"Doctor and Patient, Now at Odds"--New York Times blog

Doctor and Patient, Now at Odds

By TARA PARKER-POPE
Published: July 29, 2008
New York Times Health blog: Well

Excerpt:
“By the time you’re done with your training, you feel, in many ways, that you are as far as you could possibly be from the very people you’ve set out to help,” said Dr. Pauline Chen, most recently a liver transplant surgeon at the University of California, Los Angeles, and the author of Final Exam: A Surgeon’s Reflections on Mortality (Knopf, 2007). “We don’t even talk the same language anymore.”

Continued: http://well.blogs.nytimes.com/2008/07/28/doctors-and-patients-a-rocky-relationship/

Caregiver Workshops--September & October

Time sensitive

Vancouver Coastal Health Caregiver Workshops

September Workshop:
Four-week educational workshop series for family caregivers running from Sept. 3 - Sept. 24, 2008

Learn strategies for coping, connect with other caregivers, and find out about valuable resources and information to assist in decision-making. Participants are strongly encouraged to attend all four workshops in the series.

Presenter/Facilitator: Sarah Galuska, MSW, RSW

Location: Evergreen Community Health Centre
3425 Crowley Drive, Vancouver, BC
Begins: September 3, 2008
Time: 6:30-8:30 pm
Registration deadline: September 2, 2008
Email: caregiversupport@vch.ca
Phone: Vancouver Coastal Health Central Intake Line--604-263-7377
Cost: Free - pre-registration is required


October-December Workshop
Six-week educational workshop series for family caregivers running from Oct. 21 - Dec. 2, 2008(no session Nov. 11th). Learn strategies for coping, connect with other caregivers, and find out about valuable resources and information to assist in decision-making. Participants are strongly encouraged to attend all six workshop sessions. Pre-resgistration is required, but late registration may be possible.

Location: Pacific Spirit Community Health Centre
2110 West 43rd Avenue, Vancouver, BC
Begins: October 21, 2008
Tim: 6:30-8:30 pm
Registration deadline: October 20, 2008
Email: caregiversupport@vch.ca
Phone: Vancouver Coastal Health Central Intake Line--604-263-7377
Cost: Free - pre-registration is required. Participants are strongly encouraged to attend all six workshop sessions.

Call for Articles: Breast Cancer & Women with Disabilities

The Canadian Breast Cancer Network is hoping to publish the Fall 2008 issue of our quarterly newsletter, Network News, on the topic of living with disabilities and breast cancer. We are looking for articles of up to 2,000 words plus a short bio of the author(s) (100 words or less) and hopefully a photo. Articles can be about research conducted on the issue, including barriers to diagnosis, treatment or supportive care.

We are also looking for articles by women living with breast cancer and a disability or disabilities. It may be that you were living with a disability before being diagnosed with breast cancer, whether a physical disability or mental illness. How did a breast cancer diagnosis affect your life? What challenges have you faced? Or perhaps your breast cancer treatments or surgeries left you with a disability. Consider sharing your experience and how you have learned, or are learning, how to adapt.

We are unable to pay contributors, but will send you as many copies of Network News as you like.

To check out a recent issue of Network News, go to http://cbcn.ca/en/?section=1&category=167&regionid=&page=9792

For information or to submit an article, contact:
Jackie Manthorne
Executive Director/Directrice générale
Canadian Breast Cancer Network
613-230-3044 ext. 222
1-800-685-8820
jmanthorne@cbcn.ca
www.cbcn.ca

Patient-physician Communication: Research

With their waiting rooms crowded and exam rooms full, many physicians say they are too busy to be good communicators. Those who study physician time-management think otherwise. Certain communication skills can foster efficiency and effectiveness during an office visit without sacrificing rapport with patients, according to researchers at the University of Washington (UW) and the University of Rochester.

Their guide to a smoother flow of communication between doctors and patients appears in the July 14, 2008 issue of the Archives of Internal Medicine. Their model is based on the authors' observation: "Effective communication in primary care must include skills that enhance the quality of care while helping patients and physicians use time wisely… Making the best use of available time is important for visits of any duration."

