I've always wanted to be a doctor.
Never a writer.
With a new year and a new decade, I am determined to become a better writer not because of some childhood dream or expectation from others, but because of a near mishap that occurred at the beginning of 2000. A simple phone call changed the destiny of my brother from having a good outcome to having a great outcome. A simple phone call may have been the difference between you are cancer free to I'm sorry to tell you its come back.
It was a medical error that was avoided only because I was a doctor who was engaged to an oncologist and because my brother simply called me the night before his surgery. Based on his diagnosis, his surgeon should have referred him to an orthopedic oncologist, a musculoskeletal cancer surgeon, to perform curative surgery. Only two exist in the entire state of Connecticut. Instead, the surgeon opted to do the surgery himself even though he admitted he didn't know what the diagnosis meant.
A simple phone call the night before made the difference between being told that unfortunately your cancer came back to you are cancer free.
What if you had the knowledge to make a difference to save lives? What if you could see the problems that others don't or refuse to see? Would you feel compelled to intervene? I write and communicate this information because our healthcare system, the doctors and hospitals, that we or our families rely on at some point in our lives is not as good as it can and should be. Each of you have your stories. Healthcare reform will not fix the problem.
It was my brother's phone call and many subsequent episodes with other relatives that made me glad I became a doctor not because I could help them get better sooner, but help stop bad things from happening to them as a result of a less than perfect medical care.
Despite my knowledge, I wish I could say I stopped each and every bad outcome. I didn't. I couldn't. Every missed opportunity to intervene and make things better bothers me today. I am a better doctor today than I was a decade ago and will undoubtedly be a more skilled physician a decade from now.
As everyone this new year focuses on typical goals of becoming healthier by exercising, losing weight, and ridding themselves of vices like smoking and excessive drinking, I have a completely different lifelong mission: to educate individuals on how to get the best medical care by giving them insider tips only a doctor would know.
As a doctor I've taken a pledge to do no harm and help those who suffer. To do that I need to be a better writer.
Showing posts with label cancer. Show all posts
Showing posts with label cancer. Show all posts
Sunday, January 3, 2010
Monday, October 5, 2009
Voluntarily uninsured isn't a calculated risk but a gamble. Can you really afford to lose?
This recent NPR piece on Voluntarily Uninsured: A 'Calculated Risk' got my attention. There are some people who don't buy health insurance. They are healthy. They can afford health insurance. They don't feel the need.
They are wrong.
As a practicing doctor, it is worrisome to hear people are voluntarily uninsured because of a false belief. Having good health is highly unpredictable. Children develop cancer without having a family history or adequate time to assault their bodies with cigarettes or alcohol. Women with healthy pregnancies may need a crash C-section, which is far more expensive than a vaginal delivery. Too many people are injured from motor vehicle accidents requiring significant medical care. Non-smokers do develop lung cancer and the astronomical costs of chemotherapy.
Good health is somewhat unpredictable the same way the chances of you getting into a car accident is a crap shoot.
Assume you are an excellent driver. Never speed. Never had a traffic violation. In fact, you abide by the rules and recommendations to stay safe that other drivers honk you incessantly when you drive 25 miles an hour in a residential area and that even the police department flags you down when going 55 miles an hour on the highway because it is such an anomaly. Your passengers groan when you buckle up simply to move your car from the street into the driveway.
A drunk driver seriously injures you on your way home from work.
You did everything right and yet there you are. An accident occurred and no fault of your own.
At least you have auto insurance and can get some of the costs back.
Serious car accident or serious illness. While we have some control, in many cases it is out of our hands. In other words, while we can decrease risk by staying healthy, as a doctor I see too many times people getting seriously ill with no definable cause. Voluntarily uninsured is not calculated risk but rather a gamble. It's a gamble none of us can afford to lose because of a misconception.
As the subject in this NPR article finally admitted in the end, serious illness could bankrupt her and cause her to lose her business. She is seeking some catastrophic insurance. In the end, some insurance is better than none.
They are wrong.
As a practicing doctor, it is worrisome to hear people are voluntarily uninsured because of a false belief. Having good health is highly unpredictable. Children develop cancer without having a family history or adequate time to assault their bodies with cigarettes or alcohol. Women with healthy pregnancies may need a crash C-section, which is far more expensive than a vaginal delivery. Too many people are injured from motor vehicle accidents requiring significant medical care. Non-smokers do develop lung cancer and the astronomical costs of chemotherapy.
Good health is somewhat unpredictable the same way the chances of you getting into a car accident is a crap shoot.
Assume you are an excellent driver. Never speed. Never had a traffic violation. In fact, you abide by the rules and recommendations to stay safe that other drivers honk you incessantly when you drive 25 miles an hour in a residential area and that even the police department flags you down when going 55 miles an hour on the highway because it is such an anomaly. Your passengers groan when you buckle up simply to move your car from the street into the driveway.
