Rolling Stone's Mac McClelland tells the story of the physicians bravely breaking the law by treating patients with MDMA, ayahuasca, DMT, LSD, and other hallucinogens. From RS:
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As an internal-medicine specialist, Dr. X doesn't have any patients who come to him seeking psychotherapy. But the longer he does the work, the more "I'm seeing that consciousness correlates to disease," he says. "Every disease." Narcolepsy. Cataplexy. Crohn's. Diabetes – one patient's psychedelic therapy preceded a 30 percent reduction in fasting blood-sugar levels. Sufferers of food allergies discover in their journeys that they've been internally attacking themselves. "Consciousness is so vastly undervalued," Dr. X says. "We use it in every other facet in our life and esteem the intellectual part of it, but deny the emotional or intuitive part of it." Psychedelic therapy "reinvigorated my passion and belief in healing. I think it's the best tool to achieving well-being, so I feel morally and ethically compelled to open up that space."...
"If we didn't have some idea about the potential importance of these medicines, we wouldn't be researching them," says Dr. Jeffrey Guss, psychiatry professor at NYU Medical Center and co-investigator of the NYU Psilocybin Cancer Project. "Their value has been written about and is well known from thousands of years of recorded history, from their being used in religious and healing settings. Their potential and their being worthy of exploration and study speaks for itself."
Optimistic insiders think that if all continues to go well, within 10 to 15 years some psychedelics could be legally administrable to the public, not just for specific conditions but even for personal growth.
Mine hasn't. At least, he hasn't taken money from any of the 15 companies that have been forced to disclose information about gifts and cash they give to doctors. Pro Publica has put that information into an easily searchable database
. It's not total transparency — the drug companies whose payouts are included here only represent 47% of the total market — but it's a good place to start if you want to know whether your doctor has any conflicts of interest that could affect your health. Read the rest
I've got a good doctor, and one of the reasons I like him as much as I do is his "bedside manner"—the shorthand we all use for describing whether or not medical professionals are able to connect with their patients emotionally. But pulling off a good bedside manner isn't just about being kind and empathetic, it's also about time. Part of why I think he had good bedside manner is that he spends time talking to me when I go in for an appointment. He answers questions. He asks about my life. He takes the time to empathize, even if, sometimes, that means that a problem that could have been dealt with in 5 minutes became a 20 minute appointment.
It's hard to make people feel valued and cared about if you've only got a couple of minutes to see them before you have to move on to the next person. Unfortunately, packing as many patients into a day as possible is more efficient in a business sense. A 2005 study of 11 doctors found that they spent an average of 13.3 minutes on each patient—if you combined both face-to-face time and time spent working directly on the patient's case outside the exam room. The next year, anesthesiologist Peter Salgo wrote an op-ed in the New York Times about the pressure put on doctors by hospital administration to see as many patients as possible and move them on through with conveyer-like efficiency.
Now there's a new study that suggests the pressure to behave in a business-friendly way makes doctors more likely to have a brusque bedside manner. Read the rest
A key component of antibiotic resistance is the over-use of antibiotics. We talk about this a lot in the context of over-the-counter antibacterial cleansers, but there's a doctor's office side to this story, as well.
When sick people come into a doctor's office, part of what they are looking for is psychological wellness. They want to feel like somebody has listened to them and is doing something to treat their illness. Sometimes, that means they ask their doctor for antibiotics, even if antibiotics aren't the right thing to treat what they have.
In the past, and sometimes still today, doctors go ahead and prescribe antibiotics almost like a placebo. It's hard to say no to something a patient really wants, especially when it's likely to make them feel better—just because taking anything, and treating the problem, will make them feel better. But that is definitely not a good thing in the long term.
At KevinMD, family physician Dike Drummond offers some really nice advice for doctors who are struggling with how to make a patient feel better, but also want to avoid contributing to the growing antibiotic resistance problem. What I like best about Drummond's advice: It starts with empathy.
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If you have a major challenge working up some empathy one of two things is happening.
You are experiencing some level of burnout. Empathy is the first thing to go when You are not getting Your needs met. This is a whole different topic and “compassion fatigue” is a well known early sign of significant burnout.