Posts Tagged ‘medical education’

Patients Who Have “Nothing the Matter with Them”

Tuesday, June 9th, 2015

Among physicians with a humanistic soul, perhaps no quotation is more fondly remembered than one from Dr Francis Peabody.  He was born in 1881 to a prominent New England family, trained at Harvard and Massachusetts General Hospital and was the first director of the Thorndike Laboratory at Boston City Hospital.  Tragically, he died of sarcoma at age 46.

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Stress, Illness and Challenges

Thursday, December 11th, 2014
The medical profession has been aware that psychosocial issues can lead to physical symptoms at least since the days of Hippocrates about 2500 years ago.  Yet diagnosis and treatment for the pain and other symptoms lag far behind nearly every other form of illness.  In thinking about this I began to recognize several challenges to improving the quality of care for this condition.

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The Medical Blind Spot Continues

Monday, December 12th, 2011

The latest evidence of the woeful state of care for Psychophysiologic Disorders (Stress Illness) comes from my local newspaper.  In a Health column, we find the following question from a reader:

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How Physicians View Stress Illness (3)

Friday, April 29th, 2011

In the last two posts, we reviewed a quotation from Dr Jerome Groopman that highlighted two common physician errors, the first being to lump together all patients with medically unexplained symptoms and label them hypochondriacs.

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How Physicians View Stress Illness (2)

Wednesday, April 27th, 2011

In the last post, a quotation from Dr Jerome Groopman highlighted two common physician errors, the first being to lump together all patients with medically unexplained symptoms and label them hypochondriacs.

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How Physicians View Stress Illness (1)

Monday, April 25th, 2011

Jerome Groopman, MD is the Chair of the Department of Medicine at Harvard Medical School and an author of numerous scientific journal articles on AIDS and cancer.  His recent book, How Doctors Think, has been a best seller.

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Stress Illness and Shared Responsibility (2)

Tuesday, March 29th, 2011

As described in the last post, in the future we can teach physicians who practice diagnostic medicine to be aware of Stress Illness and to ask a few key questions.  (See the screening questionnaire on the Overview page of this site for examples).  When they uncover significant stress, they can offer the patient referral for a Stress Check-Up, where a more detailed evaluation for stress is done by a mental health professional.

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Stress Illness and Shared Responsibility (1)

Sunday, March 27th, 2011

Before I retired from practice in 2009, I developed an excellent working relationship with a Gynecologist whom I never met or spoke with.  Though we exchanged a few emails, our principal form of communication was through reading assessments of patients he referred to me.  These were usually younger women who had suffered pain in the pelvic area for months or years.  Pelvic exams, ultrasounds, CT scans and blood tests showed nothing.

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Stress Illness in Richland, Washington

Friday, March 11th, 2011

After my lecture on stress illness yesterday at the beautiful and innovative Kadlec Hospital in Richland, Washington, USA, a young specialist physician came to me with a question.  (I will change a few details to preserve confidentiality).  She described a patient with pain in his back, chest and the left lower corner of the abdomen but no abnormalities on diagnostic tests.  She went on to explain several diagnoses she considered but acknowledged that none of them were a good fit for all the features of her patient’s condition.  Her initial treatment suggestions had not been helpful and she felt the patient was about to conclude that “I’m just as bad as his other two doctors.”

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Stress, Illness, Social Change and the PPDA (2)

Tuesday, November 16th, 2010

What might the PsychoPhysiologic Disorders Association (PPDA) look like in the future?  There are so many dimensions it  is difficult to know where to begin.

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