July 22, 2018
BehindTheMedspeak: Doctors appear to have perfected the bum's rush when it comes to seeing patients
Back in the day, when I was an intern in the ER at Los Angeles County-University of Southern California Hospital in 1974-75, "Five minutes or five problems — whichever comes first," was our guideline when it came to cutting patients off and beginning the physical examination.
It's now down to 11 seconds.
Ever feel like your doctor is in a rush to get you out the door when you come in for a visit?
You're not just imagining things.
A new study finds physicians give a patient an average of just 11 seconds to describe their issue before cutting them off.
Researchers from the University of Florida determined that for all the waiting we do after we arrive at a medical practitioner’s office, its the doctors who seem to have the least amount of patience.
The study showed that just a third of physicians give patients adequate time to explain why they're there.
"Our results suggest that we are far from achieving patient-centered care," said study co-author Naykky Singh Ospina, adding specialists proved to be in the biggest hurry, compared to primary care physicians.
Ospina, who led the research team, sought to examine the flow of conversation between clinicians and patients and, more importantly, see how viable it was for the most important person in the room — the patient — to lead the discussion.
Her researchers secured videos of consultations that were filmed in clinics across the U.S. as training sessions for physicians between 2008 and 2015.
The team specifically analyzed the first few minutes of 112 consultations, looking to find out how frequently doctors let the patients dictate the conversation through inquiries such as "Tell me what brings you in today," or "What can I do for you today?"
If patients were given the opportunity to set the agenda, the researchers then timed the responses to see how long they could speak before the doctor interrupted them.
The results showed that just 36% of doctors ask questions that allowed patients to set the agenda, but two-thirds (67%) of those patients were interrupted after responding.
Researchers calculated the doctors cut patients off 11 seconds on average into a response.
"If done respectfully and with the patient's best interest in mind, interruptions to the patient's discourse may clarify or focus the conversation, and thus benefit patients," said Ospina. "Yet, it seems rather unlikely that an interruption, even to clarify or focus, could be beneficial at the early stage in the encounter."
The results also showed that only 20% of specialists give patients the opportunity to describe their issue at the onset of a consultation.
Conversely, half of primary care physicians reviewed in the study inquired about a patient's agenda off the bat.
Ospina notes the importance of physicians of allowing people to discuss their concerns right away.
"Even in a specialty visit concerning a specific matter, it is invaluable to understand why patients think they are at the appointment and what specific concerns they have related to the condition or its management," she said.
As for the reasons behind being in such a hurry, the authors suggest that "burnout" that many doctors experience could prevent them from adequately serving their patients needs. Other factors include time constraints or simply not receiving strong enough training on how to communicate properly with patients.
The original study was published earlier this month in the Journal of General Internal Medicine.
"The Life of Mary Baker Eddy" — Willa Cather
This biography was the first book written by the young Willa Cather, who would go on to become one of America's most distinguished writers.
Cather was the ghostwriter of most of the book, whose first edition showed Georgine Milmine to be the author.
In fact, Milmine was a freelance reporter who originally brought some of the book's material to McClure's magazine, where it was first published in 14 installments between January 1907 and June 1908.
The biography was published in 1909 when Cather was 36 and Eddy was 88, the highly critical account being the first major examination of Eddy's life and work.
Eddy's followers did all they could to suppress the book's publication and, according to Wikipedia, "Christian Scientists reacted strongly to it; there were reports of Scientists buying all available copies and stealing it from libraries. The Christian Science church purchased the manuscript, and soon the book was out out print."
It's now back in print and a copy is en route to me: can't wait to read it.
You can too: $5.49 and up on Amazon.
Iron Man Jet Suit
From the Evening Standard:
Selfridges is stocking an Iron Man jet suit for £340,000
The 3D-printed suit weighs 27kg (60 lbs.) and uses five kerosene-fueled micro gas turbines — two attached to each arm and one at the back — and is controlled by body movement.
A world first, it was created by former desk-bound City worker Richard Browning, a real-life British version of Marvel's Tony Stark.
He drew an on-the-spot $650,000 investment from Silicon Valley entrepreneurs who watched him take off last year.
In November he set a Guinness World Record flying at 32mph above a lake in Reading, but in theory the suit can go as fast as the human body can withstand, about 180 mph.
It uses four liters of fuel per minute.
Fan Tom Cruise will have training next month, said Mr. Browning, who is in talks with stunt coordinators for the James Bond film series and "Mission Impossible."
The inventor also says he has a "really exciting" collaboration with the military.
Now nine wealthy buyers can claim a custom-made version and full flight training from Selfridges.
A virtual reality version — using content captured on a real flight — is on offer for Londoners to test.
Bosse Myhr, menswear and technology director at the store, said: "The Jet Suit is the equivalent to the launch of the very first airplane. We are on the cusp of an era where aeronautical technology can finally be in the hands of the consumer and we are proud to be the first to offer this."
Mr. Browning, 39, worked for BP in Canary Wharf for 16 years.
When he began testing engines two years ago with help from a software engineer and volunteers, he initially saw the experiments — inspired by his engineer and inventor father — as a hobby.
Today he runs a multi-million-pound start-up, Gravity, from a former U.S. military site in Salisbury and is on a "mission to reimagine the future of manned flight."
He said: "It started out as an exploration alongside a day job. We realized we were headed in a direction that had already been thought about — the Iron Man character. Part of what people find fun is I'm not a formally trained engineer, but I've always loved taking things apart and creating things."
He said he had done a show in Spain where movie star Cruise was a guest. "He loved the horsepower and speed."
The suit is in the SmartTech concession in the Technology Hall in Selfridges.
£340,000 = $446,742.
[via my Crack®© Pittsburgh Correspondent]