A few of the lessons the researchers presented in the resulting article, "Relationship, Communication, and Efficiency in the Medical Encounter: Creating a Clinical Model from a Literature Review" include:

• focus the purpose of the visit with the patient: Instead of addressing each issue as it surfaces, creating a list at the start enables the doctor to confirm which problem is most medically urgent or most important to the patient. This approach also reduces the "Oh, by the way" issues brought up at the end of the visit.
• understand the patient's perspective: Exploring the patient's viewpoint is useful for promoting self-management, suggesting healthy changes, assessing motivation, learning the patient's family and cultural beliefs, understanding the social and psychological problems that are diminishing the patient's ability to function, or getting to the root of medically unexplained symptoms.
• reach a mutual agreement on a plan: The physician and patient decide on approaches the patient is willing to follow to manage or prevent the health concerns explored during the visit.

Throughout the office visit, it's helpful for physicians to:

• establish rapport and maintain the relationship: Some ways doctors do this are by eye contact, recognizing others in the room, or a brief warm greeting, such as, "Nice to see you." On the other hand, too much small talk steals away time from considering the patient's problems.
• practice mindfully: This occurs when physicians pay close attention to their own beliefs and reduce distractions in order to observe their patients' response to what is being said and done, and adjust accordingly. For example, a doctor lecturing on excess weight might notice the patient withdrawing. The doctor stops and asks about the patient's views. A physician who doesn't continuously monitor the interaction or doesn't check in with the patient may cover areas of little interest to the patient, and miss significant issues.
• track topics: Sometimes an interview veers off course, particularly when there are multiple topics and no clear agenda. Unless the conversation is redirected, it's likely that no clear decisions will be made on some problems before the end of the visit. Sharing an impression of what has and hasn't been covered and realigning by agreeing on what to talk about next can keep the discussion organized.
• acknowledge cues: When a physician responds with empathy to a patient's cues, a patient may reveal beliefs and preferences that can shape a successful treatment plan. Also, once their concerns are taken into account, most patients don't keep restating them. This saves time.
  

Researcher Larry Mauksch said, "Visits with the doctor that contain these fundamental elements lead to greater patient satisfaction, better adherence to medical regimes, increased self-management, better health outcomes, lower costs, and fewer malpractice claims. These skills enable physicians to do it right the first time, so they don't have to do it over."

The researchers are Larry Mauksch, a UW behavioral scientist in family medicine who studies and teaches doctor/patient communications; David C. Dugdale, an internal medicine physician and director of the UW Hall Health Primary Care Center; Sherry Dodson, UW clinical medical librarian; and Ronald Epstein, professor of family medicine, psychiatry, and oncology at the University of Rochester School of Medicine and Dentistry and its Center to Improve Communication and Health Care.

To read more about the project: http://uwnews.org/article.asp?articleID=42811

Youth Violence Prevention Workshop: Fort St. John

Time sensitive

Free Youth Violence Prevention Toolkit Training Workshop
Fort St. John workshop on August 19-20, 2008

This 'train the trainer' workshop provides training on how to conduct a workshop from the Native Women's Association of Canada Toolkit. Participants will learn the best ways to engage with youth on five main topics:

1. Domestic/Relationship Violence
2. Date Violence
3. Sexual Assault
4. Emotional/Psychological Violence, and
5. Bullying

To see a copy of the Toolkit, visit www.nwac-hq.org and look under Youth Projects. Workshops cover ideas such safety tips, early warning signs and ways to deal with it in the community.

Registration form: www.nwac-hq.org
Tel: 613-722-3033 ext 247

Consumer Health Tip Sheets

The US Agency for Healthcare Research and Quality (AHRQ) offers many consumer health resources, including:

20 Tips to Help Prevent Medical Errors
Patient Fact Sheet
http://www.ahrq.gov/consumer/20tips.htm

20 Tips to Help Prevent Medical Errors in Children
Patient Fact Sheet
http://www.ahrq.gov/consumer/20tipkid.htm

Quick Tips—When Getting Medical Tests
http://www.ahrq.gov/consumer/quicktips/tiptests.htm

Quick Tips—When Talking with Your Doctor
http://www.ahrq.gov/consumer/quicktips/doctalk.htm

Accessible Recreation/Exercise Facilities for People with Disabilities

The Alberta Centre for Active Living's newsletter, WellSpring (June 2008) features an article about ensuring full participation of people with disabilities at community facilities. While aimed at recreational facilities, this article includes excellent tips for service providers of all types and for people with disabilities. Topics covered include:

• Barriers in the physical environment
• Barriers in the social environment
• Psychological barriers experienced by people with disabilities.

