NYTimes: Rude Doctors, Rude Nurses, Rude Patients

Edward Winslow edbjwinslow at GMAIL.COM
Thu Apr 20 20:18:50 UTC 2017


Peter,

These are amazing suggestions. I'm sure that we all have some insights that
we have come up with.  I have tried to avoid saying "you have to ... (eat
less, exercise more, use RICE, ...)", but use a technique from
motivitaional interviewing and asking, "would you like me to tell you what
I think about ...?".

Ted

On Wed, Apr 19, 2017 at 12:14 PM Elias Peter <pheski69 at gmail.com> wrote:

> This is a challenge that the primary clinician faces daily, sometimes in
> the hospital, sometimes in the office, and sometimes with messaging.
>
> I don’t have a solution, but I will share a couple things I have found
> helpful:
>
>    - Frequently discussing uncertainty and the fact that diagnoses
>    represent a best explanation (I avoid words like guess) based on the
>    current data, and time and more data often yield changes.
>    - I had some of those visual illusions lying around in the office to
>    illustrate that different people looking at the same image often see
>    different things. (Almost all patients are familiar with these.)
>    - I used the analogy of a jig-saw puzzle, and how the picture became
>    clearer as more pieces were in place, but that change was part of the
>    process.
>
>
> Peter
>
>
> On 2017.04.19, at 6:39 AM, Bob Latino <blatino at RELIABILITY.COM> wrote:
>
> A family member of mine luckily has survived childhood leukemia (so far)
> when detected at the age of 3. She went through 3 years of treatments and I
> am happy to say she is cancer free.  But for the parents of such children,
> they know that status can be temporary as the leukemia can return.  I've
> learned through their experiences what parents of such children go through
> with their child's care, and how tightly bonded groups (they refer to them
> as prayer tribed) develop of like parents with kids in the same position.
> Below is a FB post of one of these other parents and the frustration they
> are going through related to getting a straight, accurate and timely Dx.
> This is just a post from 'the other side', a true picture of what families
> go through when doctors don't agree.  They don't know who to believe and
> they want to believe the doctor who is telling them the news they 'want to
> hear'.  Just an FYI as I find this relevant to our conversations on this
> forum.
>
>
>
> "Savannah is a beautiful 7 year old girl who fought leukemia once before
> as a 2 y/o toddler and is now back in the battle.
>
> Savannah is out from her BMA and LP. She did wonderful of course. We will
> not have results for 24-48 hours. I need to hit the pause button. I am so
> confused and frustrated. Two days ago not one but two oncologists said she
> had cancer. Two more on top of that said the same. Now down on the BMA room
> a different oncologist said there is still a chance she has some bad
> infection.
>
> Why can't anyone get on the same page? I don't even know who to believe at
> this point. For almost SIX months I have known something is wrong. I've had
> her to an ER and was told her back pain was from scoliosis. That the
> fatigue was from side effects or low iron. That the migraines were from
> neck alignment issues.
>
> Then we get the CT scan and get an urgent call to come back because it
> looks to be an infection in her brain and abscess behind her eye and that
> we would be admitted. Then we get to Seattle and were are told there is no
> abscess or infection. Just fluid.
>
> We get the brain MRI and were taken into a room and told Savannah had
> cancer they just weren't sure what kind and what treatment should be. FIVE
> different oncologists have told us that there was no infection or orbital
> cellulitis. The neurosurgeon told is no infection just fluid. Then today
> after her procedure the oncologist says there is still a chance this could
> all be an infection. What!? I don't even know or understand at this point.
> I feel I have been through three different nightmares. I can't sleep, I
> can't eat. I feel like I've been punched in the gut. I feel embarrassed.
> That we alerted our tribe and now this could be something completely
> different.
>
> I need to hit the pause button and unplug. We should have definite answers
> within 24-48 hours. I will answer messages and update when we know without
> a doubt. I truly am sorry.
>
> We are of course holding onto hope that it is not the C word and a
> treatable infection. These will be the longest hours of my life. I am
> asking that everyone respect my silence for a couple of days. I am beyond
> grateful how already we have been given so much love and I promise to pay
> it forward."
>
>
>
>
>
> *Robert J. Latino, CEO*
>
> Reliability Center, Inc.
>
> 1.800.457.0645
>
> blatino at reliability.com
>
> www.reliability.com
>
> <image001.jpg>
> <https://www.linkedin.com/company/958495?trk=tyah&trkInfo=clickedVertical%3Acompany%2CclickedEntityId%3A958495%2Cidx%3A1-1-1%2CtarId%3A1464096807851%2Ctas%3Areliability%20center%2C%20inc.>
>
>
>
> *From:* David Meyers [mailto:dm0015 at ICLOUD.COM <dm0015 at ICLOUD.COM>]
> *Sent:* Tuesday, April 18, 2017 6:43 PM
> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> *Subject:* [IMPROVEDX] Fwd: NYTimes: Rude Doctors, Rude Nurses, Rude
> Patients
>
>
>
>
> https://www.nytimes.com/2017/04/10/well/family/rude-doctors-rude-nurses-rude-patients.html?smprod=nytcore-iphone&smid=nytcore-iphone-share
>
>
>
>
> David
>
> David L Meyers, MD FACEP
>
> Listserv Moderator/Board member
>
> Society to Improve Diagnosis in Medicine
>
> Save the Date: Australiasia DEM, May 24-25, 2017, Melbourne Australia
>
> Save the Date: Diagnostic Error in Medicine, October 8-10, 2017, Boston, MA
>
>
>
>
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> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
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-- 
*Edward B, J. Winslow, MD, MBA*
Home 847 256-2475; Mobile 847 508-1442
edbjwinslow at gmail.com
winslowmedical.com

"The only thing new in the world is the history that you don't know"
       Harry S. Truman, 33rd President of US (1945-1953)


"... it can be argued that underinvestment in assessing the past is likely
to
lead to faulty estimates and erroneous prescriptions for future action."
        Eli Ginzberg, 1997






Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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