The importance of rapport in taking the expanding medical history

The American Academy of Communication in Healthcare (@AACHonline) tweeted an American Medical News story about the challenges of taking a medical history and importance of rapport in collecting those histories. Physicians are being asked to collect more social and health information from patients in shorter interviews, all while updating new electronic records, often with a computer in the room. The article explore the importance of developing trust between physician and patient and cultivating educational elements into the history-taking process.It is a difficult but important task, as the history-taking is an important element in diagnosis and in educating and working with the patient to develop treatment plans. The article discusses specific strategies such as question-asking and repeating back what the patient says to better understand the patient's concerns.

who should be a doctor?

The New York Times reported on a case from Sweden that raises the question of who should be a doctor, or who shouldn't be a doctor. The questions arise from several cases in Sweden of people with criminal backgrounds getting into top medical schools. Because medical schools in Sweden are not allowed to conduct background checks, it raises questions or where and when they can limit who practices medicine.

You can find the article here.

What do you think? How should Sweden approach it?

Rating your physician

The group that made restaurant, hotel and spa ratings by the public, available to the public, are now working with one health insurance group to rate physicians. The New York Times had an article today about WellPoint working with Zagat to allow patients to rate their physicians and read ratings of other physicians. Physicians are rated on such qualities as trust and communication. Some physicians and ethics groups are concerned that the ratings don't give patients useful information, and may ultimately cause harm to patients making decisions based on personality factors that have no correlations to patient outcomes. You can find the article here.

What do you think? Is this kind of rating system harmful? Is it possible for some kind of rating system to provide useful, accessible information?

Medical advice on television

The New York Times published an article on Sunday about the syndicated television show The Doctors. The Doctors is a show where a panel of physicians offer medical advice, often about topics that patients might find embarrassing to bring up to their own physician face-to-face. The show has quickly gained popularity, matching the audience of other, more established talk shows.

The article points out that the success of the show points to the public appetite for health information, especially in financially difficult times and for those without health insurance. The producers and hosts of the show, as well as health advocates, remind audiences that the information in the show is not intended to replace a visit your own doctor, but rather, supplement it.

So what do you think of the popularity of this show? What cautions do you think the show should take? What would make this tool even better for patients? How can this show facilitate patient-physician face-to-face communication?

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/

Communicating and healing through nature

My hometown newspaper, The Milwaukee Journal-Sentinel published an article today about healing gardens, green spaces at hospitals around the region and around the country, designed to give patients a place to reflect, meditate and heal. It paints a picture of how healing comes in many forms. Having a place to physically engage in the act of healing, by walking and taking in the sights, sounds and smells of the garden, can do wonders.

You can find the article here: http://www.jsonline.com/story/index.aspx?id=781180

cosmetic and medical procedures

The New York Times published a revealing article about a trend in dermatology practices across the country. Some dermatologists are devoting more of their clinic time, space and effort to cosmetic patients to the detriment of those seeking dermatology medical problems. And because the cosmetic patients pay top dollar out-of-pocket, these clinics are catering to them with nicer waiting rooms, immediate access to appointments, and longer visit times that those who are paying for medical procedures through insurance.

The article generated some interesting and heated discussion about the responsibilities of physicians, capitalism in medicine, and a two-class medical system in this country.

You can find the article here: http://www.nytimes.com/2008/07/28/us/28beauty.html?ex=1374984000&en=a17cc8b23e040a96&ei=5124&partner=permalink&exprod=permalink