Christina Spencer's blog

One group of providers seem to be conspicuously missing - the nurses. New York Times contributor Pauline W. Chen, M.D. looks at the challenges in developing a 'culture of care'.

At the start of my surgical training, I helped to care for a middle-aged patient who was struggling to recuperate from a major operation on his aorta, the body’s central artery, and the blood vessels to his legs. As the days wore on, the surgeon in charge began consulting various experts until the once spare patient file became weighted down with the notes and suggestions of a whole roster of specialists.

The patient eventually recovered, thanks to the efforts of many. Nonetheless, one afternoon while walking around the wards with the senior surgeon, I couldn’t help but make a crack about the sheer heft of the patient’s chart; it was, after all, my job to carry it around while she visited with patients.

HealthLeaders Media - Recently, HealthLeaders released the results from its annual Patient Experience Leadership Survey, and the findings were fascinating.

The report, titled “Patient Experience: Help Wanted” chronicled the ongoing disconnect between the stated priorities of the nations’ hospital executives and their action plans to meet those priorities. The report included essays by Steve Ronstrom, a prominent health-system CEO, and by Peter Kuhn, CEO of MEDSEEK. Both essays implored hospital executives to take decisive action, take accountability for HCAHPS performance and implement plans to improve the experience not just in the hospital, but across the continuum of care.

In a recent New York Times 'Doctor and Patient' column, Pauline W. Chen, M.D. discusses the possibility of new comprehensive standards that require patient-reported and quality-of-life outcomes.

Wiry, fair-haired and in his 60s, the patient had received a prostate cancer diagnosis a year earlier. When his doctors told him that surgery and radiation therapy were equally effective and that it was up to him to decide, he chose radiation with little hesitation.

But one afternoon a month after completing his treatment, the patient was shocked to see red urine collecting in the urinal. After his doctors performed a series of tests and bladder irrigations through a pencil-size catheter, he learned that the bleeding was a complication of the radiation treatment.

Medical Blogger Devin Gross discusses patient empowerment and its promising answers for healthcare questions.

Here’s a question. It’s not a 5¢ or $5 question that anybody can solve on their own without much thought or effort. It’s a $100 ask-an-expert or think-about-it-for-a-second question.

What’s the point of patient empowerment?

Much of the current discussion of empowerment deals with patients who for one reason or another have had to fight for their care. CNN’s Elizabeth Cohen opens her book, The Empowered Patient, with a moving personal story of her panicked battle to keep her child from having an unneeded spinal tap. On the site KevinMD.com, an article titled All patients will soon become e-patients, contained the quote, “But, I’m not a ‘regular’ patient. I’m pissed and I want answers. That’s where all those ‘e’s’ come from.”

Concerning the doctor and patient relationship, Pauline W. Chen, M.D. asks if when trying to contain an infection, is it possible to lose sight of the person?

Several years ago I helped care for a man who had been hospitalized with a severe infection of the abdominal wall. When his primary doctors discovered that the bacteria responsible was resistant to most antibiotics, they quickly isolated him, moving him into a single room with a sign on the door proclaiming “Contact Precautions” and directing visitors to put on gloves, mask and gown before entering.

Toronto Star reporters Dale Brazao and Moira Welsh reveal shocking living conditions in Toronto's In Touch Retirement Living. The article is among many profiling the inhumane treatment given to our aging population indicating that seniors need more protection.

The 82-year-old man, in diapers and suffering advanced dementia, slid off his chair and crashed to the floor of the Toronto retirement home.

No staffer came to help. An undercover Toronto Star reporter helped Sam up and waited. Five minutes. Ten minutes. Fifteen minutes. At twenty minutes a tired, overworked staffer appeared.

“Sam does not belong here,” she said.

That was our first night inside In Touch Retirement Living in Toronto’s west end at Lawrence Ave. and Weston Rd. Over the next week, the Star witnessed profound neglect in a place where more than half of the 18 residents should be in a nursing home receiving higher quality, regulated medical care.

Columnist Andre Picard assesses a report from the Commonwealth Fund "which provides a sobering reminder that, when it comes to health care, Canadians all too often wear rose-coloured glasses."

Canadians are proud of their medicare system and like to hail its strong points: universality, fairness and cost-effectiveness.

Medicare is, to many, a badge of citizenship, a program – a philosophy even – that distinguishes us from our neighbours to the south, whose health care system has traditionally been expensive and unfair.

The study, entitled Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally, compares the performance of health systems in seven Western countries: the United States, Canada, Germany, the Netherlands, Britain, New Zealand and Australia.

The United States, unsurprisingly, ranked dead last. The Netherlands ranked first. Canada ranked a pathetic sixth out of seven.

Are patients swimming in a sea of health information? Or are they drowning in it?

The rise of the Internet, along with thousands of health-oriented Web sites, medical blogs and even doctor-based television and radio programs, means that today’s patients have more opportunities than ever to take charge of their medical care. Technological advances have vastly increased doctors’ diagnostic tools and treatments, and have exponentially expanded the amount of information on just about every known disease.

The daily bombardment of news reports and drug advertising offers little guidance on how to make sense of self-proclaimed medical breakthroughs and claims of worrisome risks. And doctors, the people best equipped to guide us through these murky waters, are finding themselves with less time to spend with their patients.

But patients have more than ever to gain by decoding the latest health news and researching their own medical care.