A drunk driver seriously injures you on your way home from work.
You did everything right and yet there you are. An accident occurred and no fault of your own.
At least you have auto insurance and can get some of the costs back.
Serious car accident or serious illness. While we have some control, in many cases it is out of our hands. In other words, while we can decrease risk by staying healthy, as a doctor I see too many times people getting seriously ill with no definable cause. Voluntarily uninsured is not calculated risk but rather a gamble. It's a gamble none of us can afford to lose because of a misconception.
As the subject in this NPR article finally admitted in the end, serious illness could bankrupt her and cause her to lose her business. She is seeking some catastrophic insurance. In the end, some insurance is better than none.
Wednesday, June 10, 2009
Cancer Causes Personal Bankruptcy
From the Today show both financial expert Jean Chatzky and chief medical correspondent Dr. Nancy Snyderman discuss the disturbing truth about the healthcare crisis that those with insurance are going bankrupt, particularly with cancer diagnoses.
I particularly thought that Ms. Chatzky should be commended for calling attention to that fact that people do spend more time researching vacation rather than understanding their health insurance benefits! They neglect their health not understanding that having good health is the most powerful financial asset they own.
If you are healthy you can always earn more money. If you are ill, you can have all the money in the world and never get back good health. The public doesn't get the right preventive care 1/2 the time in this country. Cancer caught early can be less costly with better survival.
The complex relationship between the ability to pay and the ability to get well is only going to get worse. That's why I wrote my book Stay Healthy, Live Longer, Spend Wisely - Making Intelligent Choices in America's Healthcare System.
Medical costs are the leading cause of personal bankruptcy in this country. There is a financial reason that healthcare reform must occur. It is highly likely that President Obama will make it happen.
What it will look like is another story.
Visit msnbc.com for Breaking News, World News, and News about the Economy
I particularly thought that Ms. Chatzky should be commended for calling attention to that fact that people do spend more time researching vacation rather than understanding their health insurance benefits! They neglect their health not understanding that having good health is the most powerful financial asset they own.
If you are healthy you can always earn more money. If you are ill, you can have all the money in the world and never get back good health. The public doesn't get the right preventive care 1/2 the time in this country. Cancer caught early can be less costly with better survival.
The complex relationship between the ability to pay and the ability to get well is only going to get worse. That's why I wrote my book Stay Healthy, Live Longer, Spend Wisely - Making Intelligent Choices in America's Healthcare System.
Medical costs are the leading cause of personal bankruptcy in this country. There is a financial reason that healthcare reform must occur. It is highly likely that President Obama will make it happen.
What it will look like is another story.
Sunday, August 31, 2008
Book Review - Medical Myths That Can Kill You: And the 101 Truths That Will Save, Extend, and Improve Your Life
As a practicing family doctor and author of Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America's Healthcare System, I am a strong believer in empowering and educating patients so that they can make the right decisions to get the most out of life. As the only doctor in my family I don't think it is fair that only the people I know or care for are privy to the truth about staying healthy, so I looked forward to reading Medical Myths That Can Kill You: And the 101 Truths That Will Save, Extend, and Improve Your Life, by Dr. Nancy Snyderman, chief medical correspondent for NBC News, which has a similar same perspective.
Overall, the book was a mixed blessing. It has interesting factoids, ideas we should all take to heart, but at times is misleading. As a consumer and a patient, I thought the truths and news you can use pieces were interesting. As a primary care doctor and patient advocate, however, I felt that many parts of the book were misleading. Perhaps one of the faults is it tries to be too ambitious and attempts to cover too many topics, which often are not in depth enough to be of much value.
Dr. Snyderman points out correctly multiple times that the path to good health is through prevention by adopting healthy habits, staying physically active, and maintaining a sensible weight. The structure of the book reflects this preventive focus and chooses to debunk many myths with these clever chapter titles - Annual Checkups Are Obsolete, Vaccinations Are Just For Kids, Doctor's Don't Play Favorites, Only Old People Get Heart Disease and Stroke, We're Losing the War on Cancer, Natural Means "Safe", and You Can Just Snap Out of Mental Illness. She tackles the truth about herbal and dietary supplements, the unproven value of full body scans, as well as the importance of vaccinations and preventive screening tests for cancer, heart disease, and diabetes.
Throughout the book there are plenty of truth tidbits including, "you cannot catch sexually transmitted diseases from toilet seats; you do not need to drink eight glasses of water every day", among many others and news you can use segments that will make some readers hopefully more aware of what is myth and what is fact. These small sidebars were very interesting. I think patients and consumers will find these factoids topics of conversation.