"Are We Ready? Full Participation of People with Disabilities at Community Facilities" by Karen Robinson, Program Director, The Steadward Centre for Personal & Physical Achievement.
WellSpring June 2008 Volume 19, Number 3
http://www.centre4activeliving.ca/publications/wellspring/2008/june.pdf

"Patient Power" radio and blog

"Patient Power" is a radio show featuring University of Washington Faculty of Medicine physicians.

Every Sunday morning, Andrew Schorr's independently produced Patient Power radio show connects listeners with leading medical experts who talk about topics of interest to patients.

To listen on your radio:
Sundays
8 a.m. to 9 a.m. PDT
570 AM KVI Seattle

To listen on your computer:
Webcast around the world: http://www.patientpower.info/
E-mail your questions: andrew@patientpower.info
Call in live at 206-421-5757 or 888-312-5757

Visit the website:
http://uwmedicine.washington.edu/Global/NewsAndEvents/Patient+Power.htm

Read Patient Power blog
http://www.patientpower.info/blog/default.asp

Bringing Companions to Medical Visits: US Study

According to a survey of 12,018 US Medicare beneficiaries 65 years or older, bringing a family member or friend to medical visits improves patient satisfaction with medical care. Researchers found that:

• 38.6 percent of participants reported regularly being accompanied to medical visits
• Companions included spouses (53.3 percent); adult children (31.9 percent); other relatives (6.8 percent); roommates, friends or neighbours (5.2 percent); non-relatives (2.8 percent); or nurses, nurse aides or legal or financial officers (less than 1 percent)
• 63.8 percent of companions helped with communication, including 44.1 percent who recorded physician comments and instructions, 41.5 percent who communicated information about the patient’s medical condition to the physician, 41 percent who asked questions, 29.7 percent who explained physician’s instructions and 3.3 percent who translated the English language
• 28.4 percent of companions were reported to be present for company and moral support, 52.3 percent to assist with transportation, 16.6 percent to help schedule appointments and 8.4 percent to provide physical assistance.

Beneficiaries with regular companions were more highly satisfied with their physician’s technical skills, information-giving and interpersonal skills. Those whose companions more actively helped with communication rated their physicians’ information-giving and interpersonal skills more favourably. This relationship was stronger among patients who reported themselves to be in worse health.

Article:
Jennifer L. Wolff; Debra L. Roter
Hidden in Plain Sight: Medical Visit Companions as a Resource for Vulnerable Older Adults
Arch Intern Med. 2008;168(13):1409-1415.

Online/telephone courses from PLAN

NEW!! Home is Where the Heart is - ONLINE COURSE
$60.00
Available online
Description
PLAN's new interactive and engaging online course explores the different home options available for your relative with a disability. Videos and stories showcase inspiring living situations, checklists and interactive forms help you think about everything you need to consider when thinking about creating a home for your relative with a disability. This course comes with a downloadable practical guide and lots of inspiring ideas to help you start dreaming.

PLEASE NOTE: This workshop takes approx. 3 - 5 hours to complete. You may work at your own pace throughout the month and the facilitator will be available during the entire month.

July 8 - July 31, 2008
Register online: http://www.gifttool.com/registrar/ShowEventDetails?ID=76&EID=2240
Register by phone: 604.439.9566
Register by email: inquiries@plan.ca


Registered Disability Savings Plan (RDSP)
FREE
Available anywhere by telephone
Description
In planning for the future, you need the most current and relevant information. The Disability Savings Plan will become available in 2008. It will provide another tool for you to plan with. Join us in this FREE telelearning seminar to learn about the details, its implementation and how it will work for your family.

Wed. July 23 - 12:00pm - 1:00pm (PST)
Register online: http://www.gifttool.com/registrar/ShowEventDetails?ID=76&EID=2936

Wed. August 13 - 12:00pm - 1:00pm (PST)
Register online: http://www.gifttool.com/registrar/ShowEventDetails?ID=76&EID=2942

Wed. August 27 - 4:00pm - 5:00pm (PST)
Register online: http://www.gifttool.com/registrar/ShowEventDetails?ID=76&EID=2943

or
Register by phone: 604.439.9566
Register by email: inquiries@plan.ca

2008 International Conference on Communication in Healthcare

Time sensitive

2008 International Conference on Communication in Healthcare
2-5 September 2008
Oslo, Norway
Earlybird rate available until July 18th

Program includes:

• Teaching communication skills
• Shared decision making
• Disclosure of medical errors to patients
• Analyzing clinical communication behaviour
• Emotion and nonverbal communication
• Communication in cancer care
• Communication in different clinical settings
• Family issues and communication with children
• Gender issues in communication
• Patient and provider perspectives
• Cultural perspectives
• Web-based interventions and information technology
• Patient education

