Jenny joined CBSSM in July 2017. She works with Dr. Geoff Barnes on projects focused on improving care for patients on anticoagulants by addressing barriers to medication adherence and patient, physician, and hospital staff communication.
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Sam joined CBSSM in November 2017. She works with Drs. Julie Wright, Michele Gornick, and Renuka Tipirneni on projects examining provider-patient communication regarding chronic kidney disease, VA data sharing, and the effect of Medicaid expansion on healthcare for low-SES aging adults.
CBSSM Faculty, Kayte Spector-Bagdady, Ray De Vries, and Lisa Harris, along with Lisa Low recently co-authored a Hastings Center Report article, "Stemming the Standard-of-Care Sprawl" about clinician self-interest and the case of electronic fetal monitoring.
Link to article here.
Joel Howell was honored by the American College of Physicians (ACP) at its annual convocation ceremony in April. Howell was named a new Master of the American College of Physicians for 2017-2018. Each year, a select group of these Fellows are chosen from among the nominees for Mastership by the ACP Awards Committee and approved by the ACP Board of Regents.
Patients sometimes skip treatments because they just feel too busy. What should physicians do when their patients ignore their recommendations?
Imagine you are a businessperson who works long hours and you are on your way up to having a successful and lucrative career. You have a major business deal that will consume nearly all of your time over the upcoming month and your boss is relying on you to make sure the deal goes through. This is your chance to really make your mark and show your corporation that you are the kind of person that can handle deals as big as this one. Also suppose you have been smoking on and off for 25 years. You know it's a bad habit that could destroy your lungs, but you just can't quite kick it. Lately, you have been feeling tired, you have been experiencing chest pains when you are really busy at work and when you exercise, and you have had trouble breathing when climbing a flight of stairs. The chest pains are usually relieved by a little rest, but you decide it's time to get this examined by a doctor.
One day after work, you go to see Dr. Coral, who gives you a stress test and determines that you'll need an appointment for an angiogram to better evaluate your coronary arteries. Fortunately, you find one free day right before things get hectic at work, so you schedule the angiogram. Now imagine you have just had the angiogram and you are recovering in a paper gown waiting for Dr. Coral to come back with the results. Dr. Coral enters the room to speak with you and he has a serious look on his face. He says,
"I have both good and bad news for you. The angiogram shows that your 3 main coronary arteries are all severely blocked. The good news is that we caught this before you had a major heart attack."
"The bad news is that I am recommending you have triple bypass surgery as soon as possible. Your heart is working overtime, and it is just a matter of time until it gives out."
- I would put aside Dr. Coral's recommendation and instead take responsibility at work for the current deal. I'll wait to have surgery in about a month.
- I would follow Dr. Coral's recommendation by having surgery immediately, even though this forfeits the current opportunity at work.
A little feedback on what you chose.
- understand the information about the condition and the choices available;
- make a judgment about the information in keeping with his or her personal values and beliefs;
- understand the potential outcomes or consequences of different choices; and
- freely communicate his or her wishes