As a practicing doctor, however, there are many areas which are misleading and others that provide information too superficial to be of value. Dr. Snyderman is correct in one of her chapters that heart disease and stroke are the leading causes of death in this country. However, she uses two individuals, a twenty-six year old former beauty pageant winner, who suffered from a stroke, and a forty year old woman, who died suddenly from swimming, as reasons why we should be concerned. The problem is that these type of occurrences are extremely unlikely and rare for these age groups and gender. The typical cause of these problems, atherosclerosis, or hardening of the arteries didn't cause these cases. The former was most likely due to a heart wall septal defect or a blood clotting disorder, known as a hypercoagulable state. The latter was probably due to sudden cardiac death from a fatal arrhythmia, like ventricular fibrillation.
In the area of stroke, she talks about atrial fibrillation, a heart arrhythmia, as the leading cause of stroke. It is a cause, but this heart condition is typically found in patients over age 60 and far more common in people over 80 years old. She doesn't say that and one would naturally and wrongly assume based on the prior patient stories that it can happen at younger ages, which again is extremely unlikely.
Other areas that are covered superficially include when Dr. Snyderman discusses cancer and mental illness. She pushes for prevention as well as clarifies myths that still exist among the public. Unfortunately in the chapter on cancer, she also talks about various cancer treatments which isn't thorough enough and doesn't seem to fit in a book with this preventive theme. For the mental illness, one of the best written sections because of her personal experience, again the book is rather too ambitious and tries to cover anxiety, depression, and bipolar disorder and the various treatment options even as she admits that "it is impossible to go into as much detail as I would like to". Though she gives a website reference, perhaps it may have been better only to cover depression as she and her husband both had experienced it, and acknowledge the other conditions.
Overall, I wanted to like this book as I believe the intent of giving the public the facts about what they can do to stay healthy and well is vital. I think as a practicing doctor and insider, however, the book at times it is misleading, in some areas is too light in content and in others the information deviates from the book's intent of wellness and health promotion.
Overall, the book was a mixed blessing. It has interesting factoids, ideas we should all take to heart, but at times is misleading. As a consumer and a patient, I thought the truths and news you can use pieces were interesting. As a primary care doctor and patient advocate, however, I felt that many parts of the book were misleading. Perhaps one of the faults is it tries to be too ambitious and attempts to cover too many topics, which often are not in depth enough to be of much value.
Dr. Snyderman points out correctly multiple times that the path to good health is through prevention by adopting healthy habits, staying physically active, and maintaining a sensible weight. The structure of the book reflects this preventive focus and chooses to debunk many myths with these clever chapter titles - Annual Checkups Are Obsolete, Vaccinations Are Just For Kids, Doctor's Don't Play Favorites, Only Old People Get Heart Disease and Stroke, We're Losing the War on Cancer, Natural Means "Safe", and You Can Just Snap Out of Mental Illness. She tackles the truth about herbal and dietary supplements, the unproven value of full body scans, as well as the importance of vaccinations and preventive screening tests for cancer, heart disease, and diabetes.
Throughout the book there are plenty of truth tidbits including, "you cannot catch sexually transmitted diseases from toilet seats; you do not need to drink eight glasses of water every day", among many others and news you can use segments that will make some readers hopefully more aware of what is myth and what is fact. These small sidebars were very interesting. I think patients and consumers will find these factoids topics of conversation.
As a practicing doctor, however, there are many areas which are misleading and others that provide information too superficial to be of value. Dr. Snyderman is correct in one of her chapters that heart disease and stroke are the leading causes of death in this country. However, she uses two individuals, a twenty-six year old former beauty pageant winner, who suffered from a stroke, and a forty year old woman, who died suddenly from swimming, as reasons why we should be concerned. The problem is that these type of occurrences are extremely unlikely and rare for these age groups and gender. The typical cause of these problems, atherosclerosis, or hardening of the arteries didn't cause these cases. The former was most likely due to a heart wall septal defect or a blood clotting disorder, known as a hypercoagulable state. The latter was probably due to sudden cardiac death from a fatal arrhythmia, like ventricular fibrillation.
In the area of stroke, she talks about atrial fibrillation, a heart arrhythmia, as the leading cause of stroke. It is a cause, but this heart condition is typically found in patients over age 60 and far more common in people over 80 years old. She doesn't say that and one would naturally and wrongly assume based on the prior patient stories that it can happen at younger ages, which again is extremely unlikely.
