Stents vs. bypass surgery vs. TRUST

by Carolyn Thomas        @HeartSisters

In 2018, Dr. Dhruv Khullar warned his colleagues at an American Board of Internal Medicine conference that patients need answers on three dimensions of trust:

  1. Competence:Do you know what you’re doing?”
  2. Transparency:Will you tell me what you’re doing?”
  3. Motive:Are you doing this to help me or yourself?”        .     .

Continue reading “Stents vs. bypass surgery vs. TRUST”

Coronary stents: interventions that come with a cost

by Carolyn Thomas       @HeartSisters

Remember last month when I covered the topic of stretch pain” in heart patients who have had a coronary stent implanted?

To recap, temporary post-stent stretch pain in the chest is due to the dilation of an artery when a metal stent is being implanted inside that artery, and it typically occurs in about 40 per cent of stent patients.  A number of you wrote in with some variation of this question: “Is it still stretch pain if it’s happening months afterwards?”

And now a new study published in the Journal of the American College of Cardiology  suggests that something entirely different might be going on.2 .      .      , Continue reading “Coronary stents: interventions that come with a cost”

Dear Doctor – here’s why we need you on social media

by Carolyn Thomas   @HeartSisters

Dear Doctor,

Several years ago, when the British Medical Association openly warned U.K. docs and med students NOT to make “personal or derogatory comments” online about their patients (guidelines mercifully updated since then), I became even more alarmed than I had been. Why, I wondered at the time, was it even necessary to issue this warning to intelligent, educated brainiacs who practice medicine? And are there some physicians who should simply not be allowed on social media?

Lately, I’ve been rethinking my former alarm. And the reason for the rethink is this: I’ve noticed that many of you physicians might be in danger of abdicating your traditional role as our medical educators.     .      . Continue reading “Dear Doctor – here’s why we need you on social media”

Why is it so hard for your doctor to apologize?

Guest post by Dr. Fiona MacDonald, Dr. Karine Levasseur and Dempsey Wilford

You’ve just undergone surgery. Somehow, a mistake was made. The result is that you were harmed when you expected to be healed.

Hurt, angry and scared, you look to your doctors and ask: “What now? What do you have to say?” And they are silent.      Continue reading “Why is it so hard for your doctor to apologize?”

The medical hierarchy shift

by Carolyn Thomas   @HeartSisters   

treeJWVein-3832108_1280Many years before I finally left a decades-long professional relationship with my family physician, I had observed distressing changes in her practice. I didn’t say anything about these changes at first. They began with her new all-cash medical aesthetics clinic (think: nonstop before-and-after Botox videos looping in every exam room).

She did not post an actual sign in her waiting room telling her longtime patients what we all knew: “I Am No Longer Interested in the Practice of Family Medicine”  – but everything about her behaviours clearly announced that she’d already moved on without telling us.     . Continue reading “The medical hierarchy shift”