both sides of the coin was Re: [IMPROVEDX] Doctor lectures Valley health professionals on dangers of errors

HM Epstein hmepstein at GMAIL.COM
Thu May 18 05:36:46 UTC 2017


To Dr. Tommaso,

Thank you for your comments. That's really what patients with
difficult-to-identify acute illness want, a physician who *demonstrates *that
they care about helping them get better; who doesn't shrug and give up when
the first, or second, or even the third attempts at treatment fail. And
those of us who have taken the long, twisty diagnostic journey ourselves or
with a loved one understand how time consuming this can be for a physician
with a busy practice. We do although it's hard to be rational when you're
in pain and terrified. Just knowing that you're not alone on that shrinking
ice floe is of immense help.

Of course, at some point, patients want answers and treatments and cures.
Again and again, I hear from families that getting an accurate diagnosis,
just being told the name of what has been ailing them, can be a great
relief. But that relief doesn't last long. Then we want treatments that
work.

Perhaps one day the Star Trek tricorder will be real and answers will be
simple and swift. Perhaps one day precision medicine will reach the point
where our DNA leads the way to rapid identification and cures, with no
diagnostic uncertainty.

But until then, I'm grateful for the clinical physicians and the ER teams
and the wonderful nurses and the specialists who do as Dr. Tommaso does and
stick with us. Thank you!

Best,
Helene

Helene's Website <http://hmepstein.com/>
Helene's Twitter Account <https://twitter.com/hmepstein>
Diagnostic Error's Twitter Account <https://twitter.com/DxErrors>
Diagnostic Errors on Facebook <https://www.facebook.com/DiagnosticErrors/>
​
Helene on LinkedIn <https://www.linkedin.com/in/helenekepstein/>
​

On Wed, May 17, 2017 at 3:45 PM, Tommaso MD, Laura <ltommaso at nch.org> wrote:

>
> I have found in my primary care practice, calling a patient and admitting
> a mistake, telling a patient that I have no idea what you have but I'm not
> going to give up on trying, calling them after the visit saying I thought
> of something else we should try that didn't occur to me at the time...
> Almost ALWAYS earns greater respect and trust from the patient. I practice
> this (it is hard at first but gets easier)-and mentor my medical students
> to do the same.
>
> Get Outlook for iOS <https://aka.ms/o0ukef>
>
>
>
> On Wed, May 17, 2017 at 1:55 PM -0500, "Koppel, Ross J" <
> rkoppel at SAS.UPENN.EDU> wrote:
>
> Peggy
>>
>>
>> Your statement should be posted in front of every physician's room and
>> every hospital.
>>
>>
>> But don't hold your breath.
>>
>>
>> Ross
>>
>>
>> Ross Koppel, PhD, FACMI
>>
>> UNIVERSITY OF PENNSYLVANIA
>>
>> Sociology Dept;  LDI Senior Fellow, Wharton; &
>>
>> Affil Fac. Sch. of Medicine.
>>
>> Chair, AMIA Clinical Information Systems Working Group.
>>
>> Ph: 215 576 8221 <(215)%20576-8221>; Cell 215 518 0134 <(215)%20518-0134>
>>
>>
>>
>>
>> ------------------------------
>> *From:* Peggy Zuckerman <peggyzuckerman at GMAIL.COM>
>> *Sent:* Wednesday, May 17, 2017 2:15 PM
>> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>> *Subject:* Re: [IMPROVEDX] both sides of the coin was Re: [IMPROVEDX]
>> Doctor lectures Valley health professionals on dangers of errors
>>
>> The unaddressed issue in every medical encounter is the uncertainty that
>> exists. There have been and will continue to be wondrous gains in the
>> medical world that benefit us all.  But, the diagnosis and treatment of the
>> billions of different people, under multiple circumstances, and in the
>> dynamic changing individual body newly paired with a treatment of any kind
>> is a task that exemplifies uncertainty.
>>
>> A clear(!) recognition of uncertainty, both in the medical world and the
>> individual's world would go a long way to create an atmosphere of
>> partnership.The notion that the doctor knows all, and that medicine is
>> infallible, has been costly to everyone.  The patient who comes to realize
>> that this is not true feels betrayed, which exacerbates the situation.
>>
>> When we can comfortably discuss the uncertainty of the diagnosis, of the
>> treatment options, of the variables that the patient has, then we can begin
>> to make progress towards the 'best possible' outcomes.  The human and
>> financial losses that occur cannot be tolerated.  This requires the right
>> of the patients to partner in every medical interaction to the fullest
>> extent is the basis for the fix of healthcare.
>>
>> Peggy Zuckerman
>>
>> Peggy Zuckerman
>> www.peggyRCC.com
>> PeggyRCC.com | kidney cancer education for patients by ...
>> <http://www.peggyrcc.com/>
>> www.peggyrcc.com
>> Kidney cancer is generally a very silent disease. It is sneaky, hides out
>> for years, and is often assumed to be something else. In my case, my doctor
>> essentially ...
>>
>>
>>
>> On Wed, May 17, 2017 at 9:38 AM, Vic Nicholls <nichollsvi2 at gmail.com>
>> wrote:
>>
>>> Tom I say this because health care is expensive. Its not like 100 years
>>> or more ago when people did home remedies and death was simply a part of
>>> life. We frankly have to admit the hard fact: the US cannot support paying
>>> for all the health care of people. Hard decisions have to be made. Gotta
>>> draw the line, and vaccination is a perfect example.
>>>
>>> In addition, do you know the Somali reaction to the anti vaxxers? They
>>> were mad. They realized they got taken advantage of. They realized that
>>> doctors can be trusted.
>>>
>>> So sad. It didn't have to happen. It can be stopped.
>>>
>>> I am a harmed patient in more ways than one. Yet I want doctors to own
>>> up and fix mistakes. You don't do yourselves as a profession any good when
>>> people realize mistakes were made because that's why they won't trust you
>>> for anything. I don't want people to throw the baby (doc) out with the
>>> bathwater (all medical info/research). That's what I've seen a lot of them
>>> do: every sort of woo they'll hold onto because of harm from the/one
>>> medical establishment. It grows into the massive disaster that is anti
>>> vaccination, autism causes, etc.
>>>
>>> It starts by saying we are adult enough, as Tom put below, to stand up
>>> for our mistakes and show others how to react.
>>>
>>> Vic
>>>
>>> On 5/17/2017 9:10 AM, Tom Benzoni wrote:
>>>
>>> Maybe getting a bit tangential, but Vic brings up an interesting
>>> question.
>>>
>>> One feature that differentiates adults from children in a major way is
>>> taking responsibility for one's own choices (and conversely, not taking
>>> responsibility for other's choices, but that's a topic for another day.)
>>>
>>> Rather simple solution: If a person, family or group opts out of
>>> vaccination (not true medical exemption) they could post a bond. An actuary
>>> could price this out; we can with carbon credits. This bond could be posted
>>> by the entity proposing (in the way an employer bonds her employees) or
>>> bought a la carte. This would give an air of legitimacy to the anti-vaxxers
>>> I think they'd welcome. Don't drink from a trough you don't help fill.
>>>
>>> tom
>>>
>>>
>>>
>>> ------------------------------
>>>
>>>
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>>>
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>>
>>
>>
>> ------------------------------
>>
>>
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>>
>>
>> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
>> Medicine
>>
>> To learn more about SIDM visit:
>> http://www.improvediagnosis.org/
>>
>>
>> ------------------------------
>>
>>
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>>
>>
>> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
>> Medicine
>>
>> To learn more about SIDM visit:
>> http://www.improvediagnosis.org/
>>
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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