While this blog overall is aimed at physicians, if you have found this site as a patient, here are some online resources I recommend to my own patients:
(please see about me page for disclaimer statement)
- Cancer.Net provides timely, comprehensive, oncologist-approved information from the American Society of Clinical Oncology (ASCO), with support from the Conquer Cancer Foundation. Cancer.Net brings the expertise and resources of ASCO to people living with cancer and those who care for and about them to help patients and families make informed health care decisions.
- National Cancer Institute (NCI). NCI is the nation’s leader in cancer research.
- *within this site, shortcut link to clinical trials
- ClinicalTrials.gov. A service of the U.S. National Institutes of Health — a registry and results database of publicly and privately supported clinical studies of human participants conducted around the world.
- Leukemia & Lymphoma Society. The Leukemia & Lymphoma Society (LLS) is the largest voluntary health organization dedicated to funding research, finding cures and ensuring access to treatments for blood cancer patients.
- Breastcancer.org is a nonprofit organization dedicated to providing the most reliable, complete, and up-to-date information about breast cancer.
I am not the first physician blogger to write about the difficulties of prior authorizations, denials, and appeals, but recent occurrences in my own practice have been so convoluted that I feel they must be shared. The nonsensical denials would almost cause one to laugh, if not for the reality that each denial represents potential delay in care for the patient and redundant work for the physician — work that expands exponentially from the initial time taken to submit a carefully-worded request (in the futile hope that one might receive an approval on the first try). The incredulous laughter ...read more →
The following post is an edited transcript of my speech given on 7/8/17 at the Relay for Life 2017, Clatsop County, OR. I am very excited by this year’s Relay for Life theme, “Who is your superhero?” I am excited because I get to work with real-life superheroes every day. And this morning I get to tell you about some of them. If I had to pick just one group of people who are my superheroes, there is no question, it would be my patients. A hero is an ordinary individual who finds the strength to persevere and endure ...read more →
My smile freezes on my face as my patient says to me, “I’m so glad you’re back – that I get to see Mrs. Lycette today!” He has been my patient for several years, and I am perplexed to hear him address me as “Mrs.” rather than “Doctor.” At the same time, I really do not think he means an intentional insult, so I keep my face neutral and continue with the visit, without saying anything to correct him. But it sticks in my mind. It is not the first time one of my patients has referred to me ...read more →
I recently read a post by oncologist Dr. Stephanie Graff on the experience of blame, from self and others, that people with cancer are subjected to. The talk about risk factors and early detection makes us think we can achieve perfection, and that cancer is somehow a personal fault…let us stop making accusations and blaming persons diagnosed with cancer. They are blameless. Her post, The only perfect cancer statistic is an imperfect one, is a great resource for any of our patients who have experienced or are struggling with this. Another type of blame we can see in oncology practice is ...read more →
Recently I found myself sitting in my car in the parking lot of my clinic, unable to will myself to open the door. I didn’t want to head in to the clinic that morning. Instead I was filled with despair; overwhelmed with the events of the world. How can I do it? I thought. How can I walk in there and summon the energy to see my patients? An even worse thought: Why should I do it? What is the point in trying to heal the sick, in a broken world? In addition to world events, I had ...read more →
In recognition of National Nurses Week: Thank you to nurses for: staying behind in the room with patients and families after we deliver difficult news, not letting us shirk the tough questions, professionalism in the most difficult of circumstances, being partners in care, remembering what size gloves we wear, the phrase, “Doctor, I think you meant to order …”, making sure we eat, triaging phone calls, listening, telling us what the patient is really worried about but too afraid to ask, a calming presence, working 12-hour shifts, working over-time, knowing when to page and when it is ok to ...read more →
For many physicians, the term “compassion fatigue” may imply, as the words describe, that fatigue leads to the loss of ability to feel compassion for others. After all, what physician doesn’t have a day when s/he is too tired, running on too little reserve, and feeling some degree of emotional numbness? Many physicians may not realize, however, that compassion fatigue can go much deeper. According to the Compassion Fatigue Awareness Project, physicians and other health caregivers suffering from compassion fatigue may actually develop a secondary traumatic stress disorder. According to their website: When caregivers focus on others without practicing ...read more →
(A facetious piece. Inspired my my kids’ love of Mad Libs) Directions (in case you’ve never played Mad Libs): Play with a friend or colleague. Ask them to say a word for each type of word specified. Read the story using their words to fill in the blanks. Or play on your own, skip down without reading the story and fill in the blanks in the list before you read the story. Then read the story using your words to fill in the blanks. Why Your Doctor is Running Late “I apologize, Mrs. (person’s surname), to keep you waiting. ...read more →
(published also online on 4/10/17 in The ASCO Post, under the title The Mystery of Grace. re-published here with permission of the editor). The day after I told Nell she had seven metastases to her brain, she sent me flowers. She was my patient; I was her oncologist. I had met her 1 year prior, when she was well into her cancer journey, stage IV breast cancer at diagnosis. I took over from her current oncologist, who was moving. At our first visit together, she grilled me without mercy. Her questions were insightful, and her demeanor was tough; I ...read more →
The return from a vacation weighed on me physically. This had been a true vacation – an entire week away from clinic and spent with my family. I even managed to unplug to the point of only checking email on my phone twice per day – really! The tension that years ago took up permanent residence in my shoulders had faded away without my noticing, so that when I awoke to its sudden return, I realized that for one wonderful week I had almost become used to its absence. Almost…
There is a shortage of rural physicians in the U.S. My specialty, medical oncology, is but one of many specialties where the shortage is especially glaring. In oncology, I think there is perhaps a fear of practicing outside the walls of a large tertiary center and leaving behind the established framework and boundaries between the doctor and patient. I know it was a fear of mine when I moved to a rural community to practice nearly 4 years ago…
My patient was sitting in a wheelchair. He was in his mid-forties, and before the cancer, had held a physically demanding job that he loved. Now, the cancer in his spine had ended not only his ability to work, but any ability to use his legs…