Advertisement
Is There A Mental Healthcare Crisis In The U.S.?

Is There A Mental Healthcare Crisis In The U.S.?

We are all shocked when we see news stories of multiple people being killed by someone who seems to have gone off the deep end. While these events are extremely rare, it is a true tragedy to have them happen at all. It is often found that the guilty parties were suffering from some mental illness. These are the extremes of mental illness. However, milder forms of mental illness, such as anxiety and depression are very prevalent in the U.S. The unfortunate reality is that for many of these patients, they just cannot get mental healthcare even if they want access to it. How big is the problem? According to a survey of physicians on Sermo, the number one social network exclusively for physicians, approximately 84% of the doctors polled believe there is a mental healthcare crisis in this country. Often times, the primary care physician is left to care for these patients whom they may not feel comfortable taking care of, just because they cannot get an appointment for the patient with a psychiatrist. I often times have a patient who I believe needs to see a psychiatrist but is unable to get an appointment for up to 6 months. If a patient is having a mental healthcare urgency, they usually end up in the ER for lack of access to outpatient healthcare. But, psychiatrists are not to blame. This is rather due to a broken system that is in need of major reforms. Why is there a mental healthcare access crisis in the U.S.? 1. In the 1960’s, psychiatric hospitals closed their doors, making inpatient services very...
COPD & Cognitive Issues

COPD & Cognitive Issues

As the third leading cause of death in the United States, COPD affects about 13.7 million patients. Recent research has suggested that as many as 77% of patients with COPD and hypoxemia have some form of cognitive impairment. Despite this association, the link between COPD and mild cognitive impairment (MCI) has not been established in well-designed, population-based studies. Investigating the Link In a study published in Mayo Clinic Proceedings, Balwinder Singh, MD, MS, and colleagues analyzed data from 1,927 individuals aged 70 to 89 who participated in the Mayo Clinic Study of Aging to see if there was an association between COPD and MCI. Patients underwent a nurse assessment, neurological evaluation, and neuropsychological testing when they entered the study. A panel diagnosed MCI using standardized criteria and then reviewed medical records to identify people with COPD who developed MCI. According to the analysis, patients with COPD had a higher prevalence of MCI than those without COPD (27% vs 15%). Findings were similar for both men and women involved in the study. “In addition, COPD was associated with almost two-fold higher odds of MCI,” says Dr. Singh. The associations of COPD with overall MCI and amnestic MCI were independent of age, sex, education, apolipoprotein E genotype, BMI, depression, and a history of coronary artery disease, diabetes, hypertension, and stroke. The investigation also revealed that there appears to be a dose-response effect for COPD duration. “We observed a 1.60 odds ratio for MCI in patients who had COPD for 5 years or less, but this ratio jumped to 2.10 in patients who had a COPD duration that exceeded 5 years,” Dr....
Communication Etiquette in Medical Training

Communication Etiquette in Medical Training

Patient-centered communication can impact several aspects of the patient-doctor relationship, including disclosure of illness-related information and compliance with medical recommendations. Etiquette-based medicine involves simple patient-centered communication strategies that convey professionalism and respect to patients. “Research has shown that patients prefer physicians who practice etiquette-based medicine behaviors, most notably those who sit down and introduce themselves,” says Leonard S. Feldman, MD. Little is known, however, about  whether physicians in training are actually performing these easy-to-practice behaviors. An In-Depth Look In a study published in the Journal of Hospital Medicine, Dr. Feldman and colleagues sought to understand whether etiquette-based communication behaviors were practiced by trainees on inpatient medicine rotations. Trained observers followed 29 internal medicine interns in their first year out of medical school at Johns Hopkins Hospital and the University of Maryland Medical Center for 3 weeks. They witnessed 732 inpatient encounters and used an iPod Touch application to record whether the interns employed five key strategies in etiquette-based communication: 1) introducing oneself, 2) explaining one’s role in the patient’s care, 3) touching the patient, 4) asking open-ended questions, and 5) sitting down with the patient.   According to the findings, interns touched their patients—defined as either a physical exam or simply a handshake or a gentle, caring touch—during 65% of visits and asked open-ended questions 75% of the time. However, they introduced themselves only 40% of the time, explained their role in just 37% of cases, and sat down during only 9% of visits (Table). The study subjects performed all five of the recom-mended etiquette-based communication behaviors during just 4% of all patient encounters. Interns were only slightly more...
Get Connected

Get Connected

Get the edge on your colleagues by receiving updates directly from the Physician’s Weekly editors in multiple ways. Sign up for our weekly e-newsletter Subscribe to our RSS Feed Like us on Facebook Check us out on Google+ Follow us on Twitter Join the conversation on...
[ HIDE/SHOW ]