That’s all that a sick friend needs to hear from you. Two sentences. Nine words. Too often, what they hear instead is silence — you don’t know what to say, you’re afraid to say the wrong thing, and so the friend winds up feeling abandoned in a time of need. Or, just as bad, friends….
Continue ReadingEnd of Life
End of Life Care: The Checkbook Is Open
Medical malpractice lawsuits are so frequently blamed for the high cost of medical care that when another, actual cause (not apocryphal, like lawsuits) of expensive medicine comes around, it’s almost hard to believe. Exhibit A: End of Life care. This is the single most expensive segment of Medicare — the last 30 days of someone’s….
Continue ReadingBig Profits in Cutting Corners on Quality for Owners of Long-Term Care Hospitals
The handsome silver-haired doctor in the long white coat, standing at the nurse’s station in a photograph accompanying a New York Times story, is the national medical director for a chain of for-profit long-term care hospitals. But he puts in barely ten hours a week for Select Medical Corporation, which has no physicians in its….
Continue ReadingImproving Quality of Care by Paying Attention to the Need for Hope
Almost nothing is worse in medicine than a cold-hearted delivery of bad news that sucks all the hope out of a patient’s lungs. And almost nothing is better than an honest dialogue between doctor and patient that explores the hopes and fears of a patient faced with a very serious condition, in a way that….
Continue ReadingA Safe — and Gentle — Approach to End-of-Life Decisions
Many elderly patients suffer protracted, and expensive, deaths as health care providers pummel them with technological fixes for bodies that have already worn out. The dilemma is that while no doctor wants to give futile care that tortures more than it heals, no one also wants to be guilty of euthanasia or abandoning their patient…..
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