Austin Lam is a medical student at the University of Toronto
We often hear and use the term “patient-centred care” without having a precise definition in mind. In order to elucidate the meaning of this term, it is important to analyze the concept lying at its centre: the patient. What does it mean to be a patient? What is the core, essential definition of patient?
Some have argued for patient to be replaced with a different term. As someone who has undergone surgeries myself, I have reflected on the meaning of this word and its associated implications. My hope is that this preliminary analysis can help provide directions for future questions, emphasizing an open exploration rather than closing off areas of discussion. ...continue reading →
Sarina Lalla is a medical student in the Class of 2020 at McMaster University
When McMaster medical students learn about medical conditions in a problem-based setting, we frequently use the mnemonic “DEEPICT” (Definition, Epidemiology, Etiology, Prognosis, Investigations, Clinical presentations, Treatment) to approach them. Medical schools focus on teaching students about these important aspects of diseases; with time and practice, this information can be retained and applied by students to make them better clinicians.
However, there is also value in understanding a disease through the eyes of patients. More specifically, it is critical to recognize how facing an illness and navigating the healthcare system impacts their lives. Patients are the experts on their own experiences, and the knowledge they can present in the form of stories can teach us a lot. While we learn how to interpret information in the form of bloodwork and imaging, patients present first and foremost with a story. ...continue reading →
I changed jobs this week. On Monday, my first day, when I should have been primarily concerned with learning the office microwave-cleaning rota and orienting myself to a new Xerox print centre, I was a little preoccupied. At 8 pm on Sunday, I found out that my father had fallen, broken his hip, undergone emergency surgery, and was in isolation in a hospital in southwestern Ontario. Details were fuzzy. Hospital staff would not share much with my aunt, my father’s sister. He had managed to call her on Sunday morning, 24 hours after his fall, once he had come round after anaesthesia. He needed her to go to his house to make sure my mom was okay. My mom wasn’t answering the phone.
Unanswered phone calls are not uncommon at my parents’ house. My father is quite hard of hearing, after spending 37 years as an infantry officer. My mother tends not to answer the phone because she is self-conscious. She has a severe cognitive disability ...continue reading →
Iris Gorfinkel is a General Practitioner and Founder & Principal Investigator of PrimeHealth Clinical Research in Toronto, Ontario
I’d been attending this particular patient’s medical needs as her GP for the past five years. Enid dressed impeccably, was a young 85 years of age and had the amenities that most elders dream about. She had her health, financial security, education and a strong intellect. What she was missing was companionship.
“If only I had someone to travel with,” she lamented.
Hardly 24 hours later, I was asked to see Fred who had been my patient for 7 years. He was a robust 87 year old, financially secure, well educated, and possessed a marvelous sense of humor. He had remained active despite having lost his partner to lung cancer the year before.
“I miss having someone when I travel,” he told me.
Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete. This is her last blog, a year on from her diagnosis of lung cancer.
My last CMAJ blog was written and posted in April, 2015, when I was anxiously waiting the results from a CT scan of my lungs, following surgical and oncology treatment for non-smokers’ lung cancer. I’m overjoyed and relieved to write that the CT scan shows that my lungs are clear, that there is no evidence of disease. Now, I am emotionally free to get on with my life, to try to overcome the residual side effects of chemotherapy, and to regain some of the strength and fitness that I have lost.
I wish it were just that easy! As happened thirty years ago, following treatment for breast cancer, I now find myself asking, “Why me?’ not the unanswerable Why Me? that one asks when first diagnosed, but the Why Me? that follows successful treatment ...continue reading →
At six months and counting, life has mostly returned to normal, although persistent heaviness in dependent parts still creates intermittent discomfort. A long bicycle ride with insufficient padding had me worrying about Fournier’s gangrene for days. Wearing old lycra with my new contours, I did a brutal number on one upper thigh and side of scrotum. ...continue reading →
Janet Whitehead works and lives in Vancouver, BC. She is the mother of 3 children and has a granddaughter.
Five years ago I was diagnosed with lung cancer. I had most of my left lung and lymph nodes removed in my first surgery and tumours removed from my right lung in a second surgery three months later. I’ve never smoked.
It was a huge shock. Like most people, I thought only people who smoked got lung cancer. But that’s not the case.
Through my husband’s work, I am aware of radon gas and the fact that it is a leading cause of lung cancer. We sent radon detectors to the two homes where we had lived in eastern Canada. One of the homes, located in the heart of Ottawa, tested a staggering 16 times above the Health Canada radon guideline ...continue reading →
Patricia Lightfoot is Associate Director, Online Physician Learning, at the new CMA subsidiary "8872147 Canada Inc."
I read Girl in the Dark a few months after escaping from a darkened room, where I had lain blind-folded and ear-plugged, the prisoner of an implacable captor, with whom no negotiation was possible. My time spent in darkness was the consequence of a concussion, sustained following a severe fall when cycling down a hill on my regular Saturday ride. A full recovery eluded me for months, in spite of my intense desire to be well and active. Once I had served my sentence ...continue reading →
Sudhir D'Souza is a semi-retired paediatrician practising in Ontario
“About 80 per cent of health data is captured in physicians’ offices. Electronic records connected to hospitals and provincial health databases will provide a comprehensive and secure picture of a patient’s health.”
Greg A. Reed, Former CEO of eHealth Ontario
What happens when you leave a clinic? Do you remain the ‘health information custodian’? Do the electronic charts move with the patients who follow you?
In January, I decided to leave a ‘turnkey’ clinic and start my own practice. To accommodate patients for whom location was paramount, I allowed my electronic practice records housed in a server located in my office to be amalgamated under an Application Service Provider (ASP) EMR – cloud based – with the rest of the physicians in the clinic space we had shared. ...continue reading →
Peggy Cumming, is a wife, mother, grandmother of 6, sister, niece, cousin and friend, as well as a teacher - retired after 34 years in the classroom - and an athlete. She is now post-surgery and post-chemotherapy.
The waiting room for my Thoracic Surgeon is much like any other. The unspoken, unwritten ‘Waiting Room Rules’ seem to apply: No Eye Contact, No Conversation, Appear Calm. With unfocused eyes, patients flip through outdated, uninteresting magazines, or scroll through previously read emails on smart phones. Outwardly, all is calm, quiet and relaxed. However, a rapidly pulsing crossed leg says otherwise....
In a few weeks, it will be my turn to deal with my stress in this waiting room. I will be trying to follow the rules, but the reality is that my anxiety levels will be off the chart. My appointment will be to receive feedback/results/information from my most recent CT scan. ...continue reading →