Plus posters and exhibition area.


http://www.each-conference.com/

Dr. Enid Wolf-Schein: Structured Methods in Language Education workshop

Time sensitive

Enid Wolf-Schein, Ed.D., CCC-SLP; Adjunct Professor University of Alberta
SMILE: Structured Methods in Language Education
August 14 & 15, 2008, Vancouver

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Enid Wolf-Schein

What is SMILE? SMILE jump-starts literacy and encourages the development of functional language. A systematic, multisensory communication development program, SMILE engages children as they progress through basic attending, phonemic awareness and sound–letter knowledge to the use of language in a descriptive and conversational manner. SMILE is a method of teaching speech, reading and writing to children with severe language and communication delays. It begins with phonemes (the building blocks of speech) and progresses to the development of short stories. It also incorporates development of attention, specific and consistent teaching methodology, use of structure, routine and immediate reinforcement. Ongoing attention to generalization ensures that the pupil does not end up with a series of splinter skills that are not functional. SMILE is based on the Association Method, which uses a combination of visual, auditory, tactile and kinesthetic associations.

Who Should Attend this Workshop? ACT has brought Dr. Wolf-Schein back to BC because of the very positive response to her previous workshops. Teachers, SLPs, educational assistants and parents have reported that SMILE is an effective low-tech, multisensory methodology that can be individualized for students who are speaking or reading very little or not at all. It can be easily adapted for students who are using an ABA approach in their early intervention program. While it has been used extensively for pre-schoolers, it is also useful as an approach to teaching reading for students who need a more individualized approach.

For Which Students is this Method Appropriate? This method can be used successfully with any pupil who has a severe language-learning disability who is still struggling despite intensive efforts to encourage speech and language. Generally these children do not imitate easily or generalize readily. They often seem to have problems with auditory memory, and they may lack expressive speech in the presence or absence of language comprehension.

Children with an inability to express or to understand language symbols are a diverse group with respect to their disorder. They may be classified as aphasic, or have ASD, Down Syndrome, central auditory dysfunction, impaired hearing, or a mental handicap.

The Workshop The program is taught in five language modules. Module 1 begins with attention-getting exercises, goes on to the teaching of single sounds and letters, and then consonant–vowel combinations. As the program progresses, pupils develop increased phonemic awareness, sound–letter knowledge, auditory and visual discrimination, sound and letter sequencing skills, word recognition, picture–word association, short sentences, and finally, concept stories using speech, reading and writing. The workshop will cover the manuals and materials and include simulations. Extensive videos of students with both autism and other challenging conditions will be utilized.

The Presenter Enid Wolf-Schein, Ed.D., CCC-SLP, has her Doctorate in Special Education and is a certified Speech Language Pathologist. An ASHA Fellow, Dr. Wolf-Schein has published extensively in academic journals and provides training internationally. One of her current efforts is consulting to programs for special populations in Broward County, Florida, where she is in private practice.

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Full Registration Brochures: see www.actcommunity.net or see contact information below.
Online Registration: Go to www.actcommunity.net
Bursaries: If you are low income and / or traveling to attend a workshop, ACT has some bursary funds available. Please apply for a bursary before registering. See website for more information.
Support & Information: ACT’s team of Information Officers can provide support and information on a wide range of autism-related topics and can advise on whether a workshop is appropriate for your needs. Contact ACT by email at info@actcommunity.net, or by phone at 604-205-5467 or 866-939-5188.

Survey: Complementary/Alternative Medicines for Menopause Symptoms

Time sensitive

My name is Carole Lunny and I am now conducting a study, Use of Complementary and Alternative Medicines for Menopause Symptoms in Women With or Without HIV, that looks at how women use complementary and alternative medicine for menopause symptoms.

The study is located online and only takes ten minutes to complete. The study can be accessed by copying and pasting this link: http://www.surveymonkey.com/s..aspx?sm=1LMRRo6siAL_2bWhvc108oAQ_3d_3d

This study has been approved by the Athabasca University Ethics Board. I am looking for women between the ages of 40 to 60 to participate.

If you know of any women HIV-positive or HIV-negative who might qualify please forward this email to them. I would like to disseminate this study as widely as possible since there has been very little research conducted to date on this topic.

Please contact me at carolelunny@gmail.com with any comments or questions.

Thanks very much,

Carole Lunny