Hello and welcome to my Nuzzel newsletter!
(Medical Director of Common Practice, doc, life-long learner, passionate re:enabling conversations that help us live well, speaker, loves family, music, Philly)
Happy Sunday from the NJ shore. Some good info about what Medicare Advantage programs will be able to offer this fall; a great perspective about sexism in academic medicine; 2 articles about culture; and 2 articles about end of life planning
What are the rules we expect the body to follow? When my wife, Cathreen, had our second child, on Thanksgiving Day 2016, we expected her body to return to its pre-pregnant state. For nearly the entire nine months, Cathreen had horrible morning…
Jeff CohnAny thoughts about achieving 'cultural competence' should disappear upon reading this. Accept that this is not realistic, ask lots of questions, strive for 'cultural humility'
The New York Times
– Jul 20, 3:00 AM
In the gym at Paul Junior High School in Washington, D.C., in the spring of 1968, not that long before the assassination of the Rev. Dr. Martin Luther King Jr., I asked a buddy whether he was interested in a certain girl. He told me that he was not…
Jeff CohnAnd cultural humility pertains even (especially?) to cultures that you think you know well...
Jeff CohnThis is about variability in end of life care across the US. Bottom line- most of the variability driven by physician attitude and availability (or lack thereof) of resources, rather than patient choice
The New York Times
– Jul 20, 10:21 AM
Did you fall in the bathroom and fracture your hip? Medicare, if you have it, will pay thousands of dollars for surgery to repair the injury and thousands more for your resulting hospital stay and rehab in a nursing home. But Medicare wouldn't have…
Jeff CohnAn excellent summary by Paula Span- lots of social services may now be included in Medicare Advantage programs, but not in all programs and not for all subscribers, necessarily
– May 14, 2013, 9:14 PM
When I worked in hospice palliative care, I remember being gobsmacked one day while reading in a medical journal about Dr. Harvey Chochinov 's research on Dignity Therapy out of the Manitoba Palliative Care Research Unit. (1) His studies determined…
Jeff CohnAsking about what's important to the person (patient), and what we should know about them that's not included in the medical history (like values, hobbies, etc.) is associated with better outcomes from the person's perspective
Q How can I convince my aging parents to get their end-of-life affairs in order? A Asking an aging loved one to face the reality of end-of-life care typically elicits two polar opposite reactions: understanding and acceptance or avoidance and, at…
Jeff CohnEven more important than documenting end-of-life choices in an advance directive is having conversations and planning together, especially as conditions change/worsen
One fine spring day a few years ago, I had a thought — one I probably should have had much earlier, one that would return to me over and over, usually when I was trying to fall asleep: Everything is not going to be okay. For…
Jeff CohnThis is much more practical than the preceding article. Playing the Common Practice game Hello with parents (even just a few questions) can be an excellent way to get the conversation started and learn stuff about each other comfortably
Among the toxic effects of workplace sexism, certain topics receive a lot of press: unequal pay, sexual harassment, inadequate maternity leave, a shortage of women in leadership roles. Less discussed is the psychological impact of such…
Jeff CohnThis should get you mad- and hopefully make you do something about it if you're in a position to do so
By LAURAN NEERGAARD and EMILY SWANSON
WASHINGTON (AP) — Would you want to know if you harbor a gene linked to Alzheimer's or another incurable disease? A new poll finds most Americans would. Some 17 percent of Americans already have undergone at least one kind of DNA test, and…
Jeff CohnThis is about risks, not destiny (at least most of the time). I can see how having this info could be somewhat empowering- I think you'd want to be partnering with a good healthcare team that could provide some guidance along the way
The Washington Post
– Jul 20, 2:32 PM
A day after the NFL and the NFL Players Association announced an agreement that put the league's new national anthem policy at least temporarily on hold, people on both sides expressed hope Friday that they will be able to reach a mutually…
Jeff CohnSaid the head of the players union, 'We need to sit down and talk. Probably that's what we should have done in the first place.' Ya think?????