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...that note, you're somewhat critical of the limits placed on medical residents' workweeks. You say they don't really get enough time with patients. I don't know that I'm against the limitation on residents' work hours. I do think it's very likely that residents will make fewer mistakes if they're not tired. But the way residents now learn medicine was developed by Sir William Osler at the beginning of the 20th century. It was great back then. Doctors lived in the hospital; that's why they're called residents. Patients also resided in the hospital...
...recurring themes in the book is the fact that too few doctors sit down and hear out the patient's story. Why is that? It's hard to listen to a story that's not told well. That's a terrible thing to say, but we all feel this. You know, when we're at the dinner table and Uncle Dave is telling a long, windy story, what you're really thinking is, "Where is this going? What is the bottom line?" That kind of impatience is not just limited to the dinner table; that's often how doctors feel...
...often interrupt patients. There have been several studies done that show that on average, doctors let patients talk for 20 seconds before interrupting. Some doctors interrupted after only three seconds. Once interrupted, patients are often reluctant to go back to their story. After you answer the doctor's question, say, "Let me just go back and tell you what happened." I also think patients need to be empowered to ask doctors to explain things in language they can understand. The patient is, after all, the owner-operator of his or her body. We wouldn't go to a mechanic...
...doctors for counseling patients on end-of-life care every five years. Opponents of health-care reform have latched onto the provision, claiming it would lead to forced euthanasia or "death panels" to decide whether lifesaving care for the elderly is cost-effective - despite the fact that the bill says nothing about either of these frightening issues. In fact, geriatricians - doctors trained specifically to care for the elderly - support the provision, arguing that it will encourage patients to express their own preferences rather than leave doctors and family members to guess what they want once they're no longer able...
...employed and less likely to have used welfare services, and their children were less likely to be victims of child abuse. Another evaluation of a Memphis-based program found that nurse visits improved the chances that parents would stay together after the birth of their child. Researchers say the programs are also linked to higher birth weights, increased involvement from fathers and improved school readiness for kids...