Other areas that are covered superficially include when Dr. Snyderman discusses cancer and mental illness. She pushes for prevention as well as clarifies myths that still exist among the public. Unfortunately in the chapter on cancer, she also talks about various cancer treatments which isn't thorough enough and doesn't seem to fit in a book with this preventive theme. For the mental illness, one of the best written sections because of her personal experience, again the book is rather too ambitious and tries to cover anxiety, depression, and bipolar disorder and the various treatment options even as she admits that "it is impossible to go into as much detail as I would like to". Though she gives a website reference, perhaps it may have been better only to cover depression as she and her husband both had experienced it, and acknowledge the other conditions.
Overall, I wanted to like this book as I believe the intent of giving the public the facts about what they can do to stay healthy and well is vital. I think as a practicing doctor and insider, however, the book at times it is misleading, in some areas is too light in content and in others the information deviates from the book's intent of wellness and health promotion.
Thursday, June 5, 2008
Cancer Patients - Is It Okay to Be Scared?
The New York Times published an article titled "When Thumbs Up Is No Comfort" and the health blog asked a simple question - “What do you think? Is upbeat and positive the best way to cope with cancer? Or does unvarnished optimism deny us the opportunity to confront our real fears?”
As we say in medicine, the answer is it depends. Taking a completely different example, years ago and even today, it is considered by society that a woman giving birth should be the happiest day of her life. New moms and dads should be absolutely thrilled about having a baby. It seemed that all new parents needed to smile, say how grateful they were, and repeat the mantra on how overjoyed and happy they were for the blessed event.
Certainly, having children is a precious event and most of us would never give them up. However, the societal pressure that parents should be ecstatic buried for years a more complex discussion of post-partum depression and the challenges and stressors of being parents. If one asked for help or appeared not to cope well with this monumental change then it seemed like there was something wrong with the person. Consequently they became even more alone. It hasn’t been until recently that people are more open about how difficult (and rewarding) it is to be a parent.
So for cancer, public figures, by their nature and profession need to be upbeat. For the rest of us, it is okay to be scared, frightened, and far from stoic. We all have public faces and private faces. We must reveal those private moments with our doctors, our partners, in this challenge. The right treatment for you is what you, the patient, are comfortable with. Find a doctor that listens to you and your needs and supports you and protects you from others, who cannot truly understand your experience, although they mean well.
What patients often don’t realize, but experienced and wise doctors do, is that “fighting” cancer and “not fighting” cancer provides different outcomes and one choice is not necessarily better than the other. Some patients value quality of life over weeks and months of chemotherapy and radiation and their related problems. Others prefer the latter hoping for more time later on.
As someone who had family members diagnosed with cancer, it is extremely stressful, hard, scary, and frightening for all involved. By understanding this, it has made me a far better doctor as I will routinely tell patients that it is okay to be in shock, unsure, and terrified when diagnosed with a serious illness.
What I think people fear the most is if we, doctors, family, and friends, somehow think less of them if they display these emotions. As a doctor, I reassure them that I will always be there for them on good days and bad days. In the end, isn’t that what we all want?
As we say in medicine, the answer is it depends. Taking a completely different example, years ago and even today, it is considered by society that a woman giving birth should be the happiest day of her life. New moms and dads should be absolutely thrilled about having a baby. It seemed that all new parents needed to smile, say how grateful they were, and repeat the mantra on how overjoyed and happy they were for the blessed event.
Certainly, having children is a precious event and most of us would never give them up. However, the societal pressure that parents should be ecstatic buried for years a more complex discussion of post-partum depression and the challenges and stressors of being parents. If one asked for help or appeared not to cope well with this monumental change then it seemed like there was something wrong with the person. Consequently they became even more alone. It hasn’t been until recently that people are more open about how difficult (and rewarding) it is to be a parent.
So for cancer, public figures, by their nature and profession need to be upbeat. For the rest of us, it is okay to be scared, frightened, and far from stoic. We all have public faces and private faces. We must reveal those private moments with our doctors, our partners, in this challenge. The right treatment for you is what you, the patient, are comfortable with. Find a doctor that listens to you and your needs and supports you and protects you from others, who cannot truly understand your experience, although they mean well.
What patients often don’t realize, but experienced and wise doctors do, is that “fighting” cancer and “not fighting” cancer provides different outcomes and one choice is not necessarily better than the other. Some patients value quality of life over weeks and months of chemotherapy and radiation and their related problems. Others prefer the latter hoping for more time later on.
As someone who had family members diagnosed with cancer, it is extremely stressful, hard, scary, and frightening for all involved. By understanding this, it has made me a far better doctor as I will routinely tell patients that it is okay to be in shock, unsure, and terrified when diagnosed with a serious illness.
What I think people fear the most is if we, doctors, family, and friends, somehow think less of them if they display these emotions. As a doctor, I reassure them that I will always be there for them on good days and bad days. In the end, isn’t that what we all want?
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