted by their loved ones, and without aggressive medical treatment if they so choose. The convent offers a model of care for elderly patients, in which they are able to express their desires, and to be comfortable and at home in their last days. At the core of the model are open communication between patients, physicians and the social network and respect and tender care for patients at the end.

How does what we believe affect how we communicate?

How does what we believe affect how we communicate? How does religious belief intersect with professional life, especially when the profession is health care? These questions piqued my interest in 2005 and I had the opportunity to explore them as I pursued my Master of Arts degree in communication at Marquette University. I defended my thesis and graduated in 2006. But I still had more to learn and to share, so I took my thesis research on the road. I presented my findings at the International Conference for Communication in Healthcare in 2007, and then began the process of submission, rejection, revision and resubmission to get my thesis research published. The result was a more refined look at the question that first caught my attention: How does what we believe affect how we communicate? In the survey, I found that a nurse's religious beliefs can enhance the clinical experience without the nurse trying to impose his or her beliefs on the patient, as the nurse works to make sure the patient's religious beliefs are upheld.

The article has been accepted for publication in Patient Education and Counseling. You can find the article here. If you do not have access to an academic library and would like to check out the article, please let me know.

The danger of nurse stereotypes

Theresa Brown, an oncology nurse and regular contributor to The New York Times Well column, wrote this week about a new book, "Saving Lives: Why the Media’s Portrayal of Nurses Puts Us All at Risk.” The book and Brown's column explore the stereotypes surrounding nurses and the problems that those stereotypes can create. The stereotypes come from everything from media depictions of nurses to lack of understanding about the range and depth of nurse education. Such stereotypes can impede effective communication between patients, nurses and other medical staff, and as such can impede clinical care.

Many patients never learn the complex and diverse roles that nurses play until they find themselves in a hospital bed. Better educating the public about the many different roles in medicine will create a better clinical environment for everyone and will take some of the mystery, and fear, out of the medical experience.