Annals of family medicine
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Annals of family medicine · Nov 2020
Effective Hearing Loss Screening in Primary Care: The Early Auditory Referral-Primary Care Study.
Hearing loss, the second most common disability in the United States, is under-diagnosed and under-treated. Identifying it in early stages could prevent its known substantial adverse outcomes. ⋯ An electronic alert used to remind clinicians to ask patients aged ≥55 years about hearing loss significantly increased audiology referrals for at-risk patients. Audiologic and audiogram data support the effectiveness of the prompt. Clinicians should consider adopting this method to identify patients with hearing loss to reduce its known and adverse sequelae.
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A weekly habit of viewing my performance data led me to question the value of my doctoring. I tried to answer this quandary in my head for months, but it was a patient encounter that revealed what I had been searching for. As a doctor I am bound to the care of another, especially when disease, disability, or injury create any space between a patient and their personhood. ⋯ To offset my data habit, I have adopted a practice that reviews my patient care and interior movements at the end of the day. The daily exercise has uncovered a pattern in which my anger, despair, or isolation are invariably are tied to those times when I have failed to stand in the breach with a patient. More importantly, the practice illuminates my finest hours, when I have entered into that chasm with an unstated and binding promise to my patient that they will not be abandoned.
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I delayed my neurology rotation in medical school because I was trying to ignore the symptoms of dementia developing in my mother. They became painfully apparent when I saw my parents less frequently after I moved away for residency, and finally had to be addressed when I had a child of my own and felt unsafe having her care for him. Through my experiences with her and in my training in palliative care and oncology, I have learned that tools like the Mini Mental State Examination (MMSE) and Functional Assessment Staging Test (FAST) can only tell us so much; the true measure of a patient's decline can be found in the patient's and family's own story.
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Annals of family medicine · Nov 2020
The "Foresty Way": My Mother's Brave Choice of Medical Aid in Dying.
I miss my mom, who died last year, and I want to tell the happy story of her death, or perhaps the story of her happy death through her choosing and accomplishing medical aid in dying. My mom was 85 when she died, had atypical presentation of lymphoma which took time to diagnose, and went through 3 painful months of surgery, radiation, and a single horrific round of chemotherapy. ⋯ When she was in the hospital recovering from chemo, I witnessed 3 amazing doctors being true to core values of their profession. But the most profound aspect and gift of the events surrounding her death was the way in which making an informed choice gave my mom back her presence-allowing her both peace and power in the end of her life.